HSV-1 and HSV-2 igg both positive?!

[Yradah]

Dear doctor,

My wife has made the igg hsv both types tests, she used to have blisters on her outer side of the left hip. The blisters didn't occur for the last 9 month.
The results came as follows:
- HSV-1 igg 2.9 index
- HSV-2 igg 5.9 index

What does it mean? Is she positive for both?! Most people in all forums come positive in only one type!
What does it mean that HSV-2 is more than HSV-1?
Does it mean that i also definitely have it now?
What are the precautions we should take?
If pregnant at anytime does it mean that the virus will be transmitted to the baby?

I thank you in advance and waiting for your reply.

[Edward W Hook, MD]

Many people who have HSV do not have outbreaks after the first one. For HSV-1 this can occur during childhood.  For your wife, the outbreaks on her hip may be the site of her infection.  Persons can get such infections with direct contact to parts of the boy other than the genitals/  

I cannot comment on the timing of her infection.

If her outbreaks are only on her hip, the chance of infection at the time of childbirth is probably low but she should discuss this with her obstetrician, as I said.

Same comment about preventative acyclovir. This should be discussed with her doctor.

Vitamins and good nutrition are always a good thing to pursue. They have not be proven to reduce or prevent outbreaks however.  EWH

[Yradah]

I couldn't thank you enough Doctor
You have been a great help

And for all of you here ... May God always help and protect all of you.

[Yradah]

Dear Doctor,

Thank you so much for your reply ... It really helped to understand a lot.

I still have one little thing to understand ...
My wife never had the blisters around or on the genitals nor mouth ... So is it possible that someone get HSV-2 and never get outbreaks on genitals and get HSV-1 without anything on the face nor mouth and only always have blisters in the same spot on the hip?

Is the timing of getting the first blister related somehow to when one got infected?

If - when they come - the blisters appears ONLY on the outer side of the hip ... Is it still worrying to be transmitted to the baby at the time of the delivery?

You said that she should take preventive antiviral drug like acyclovir ... So when should she take it and for how long? And is it safe while pregnant?

Is keeping the immunity high by good nutrition and vitamins enough to completely avoid outbreaks?

Thanks again for your support.

[Edward W Hook, MD]

Welcome to the Forum.  If your wife has had recurring blisters which occur on the outside of her hip, this rash may be due to herpes.  The only way to be sure is with a culture.  What her blood tests do show is that she almost certainly has HSV-2 infection but it does not tell you where the infection is.  Her HSV-1 blood test is in a range where she may well have HSV-1 as well but it is less definitive and to be honest, of less consequence- about 60% of American adults have HSV-1 although most do not know they are infected.  About 10-15% of American adults do have both infections at the same time.  In answer to your other questions:

What does it mean that HSV-2 is more than HSV-1?
The magnitude of the numbers and difference between the two levels is not of consequence.  If her tests were repeated, the numbers could vary but the variation would probably not be of importance.

Does it mean that i also definitely have it now?
No, it does not mean that you have HSV.  It is not at all uncommon for one member of a couple to have HSV and the other not to despite years of sexual contact.  In this situation, for you to get a type specific blood test for HSV (1 and 2) might be a good idea as it will inform you and your wife as to measures that you may wish to pursue to prevent infection if you are not infected at this time.  

What are the precautions we should take?
Without precautions there are 4 steps which can be taken to reduce the risk of transmission of infection to an uninfected partner. For you, the first step is to find out if you are un-infected or not.  If you are infected but were unaware, then you have nothing to worry about – you cannot get infected again. If you are not infected, knowing that your partner has HSV, avoiding sex during outbreaks, using condoms and for her to take preventative therapy with a drug such as acyclovir or valacyclovir will reduce the risk of transmission dramatically. Without such measures, HSV-2 is transmitted within sexually active couples at a rate of about 7% per year.

If pregnant at anytime does it mean that the virus will be transmitted to the baby?
No, actually the risk is low although she should be sure to let her obstetrician know that she has HSV if she should become pregnant.

I hope these comments help.  Your first step is for you to get a blood test. EWH