STDs Expert Forum
test results
About This Forum:

The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

Font Size:
A
A
A
Background:
Blank
Blank
Blank
This expert forum is not accepting new questions. Please post your question in one of our medical support communities.
Blank Blank

test results

I am 60 years, and last week had a comprehensive STD panel of tests. All tests were negative except for HSV1 5.0 ;and HSV2 5.0.  I am divorced and  I never had a HSV 1 or HSV 2 test in the past, but had other tests in the past that were negative for the other STD's, so I remain free of other STDs and  remain in overall good health.
I have had "fever sores" since childhood from a very young age, over the past 50+ years, maybe once a year or more when younger with colds, intestinal upset and flu.  I rarely get them now as an adult maybe once every 24 months and if I do it is short lived, and sometimes from severe sun exposure.  They disappear quickly.
Question 1:Since I tested positive for HSV1, is this to be expected (and maybe "normal" )since I have had blisters my entire life and my body has been fighting this forever and thus anitbodies are present in my blood, so this positive blood test result is to be expected. ? Once you have antibodies you always have antibodies ?  
Question 2.  Since I tested positive for HSV2, and antibodies are present in my blood, is it possible that my exposure to HSV2 also occurred way in the past  as a young man?   I do not presently have any symptoms with my genitals and don't recall any in the last 25+ years.  Is it possible that I was exposed to HSV2 a long time ago, and it will always show up in my blood test ?
When I was married, my wife never had any herpes symptoms. .
After my divorce 15 years ago,  none of my partners had any signs of herpes and none have complained of any problems.  But I had a number of partners post divorce.  If I am not with a long term partner for many years, when I do have sex I almost always use a condom.
I am hoping you can shed some light on the possibility that the HSV 1 & 2  have been in my body most of my life and possibly "dormant", however since I have the antibodies it will show up in current blood work. Thanks for your help and feedback.



239123_tn?1267651214
Welcome to the forum.  Thanks for your question.

Your situation is not unusual.  You are infected with both HSV-1 and HSV-2.  Your HSV-1 infection almost certainly is oral; most are, and your history of cold sores is consistent with an oral herpes infection.  Your HSV-2 infection is almost certainly genital.  Infection is rare at anatomic sites other than the genitals or anal area.

The presence of antibody does not just indicate "exposure"; it denotes infection.  It says nothing about how long either your HSV-2 or HSV-2 infection has been present.  However, it's a good bet your HSV-2 infection was indeed acquired many years ago, as you suggest.  The positive tests also do not say very much about activity of your herpes infections.  That your wife of many years remained free of symptoms, that several later sexual partners did not develop symptomatic herpes, and that you have not had noticeable genital area outbreaks all suggest your genital HSV-2 is quite inactive and has been for many years.  But there are no guarantees:  most infected people have periods of asymptomatic viral shedding -- i.e. periods when the virus is transmissible -- and you could infect your next sex partner.  To your specific questions:

1) Yes -- given your history of oral herpes (cold sores) your positive HSV-1 result was to be expected.  Antibodies (and actual infection) persist for life.

2) Yes, your infection likely was acquired many years ago.  See the discussion above.  You should be alert to recurrent genital herpes symptoms that you didn't previously notice.  Research shows that around 60% of people in your situation -- no symptoms but positive HSV-2 blood test -- come to recognize recurrent herpes outbreaks.  However, that resarch mostly involved people much younger than you (most in their 20s-30s); at your age, I suspect you'll not notice anything.  Still, you should be alert to minor sores, irritation, etc -- and if anything shows up, get examined promptly (within 2-3 days) for professional examination and perhaps testing of a lesion for the virus.

If you have a current more or less regular partner, I would recommend that she (or he, if you have sex with men) be tested for HSV-1 and 2; and you should divulge your test result.  If that person is negative for HSV-2, you can then consider precautions to prevent transmission (condoms, anti-herpes therapy).

This is a very complex topic, and most likely you'll have many more questions.  A couple of excellent resources on genital herpes are the American Sexual Health Association (www.ashasexualhealth.org) (disclosure:  I'm on ASHA's Board of Directors); and the Westover Heights Clinic of Portland, OR (www.westoverheights.com).  The WHC owner/director, Terri Warren, is the moderator of MedHelp's herpes expert forum -- still another excellent resource.

Best wishes--  HHH, MD
3 Comments
Blank
Avatar_m_tn
In you answer, next to last paragraph you state " consider precautions to prevent transmission (condoms, anti-herpes therapy).  I just want to confirm that by anti-herpes therapy you mean taking a medication prescribed by a doctor ?  This would be pills not topical crème correct ?
Also would I need to take medication every day or only if symptoms were detected ?
thanks for your help.
Blank
239123_tn?1267651214
There are no topical agents that would have any benefit.  The most common regimen to suppress HSV2 is valacyclovir, 500 mg once daily by mouth.  So it's easy to take and side effects are rare.  Alternatively, individual outbreaks can be treated to speed healing, but since you're not having known outbreaks there is no point; and that treatment would not protect partners.

I'm not sure you need suppressive treatment.  You could speak with your partner about it.  As discussed above, it seems likely you are shedding virus infrequently, and your partner might be willing to take whatever small risk there is of transmission.

I would recommend you discuss the situation with your personal physician; or if s/he is not especially familiar with herpes, ask for referral to someone who is.  Then follow the advice you get.
Blank
Continue discussion Blank
MedHelp Health Answers
Blank
Weight Tracker
Weight Tracker
Start Tracking Now
RSS Expert Activity
469720_tn?1388149949
Blank
Abdominal Aortic Aneurysm-treatable... Blank
Oct 04 by Lee Kirksey, MDBlank
242532_tn?1269553979
Blank
The 3 Essentials to Ending Emotiona...
Sep 18 by Roger Gould, M.D.Blank
242532_tn?1269553979
Blank
Control Emotional Eating with this ...
Sep 04 by Roger Gould, M.D.Blank