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Low positive HSV-2 test but no lesions

Married 13 years and I’ve had 2 kids and no symptoms. Recently went to the doctor for an infected hair bump in the Genital region. Doctor prescribed Bactrim for the bump. Dr wasn’t concerned about bump but asked if I would like blood testing to confirm. I said sure!!! A week later I’m devastated with the news of a positive test hsv-2 test (1.25) I’ve been devastated since the testing. I have a child with special needs who needs their mom healthy and not with some virus to slow her down!! Since testing I’ve not eaten well and been pretty depressed. I have never had any symptoms previously that I can remember. For the last week the corner of my lip has hurt and seemed painful but no bumps or lesions have ever formed. I also even went to the extent of calling and getting an antiviral because I just knew it was my first OB since the devastating news. I’ve been taking the antiviral but I still have the pain but still not lesions. Is this an outbreak? It’s been 7 days with Pain and no lesions? Is it worth even doing another test? I’m worried sick about giving this to my special needs child/immuno-compromised child who I have to care for with toileting and feeding.  Am I just crazy? I’ve had a very stressful life with my daughter so it’s confusing as to this being my very first outbreak if that’s what it is. I need help!! I’m losing my mind!!!
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207091 tn?1337709493
Okay, so take a breath.

First, you have about an 85% chance or better of this being a false positive. The official test guidelines state that anything over a 1.10 is positive, but the CDC and experts all agree that anything under a 3.5 needs to be confirmed.

What type of test did you have? It should say IgM or IgG. If it's an IgM, ignore it entirely. It's unreliable and shouldn't be done on anyone except newborns.

If it's an IgG, I would suggest that you get a test called the Western Blot done. It's a different type of test, and can tell you for sure if you have it or not. Your doctor can order (see links below) and your insurance should cover it.

If you do have herpes, there is no reason that your life or parenting will change in any meaningful way in regards to your parenting. I've had herpes for 15+ years, and it hasn't slowed me down at all. If you have a busy life with 2 kids, one with special needs, not eating well will run you down a lot more than herpes ever would. :(

Hsv2 almost never infects the mouth. If you're having pain in or around your mouth, it's from something else.

Has your spouse tested? They should start with a type specific IgG blood test.

Here are some links that you can show your doctor if he/she hesitates in ordering the Western Blot -


https://www.kevinmd.com/blog/2013/07/order-herpes-igm-blood-test.html (If your test was an IgM)

https://westoverheights.com/herpes/the-updated-herpes-handbook/ - This is written by one of the world's leading experts on herpes. It's also free, and has info on testing. :)

https://www.cdc.gov/std/herpes/stdfact-herpes-detailed.htm - this is from the CDC, and explains about the IgM, and low positives on the IgG, and that follow up testing after is recommended. It's taken from the official STD treatment guidelines that if your doctor is testing for and treating STDs, he/she should be familiar with.

http://depts.washington.edu/herpes/pages/frequently_asked_questions - info on this about your doctor ordering the Western Blot.

So take a deep breath, and work with your doctor to figure this out. We'll be here to help as you do.
Helpful - 0
It was the IGG test. I have looked into the western blot.  My husband waited until marriage. (He’s a rare diamond for sure) I on the other hand did not...5 partners total. (14 years ago) Which makes me feel even more awful because my husband is AMAZING! Even through this experience he has been nothing but supportive but I’m still struggling! I’ve also heard from doctor it normally doesn’t affect the mouth but my corner lips have been in pain!! But no lesions. I also have a red spot on the side of my nose that popped up around the same time but doesn’t hurt and hasn’t resulted into a blister or pimple. Just red. I’ve never had a cold sore EVER! So all of this is so new to me and I’m so worried about cathing my daughter and dealing with her ports that she has that I will somehow give this to her. Again I have been married for 13 years and had no symptoms that would ever indicate this to me! Isn’t Hsv-2 something doctors typically screen for during pregnancy? I’m currently waiting on those records to see if there are any test results that mind ease my mind some.
So it sounds like you're assuming you have it, and I'm not sure why? The odds are very much in your favor that this is a false positive.

But JUST IN CASE you do (and I'd be surprised if you do), let me address some things.

First, get the things on your mouth and nose cultured with a PCR swab. It's very sensitive, and even without an actual blister, it can often pick up the herpes virus. Your doctor should be able to do this. If it's not herpes, you need to find out what it is, so a wound culture (which looks for everything) would also be a good idea.

