HSV 1 husband and wife

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41 yo male 10 yr monogamous marriage recently had primary ob of genital HSV 1.  initial blood tst showed HSV 1 and 2 - specific AB IgG, HSV 1 IgG <.91 and HSV 2 IgG <.91, HSV 1 and 2 IgM Abs, Indirect HSV 1 Igm antibodies 1:10, HSV 2 Igm Antibodies 1:100.  Following blood work had culture of sore via Virus Culture: VZV/HSV W/DFA result Herpes simplex 1 isolated.  Meanwhile wife freak out never had an ob goes for blood test.  Her results HSV 1 IGG Type Spec result 1.0 High, HSV 2 IGG, type spec <.91 and HSV 1 IGM antibodies <1.10 and HSV 2 IGM antibodies <1.10.  Again she's never had an OB so it appears she has had HSV-1 for quite some time.  I had chaffing from genital shaving and am thinking thats how i contracted HSV-1 genital from her from intercourse or oral.  The problem is now she won't have intercourse oral or vaginal out of fear that i can give her what she gave me.  We have 3 yng kids and a monogamous relationship for 10 yrs.  Can anyone assuage her fears that i can't give her anything?  From my understanding she has antibodies that are preventing her from ob's and that i could not reinfect her.  That's the best i've ascertained from my research but it's going to take an expert to convince her.  Please help!  Someone like Dr. H. Hunter Handsfield seems to be the best fit.  Thank you!

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Sorry for the impatience.  As I'm sure you can imagine this has been a very trying period for us both.  I greatly appreciate your expertise.
Sincerely.

[Edward W Hook, MD]

I happy to answer but no one man's the site 24/7- you need to be patient.

An eqivocal result means just what it says, perhaps there are HSV antibodies and perhaps there are not.  Given the history you provide it is likely she does have HSV-1 antibodies, just at a low level.  Before you ask, there are no data on the antibody level and what it means related to the duration, location, or severity of infection. In general, levels are a bit lower in long standing infection.  If you wish a more defintie answer to the presence of absence of HSV antibodies, your wife should request  that serum be sent tot he University of Washington (no where else) for a Western blot test.

EWH

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If you could kindly reply to the equivocal question I believe that her questions would be resolved as well as my stress regarding this issue.
Thank you very much for your assistance!

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when i'm typing in the range it is not taking the symbols correctly!  i will spell it out.  It states negative is less than .91, equivocal is between .91 and 1.09 and positive is greater than 1.09.  Hopefully when i hit post this time it doesn't change anything.  Again her result was 1.0.
Thank you

[TBBB]

Just to completely clarify the range for her test it states the reference range is 0.00-0.90, Negative is 1.09.  This would place her result, 1.00 in the Equivocal range for HSV-1 IgG hence the questions listed above.
Thank you again!

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there is a typo in my post.  Regarding the range explanation it should say states Negative <0.91.  Sorry for the confusion.

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In sharing your very helpful response with my wife she had an additional question regarding her blood test that was performed.  The lab report shows that it was a HSV 1/2 Herpes Select IgG done by Labcorp.  The results state the following: HSV 1 IgG 1.00 and the Ref. Range is 0.00-0.90, under units it says Index followed by High, (which when comparing to mine means a flag), then status which says Final.  The range explanation states Negative 1.09.  Then the report says, NOTE: Negative indicates no antibodies detected to HSV-1.  Equivocal may suggest early infection.  If Clinically appropriate, retest at later date.  Positive indicates antibodies detected to HSV-1. Her question is with regards to the equivocal range and her result being 1.0.  Can you shed any additional light on this for her as to why this might be in the equivocal range and what that means with specific regards to the Herpes Select Test?  Her HSV 2 IgG came back as <.91 with a ref. range of 0.00-0.90 and negative being < 0.91 and Equivocal being .091-1.09.  Does her HSV-1 result of 1.00 (equivocal) indicate positive for HSV -1? I have had no other opportunities for exposure so I can't imagine how else I would have contracted this.  Any clarification of her results would be much appreciated.  Thank you.

[Edward W Hook, MD]

Her result is certainly consistent with her having HSV-1 and the scenario we discussed.  

I'm not sure what more to say.  You both have HSV-1.  Once persons get HSV, they will not get infected again at another site, even with direct exposure.  Sex between persons who both are infected withthe same type of virus (i.e. HSV-1 or HSV-2) will not get re-infected at another site through sexual contact with another person infected with the same type of virus.  EWH

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One final question please. Based on my response above that she did have the herpes select IgG test with the results listed above is there anyway that you could elaborate any further to completely put her mind at ease that she would not be in any risk by resuming intimacy?  He fears are all of the sudden having outbreaks since she has never had them, me giving her genital hsv 1, and or spreading it to other parts of her body etc. Sorry to ask but I want to make sure that she's very clear that she's not at risk for any if the above.  I understand it completely but it would be best for her to hear it from someone with your qualifications.
Thank you again. This is my first time using the site and I'm very happy with the response time and the qualifications of the responders.

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I'm so sorry I forgot to say thank you for the amazingly quick response!

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She did have a HSV 1/2 Herpes Select IgG with the results being 1.0 - high with a ref. range of 0.00-0.90 for HSV - 1 and negative for HSV - 2.  Does this validate your conclusion?
Thank you!

[Edward W Hook, MD]

Welcome to our Forum.  I think that the scenario you describe is on track.  My guess is that your wife has oral HSV-1.  Among HSV-1 infections, oral infections are more likely to be transmitted to others (through kissing to cause cold sores, or through oral sex to cause genital HSV-1 infection) because there is relatively more shedding of the virus from oral sites of infection than genital infections. Once a person has HSV (-1 or -2), they cannot get that type of infection again through exposure to infected partners.  This is because once infected, a person develops antibodies and other immunological factors which prevent infection at other sites on their body.  

My suggestion would be that she should validate that she has HSV-1 with a type specific, IgG antibody test such as the HerpeSelect. There is no reason to get IgM testing

I hope this is helpful.  EWH