HSV-2 Low Positive From Oral Sex

[perkingstart]

I’ve never had intercourse with anyone (anal or vaginal). I have however had 2 encounters where oral sex was involved (Male-to-Male) with no protection/condom. I had no active sores nor did I notice sores on them at the time. I haven’t talked to the first person but the second one said he hasn’t had an HSV test down before but he has never had sores on the penis or anywhere else aside from the mouth as a kid. I never had any symptoms on the following days (except the one I mention down below). Aside from these encounters, I haven’t had any sexual interaction with anyone.

1st Encounter: 12/2019
2nd Encounter: 9/2020

I went to my GP for the annual checkup and he asked me if I wanted an STD exam, I said sure (I had never had one done before).

To my surprise, HSV-1 and HSV-2 came back positive. I never knew I had HSV-1 but knowing this I remembered having cold sores as a kid quite often so guess that’s been there for a while. The HSV-2 was a surprise though

Results-Quest
10/04/2020 – With GP
HSV-1: 32.00 H
HSV-2: 1.64 H

10/17/2020 – Quest
HSV-2: 1.79 – Inhibition Test: Positive

Labcorp
02/7/2021
HSV-1: 29.50 H
HSV-2: 1.59 H – Supplemental Test: Positive

I did develop balanitis (no sores of any kind anywhere) about 1.5 months after the last encounter. I still have it in fact (it’s been permanent for the last 4 months), just on the head of the penis. No symptoms though. No itchiness, no pain, nothing. It’s just red. Could this be a symptom of HSV-2?

I know both supplemental test positives don’t look good, but since the index value never went up even after 6 months from last exposure and in fact went down a little on the last exam, I wonder if this could be a false positive.

I will get the Western Blot from you, I’m just waiting a little longer since this year and the previous were a little rough financially.

What are the odds of this being a false positive?

Is it common to get HSV-2 from oral sex?

[auntiejessi]

This has to be a false positive. Getting hsv2 from oral sex is so unlikely that I can't imagine it happening.

First, oral hsv2 is very rare. It does happen, but when it does, it rarely recurs (meaning the people who have it don't usually get outbreaks) and it rarely sheds. This means they don't transmit it.

Given that it's so rare, recurrences are rare, shedding is rare and transmission is rare, I can't imagine the odds that the 2 men you've had oral encounters with would have oral hsv2 and transmit it to you. You might as well buy a lottery ticket, but you won't enjoy your winnings because you'll get hit by a bus after being struck by lightning.  ;)

However, the chances of a false positive on an hsv2 IgG test? Pretty good. In this case, at those numbers, it's probably around 80-85%, statistically, if you'd had a risk for hsv2.

The supplemental tests mean nothing. I've talked to a bunch of people here who have tested positive on the supplemental tests and gone on to get negative western blots. I can find no rhyme or reason to that, either.

You state that you're going to get a western blot with us - we don't offer it, so I hope this means you copied and pasted this from Terri Warren's site. If you haven't talked with her, she's the one to talk to about the western blot, but I don't see any reason to run out and get the western blot except for peace of mind.

Has a doctor seen your symptoms? You may need a prescription cream. Using cortisone can help ease symptoms, but it's not really meant to be used that long, and sometimes balanitis needs an antibiotic. Since it's lingered this long, it's time to get it checked. If you don't have insurance, call your local health department and ask what services they offer for residents with no insurances. To find your health department, google your county and health department, like Cook County Illinois health department.

[perkingstart]

Thanks for replying!

What do you think are the chances of me having it orally? Oral sex was performed both ways (me-them, them-me). I'm assuming low as well since you said is rare?  (I don't know if it matters but I've had oral HSV-1 since I was a kid like I mentioned)

[auntiejessi]

Yes, it's very low. Herpes doesn't go from the genitals to the mouth - even if someone had genital hsv1, and more so if it's ghsv2.

Here are some threads you can read about people who were in your situation with a low hsv2 positive and tested negative on the Western Blot -

https://www.medhelp.org/posts/Herpes/Second-IgG-test-done--Now-HSV-1-and-HSV-2-positive-Please-help-I-am-freaked-out-/show/3057809

https://www.medhelp.org/posts/Herpes/How-reliable-are-positive-HSV2-supplemental-test-results/show/3056690

https://www.medhelp.org/posts/Herpes/False-Positive-Western-Blot-Update/show/2818624

https://www.medhelp.org/posts/Herpes/HSV1-and-HSV2-SPEC-AB--IGG-W-RFX/show/3053216

https://www.medhelp.org/posts/Herpes/Timing-for-western-blot-test/show/3054778

Some had positive supplementals, some didn't get the supplementals at all, but it's interesting reading, and shows how likely yours is to be a false positive. (Oh and they are all long - get comfy.)