There's something called cheilitis that may be what you have in the corners of your mouth - https://www.webmd.com/oral-health/angular-cheilitis#1

So you're husband is amazing - I'm happy to hear that. It doesn't make you any less amazing because you had sex before marriage than his not having sex before marriage makes him more amazing. That's not really a thing. :)

I understand why you're worried about your daughter and her ports and cathing, but IF this is herpes, and that's a great big IF, you aren't infectious from your hands. You'd only be infectious from the site of infection, and like you said, hsv2 almost never infects the oral area. Even if you touch a sore and then her port, she isn't going to get it that way. I assume you take good precautions (washing hands, wearing gloves, etc.) so things don't get infected or she doesn't get sick, so if you do have herpes, those steps will be enough.

Herpes is sometimes screened for during pregnancy, but it's not routine. It depends on your doctor. You're not high risk, so they may have skipped it with you.

I understand why you're upset - this is confusing and no one wants herpes. Add in that you are low risk, and have been married for so long, and care for a special needs child, I totally get it. Remember that you have at least an 85% chance of this being a false positive. For your mental health, at least, you should consider a Western Blot.

Let us know what you decide.

Hang in there, and enjoy the holidays. :)

Thank you so much for your support and information. The doctor completed another test...not sure what kind and we are waiting for results. Based on those results we will look into the western blot test and getting that completed. Travel may be required but for my peace of mind it may be needed at this point. My greatest concern is just my daughter who has special needs. I would never want my mistakes to effect my children. I’ve been blessed with an amazing husband who has been so supportive and understand. Not many can say that I’m sure. So I’m trying to be grateful for the positive things in my life right now even lthough it’s been a struggle! Thank you again for the support and information. You are helping so many people.
If your doctor did the same kind of test, don't be alarmed if it comes back with similar results. You should find out the name of it.

You shouldn't have to travel to get the WB, unless you want to travel and this is a reason to do it. Your doctor can order it and do it and you shouldn't have to leave your town.

I'm glad your husband is so supportive, but remember that it's his job to be supportive and to trust you if you've given him no other reason to. Make sure you aren't putting him on a pedestal that's unfair to you both. You are definitely blessed, so just enjoy that.

Even if you do have herpes, it won't affect your children unless you have inappropriate contact with them. If you have it, and have another child, the only concern would be is if you had an outbreak during delivery, but there are steps to take to prevent that. Millions of women with herpes give birth naturally each year to healthy babies.

Try to keep in mind that the odds of you having a false positive are about 85% or higher. That's what you need to remember now. :)
I just received the results of my test. It was an IGG with reflex test from what I can see from the test results. It was again positive with a value of 1.20.  So is this test reliable? My first result was an IGG with a 1.25.  Do I go ahead and spend the money on the western blot or is it just a waste? Thanks for the information.
Does it say what kind of test the reflex is? Is it LabCorp? The only thing I can find from LabCorp seems like they do another IgG test for their reflex test, which is pointless. I don't think Quest does a reflex test.

I'd get the WB if you can afford it, or if you have a big need to know the results for sure. I still think this has an 85% of being a false positive, but it's entirely up to you. If you can't spare the money - and it's a lot if it's not covered by your insurance - see if you can get a BioKit test from your doctor.

I'm really sorry you're going through this.
It says it’s an IGG hav 2 reflex with inhibition test it was through quest
Okay, so that test hasn't been studied in asymptomatic people, so we don't know how reliable it is for people like you.


"Other confirmatory tests also exist, for instance Biokit’s HSV-2 Rapid Test and Quest’s own HSV-2 IgG Inhibition assay. The latter, which adds only $4 to the price of the HerpeSelect test, performed well in a study conducted over a decade ago. Rick Pesano, the medical director for infectious disease at Quest, believes that with more awareness, the test could stand in for the Western blot. But the test was not mentioned in the USPSTF guidelines because it still has not been evaluated in asymptomatic individuals, according to Cindy Feltner, associate director of the RTI-UNC Evidence-based Practice Center, who helped prepare the science review for USPSTF."

It's still an IgG and still really low.

I can't tell you what to do. It's not my body or my money. If you have it, it probably won't change a lot in your life. Your husband doesn't seem to care, your care routines with your daughter doesn't need to change.

So, it's up to you. If you are comfortable with the results, and don't care to pursue it any longer, that's a perfectly acceptable and understandable response. If you want to get the WB, that's also perfectly acceptable and understandable. You could also ask Terri Warren, who is one of the world's leading experts on herpes. You can do that for $20 on her website - https://westoverheights.com/herpes-questions/ That may be a good way to determine your next steps.

If you decide to go for further testing, let me know what happens.

Happy 2020!

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