Understanding test results

[mystupidex]

I just got my test results and they are as follows.  HSV2 positive with 3.70 and HSV postive with 7.01.  Based on those numbers is it possible to know how long ago I may have gotten the HSV2.  I think the HSV2 infection came about 12 years ago or potentially 18 months ago.   Also does a higher number mean a more intense virus?  Is 3.70 a slight, medium or heavy virus in you?  Can you tell how often you will have outbreaks or shed based on those numbers?  How likely to transmit it is it with those numbers?  One last thing my doctor is suggesting I switch from 1 gram of Valtrex per day to 500mg per day.  Will making a sudden change cause me to have outbreaks or be more likely to transmit it to my partner.  Isn't 1 gram a better safeguard?  Also if I did get HSV2 12 years ago and that is my number how likely is it that I can transmit this to my partner while on Valtrex?

[Bobby617]

A related discussion, Is the Shingles lab test result the same as Herpes 1 and 2? was started.

[Terri Warren, RN, Adult Nurse Practitioner]

One gram per day is not appreciably better than 500 mg, I don't believe, for the person with recurrent genital herpes.  A sudden switch to 500 is unlikely to precipitate an outbreak.  Herpes blisters are normally filled with clear fluid.  Swollen lymph nodes are non-specific, and can be present for many reasons - we don't know if that means that you might be shedding or not.   The same is true with tingling.  Oral HSV is in the nerve that innervates an area from chin to eye, including the ear.

Terri

[mystupidex]

Thanks Terri.  I called about the results from the swab that was taken 6 years ago and all they said is that is was positive but not typed.  I believe the recent results and do not a need a retest. So does the number coorelate with how strong the virus is in your body?  And if I did get this several years ago aren't I less likely to transmit it?  Do you have any knowledge of how much better 1 gm is versus 500 mg daily? Will it making a sudden switch make me more likely to have an outbreak.  Also can you please let me know what sort of liquid is in a lesion.  I sometimes get small blisters around my mouth.  Would the liquid always be clear and does it ever get yellow or greenish and is there ever a solid discharge like a pimple?  Do they refill after popping?  If you feel a dull pain in your lymph nodes in the groin should you assume you are shedding.  I would say I get tingling on my upper lip and near my pubic bone about 1 x month.  Would I be shedding with that.   I also heard the HSV1 virus is located near your ear.  I have another pea size lump that is swelled in my ear lobe.  Could it be related at all.  I did have a small what appeared to be a cold sore last week below my lower lip.

[Terri Warren, RN, Adult Nurse Practitioner]

You didn't ever answer my previous question about whether the swab test you had done was positive or not, and if positive, for which type.  Did you get those records for me?  I would not feel the need to confirm an HSV 2 result that is 3.7.  We do confirm all positives with a value of 1.1 to 3.5, so you are just over the limit of what we would consider necessary to confirm with a second test. We can't tell anything about how often you shed or will have outbreaks based on these results, nothing.  Nor does it tell us anything about transmission rates.  Generally, 500 mg is adequate.  But suppression is not perfect to prevent transmission.  You will still likely shed from time to time, but it does reduce transmission by about half.  Your chance of transmitting on meds is around 2% per year, condoms will improve that.  If you are more comfortable on 1 gram, that's fine.  You could also break 1 gram in half and take 500 mg twice daily, but again, not much difference at all from 500 once a day.  If you want to confirm these results, I would recommend a western blot from Quest labs (done at UW), the test code is 34534.

Terri