HSV-2 IgG test results and possibility of being infected with HSV-2

[Renee1010]

Dear Ms. Terri Warren,
You have accomplished a lot of researches/studies/publications regarding Sexually Transmitted Diseases,  especially in the areas of Herpes Simplex, HSV-1 and HSV -2. So impressive! If you don't mind, I would like to seek some professional insights from you.

A. Here are inconsistent Herpes test results:

Sept 2012: HSV-2 ABS Igg EIA - result 0.19
Oct 2012: HSV-2 Type Specific Igg - result <0.2
Jan 2013: HSV-2 Igg Herpeselect AB - result 0.72

Questions:
1. Can a patient's HSV-2 test results be drastically inconsistent within 3 months as showing above, assuming the patient was not exposed to HSV-2 virus and/or infected by HSV-2 at all?
2. If yes, what is the percentage of the patients' test results are drastically inconsistent as showing above?

B. Possibility of being infected with HSV-2

If a HSV-2 negative person lives with a HSV-2 positive person for 22 months, and they have unprotected sex 2-3 times a week every week, what's the possibility for the HSV-2 negative person to be infected with HSV-2? Assuming the HSV-2 positive person was infected and outbreaked with HSV-2 at the very beginning of their relationship, and has had outbreaks once every month or every other month.

C. Impact of anti-viral medicine on HSV-2 positive person's blood test results:

Can a HSV-2 positive person take anti-viral medicine to the point his/her HSV-2 blood tests show negative results as above in Point A? Assuming tests are type specific, Herpeselect etc, as those tests in Point A.

Thank you in advance,

[Terri Warren, RN, Adult Nurse Practitioner]

The 4% means that if there were 100 women with HSV 2 having sex with 100 men who didn't, twice a week for a year, 4 men would become infected with HSV 2.

I still don't get point A.  You will have to be clearer.

Terri

[Renee1010]

Dear Terri, thank you so much for your prompt reply!  Your comments are very helpful!

Can you explain what the 4% rate means?  Does it mean that in one year, if they have unprotected sex for 100 times, during 4 times out of the 100 times, the woman is contagious, thus can infect the man 100% for sure during that 4 times?  

Also, can you look at point A again?  Not sure if the clarifications I made yesterday are enough.  

Thanks so much Terri!  Your expert comments are incredibly valuable!

[Terri Warren, RN, Adult Nurse Practitioner]

the way you have framed these questions is confusing to me.  It might have been easier just to state what the situation is, but I'll try.  
If an HSV 2 positive woman is having sex with and HSV 2 negative man, she is not taking antiviral therapy, there are no condoms used, and the man knows about the herpes (key point), the transmission rate is about 4% per year.  More than two intercourses per week, slightly more risk.  

Seroconversion means a blood test that goes from negative to positive and indicates new infection.  

If a person with new infection takes antiviral therapy right away, it can postpone antibody development for a while - we've seen 9 months so far as the longest.  Don't know beyond that.

A few people are infected and don't test positive by traditional of even western blot testing, yes.  Not many

Terri

[Renee1010]

Dear Terri (sorry spelling your name wrong earlier), to further clarify my questions:

In point B: Assuming the HSV-2 positive woman has genital HSV-2, and assuming their unprotected sex involves genital intercourse each time they had sex.

Thank you in advance Terri!

[Renee1010]

Dear Terry, thank you for your responses.  To clarify my questions:

In point A: Assuming the person doesn't have HSV-2, and he is not having sex with anyone who is HSV-2 positive.  What would be answers to the two questions?  

You mentioned HSV-2 blood test numeric values may vary.  What's the numerical difference you see for negative situations like in point A?  

In point B: Assuming the HSV-2 negative person is a man, and the HSV-2 positive person is a woman.  The HSV-2 positive woman has never been on antiviral therapy, and they never use condoms or any other protections while having sex.

In point C: Thanks for the answers! More questions:
1. What does seroreversion mean exactly in HSV-2 infection?  What percentage of patients experience seroreversion?
2. If a person has new HSV-2 infection and takes antiviral right away and continues taking antiviral for the rest of his life, is it possible that his antibody never develops?  
3. If a person has antibodies in his body for years, is it possible that the available HSV-2 blood tests (Herpeslect, WB, etc.) never detects his HSV-2 antibodies?

[Terri Warren, RN, Adult Nurse Practitioner]

Questions:
1. Can a patient's HSV-2 test results be drastically inconsistent within 3 months as showing above, assuming the patient was not exposed to HSV-2 virus and/or infected by HSV-2 at all?

While it is normal for the numeric values to vary (and they almost always do), yours is a high negative.  If you are repeatedly having sex with someone who is HSV 2 positive, you may be in the process of seroconverting, going from a negative status to a positive one.  This would mean that you might be recently infected.  Am I reading your description of your situation correctly?  
2. If yes, what is the percentage of the patients' test results are drastically inconsistent as showing above?


B. Possibility of being infected with HSV-2

If a HSV-2 negative person lives with a HSV-2 positive person for 22 months, and they have unprotected sex 2-3 times a week every week, what's the possibility for the HSV-2 negative person to be infected with HSV-2? Assuming the HSV-2 positive person was infected and outbreaked with HSV-2 at the very beginning of their relationship, and has had outbreaks once every month or every other month.

I don't know the sex of the people involved.  I also don't know if the person who has HSV 2 is on daily antiviral therapy or if condoms are used.  Can't' tell you without that info.

C. Impact of anti-viral medicine on HSV-2 positive person's blood test results:

Can a HSV-2 positive person take anti-viral medicine to the point his/her HSV-2 blood tests show negative results as above in Point A? Assuming tests are type specific, Herpeselect etc, as those tests in Point A.

This is called seroreversion and can happen without taking medicine.  However, it is truly uncommon to go from being positive to being negative.  If a person has new infection and takes antiviral therapy, they can delay the time to when their antibody test is positive.

Terri