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Avatar universal

HSV2 seroconversion

I understand most people will have seroconversion by 20 weeks so my question would fall to the other 1%.  Here is my scenario:
Former partner 1st outbreak 18 months ago.  Diagnosis HSV1 genital.  No culture.  Herpes Select HSV1 pos, HSV2 neg. Me: HSV1 pos, HSV2 neg  Assume oral to genital transmission.  
2nd outbreak 19 weeks ago.  No culture, herpes select HSV1 pos, HSV2 neg (both of us with new partners).  
3rd outbreak 1 week ago.  Culture HSV2 positive, herpes select HSV2 negative, HSV 1 positive.  Me:  HSV2 negative, HSV 1 positive.  No genital symptoms for me.  However, current partner developed 2 lesions that were visually diagnosed by two different doctors "HSV" 16 weeks ago.  His cultures 3 weeks apart both positive for staph instead. His Herpes Select HSV2 negative and HSV 1 positive.  No further testing was done.  Current partner for my ex has no genital symptoms but tested HSV2 positive and HSV1 negative.  My question is, do I, or my current partner need retested for herpes via western blot? Is it possible that I am passing HSV2 to people and have no genital symptoms and no seroconversion via Herpes Select?
Thank you!
4 Responses
Avatar universal
Some clarifying questions:
- how soon after the genital outbreak did your partner have the positive HSV1 blood test?
- is every test you describe IgG for HSV2?
- did this partner have their culture correctly typed? First the sample is cultured for the presence of HSV and could be either. Often the process stops here and assumed to be HSV2. A further step is required to truly confirm that this ex partner has HSV2.

The chances of you having HSV2 appear zero to negligible. The 1% you refer to are most likely people with immune deficiencies they'd know about and would have a positive swab owing to probably bad symptoms.

Please answer above questions and I'll finish the likely story.
Avatar universal
immediate HSV1 + first outbreak.  I doubted he had HSV genital based on this but he chose to believe it was accurate.  All tests IgG herpes select.  Please elaborate on correctly typing a culture? There was only one culture done (on my ex) and it was one week ago.  All of the other lesions were not cultured.  I appreciate your input!  
Avatar universal
We were in a low risk relationship for 4 years prior to 1st outbreak.  I had no other partners.  He had one other low risk partner during that time.  Also, he is certain all three lesions were in the same spot.  He was told the new lesion last week was type2 HSV and I know they were expecting it to be type 1.  
Avatar universal
If your partner blood tested HSV1+ at the time of the first genital outbreak, and has never tested positive for HSV2, then he most probably does not have genital herpes. His outbreak was another condition. He has an oral HSV1 infection from his youth. You did not infect him with HSV1 he already had it.

Staph can be confused with herpes.

Swabs are often not typed, just tested for HSV and assumed to be HSV2 in many instances. In this case though it would appear your ex partner has just been infected with HSV2 from his current partner. He will test positive for HSV2 antibodies soon enough. It would be worth his while checking the culture was properly typed. This means a further test on the culture once HSV has been established.

You do not have genital herpes, HSV2 or otherwise.
1 Comments
Thank you I appreciate the opinion from an unbiased person!  And I will follow up with him about further testing on the swab! But it seems most likely to me as well that he has a new HSV2 infection.
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