timeline for seroconversion

[Adjusting1]

I had a positive HSV2 Western Blot drawn July 30th and I was encouraged to post a new thread with any questions resulting from that definitive positive.  I am now wanting to sort out (if I can) when my exposure happened and from whom.  I will lay out the timeline of relationships and test results.  Would you please let me know the likelihood of which partner exposed me?  My current partner will not be tested.  I have asked him to do so a number of times and have accepted that he is not going to do it.

June 2009 - negative HSV testing as part of routine annual GYN exam

Feb 23rd 2010 through March 13 2010 relationship with previous partner

March 26 through present day - relationship with current partner
June 24 2010 HSV testing again as part of annual GYN exam.  HSV2 was 2.12 at that time
July 2nd 2010 repeat test at internists's office - at that time IgG for HSV2 was 1.06 and IgM was 3.07
July 16th repeat again at internists - this time IgG for HSV2 was 1.47 and IgM was 2.73
July 30th - Western Blot was drawn which came back positive.

Given that timeline and those test values, can you give me any information about which partner is most likely to have been the source of my exposure?
Thanks.

[Terri Warren, RN, Adult Nurse Practitioner]

A person can seroconvert as quickly as a week (unusual) or as along as 4 months.  I have to think that the IGM test is not useful at sorting this out.

It sounds as though your current partner has thought this through and is making a decision based on current and correct facts.  If he is comfortable with this, then I say go for it.  You've done your part here.  In terms of medicine daily - I think if I were you, I would do it, but it could easily go either way, and this is something you and your partner should decide together.

Terri

[Terri Warren, RN, Adult Nurse Practitioner]

No, unfortunately, I can't.  It could be either person since you had sex with them both between a positive and negative test result.  The 2.12 in June was your first positive, even though it was low.  Did you have any abnormal symptoms genitally during your relationship with either partner?  UTI or bad yeast infection?  

Did you have unprotected sex with both partners?  Has the other person been tested or will they be tested?  Any thoughts about why your current partner refuses to be tested?  Perhaps he already knows he has herpes?  Perhaps he doesn't want to find out he may have infected you?  The thing is, if he is also infected then you can have sex without worries, but if he is uninfected, then you should be on daily therapy.  I personally think it is odd that he doesn't want to be tested.  What does he say about the possibility that he may acquire HSV 2 from you if he is uninfected?  

Terri

[Adjusting1]

Thanks. I have started daily Valtrex to reduce the risk of transmission to him. After much discussion, he has agreed, reluctantly, to find out his status. If he's positive for HSV 2, I'll discontinue the med. If he's negative I will keep taking it. I got your book recently and will I'm sure get a lot of information (and much needed strategies for getting my head around this) from the book. Two final questions for you:
1. Am I correct that my chance of transmitting to him is around 3 percent in a year of unprotected sex, and the Valtrex drops the risk by half?
2. My internist mentioned the idea that I might not have had any symptom or outbreak because my body might have effectively cleared all of the virus from my system. Your thoughts about that?
Thank you for all of your help.

[Adjusting1]

I am in agreement with you about everything you said regarding my current partner being tested.  I've pointed out that if he is positive, we can have unprotected sex without anxiety, and that if my infection was from my previous partner, he is choosing to expose himself to risk unnecessarily by having unprotected sex with me knowing that I am seropositive.  He appears to be very phobic about any and all medical visits/issues/testing.  I think he is someone who is simply very frightened of the medical system.  I am very frustrated with him about this issue and have discussed with him every issue you brought up, and he still does not want to be tested.  I pointed out that unless we marry, he will have to face this at some point because he cannot have sex with others after me and expose other people - IF he is indeed seropositive.  He states he will deal with that when that time comes.  He states that he feels the risk of seroconversion having sex with me is low enough that he's willing to take the risk.

Neither my current partner nor I have ever had any symptoms indicative of HSV 2 infection. I have been treated for BV recently but had an exam at that time (June 2010) and there was not evidence of herpes genitally at that time.  I did have unprotected sex with both partners.  The other relationship ended on bad terms and I have not spoken with that person about this issue.  He is not someone I believe would respect my privacy surrounding this issue.

Should I be on daily therapy such as Valtrex even though I have never had symptoms?  I hate to take a daily medication for the rest of my life when I've never had symptoms.  

How quickly does a person typically seroconvert after exposure?  Is every person I had sex with between June 2009 and June 2010 the possible source of my exposure?  My internist indicated that the IgM value on the July 2nd lab draw indicated recent infection....