Aa
HSV II at 3 months
I had unprotected sexual intercourse with an asymptomatic partner who has tested positive for HSV II (>5 H). He has never experienced any symptoms. I have had absolutely no symptoms since the encounter. I took an Igg test with Lab Express (I'm not certain as to which test they utilize?) and it came back negative (<.90). This is 13 weeks after exposure. Can I take these negative results and accept them as true or is it absolutely imperative that I keep testing? And if so, for how long? I know cases exist that take past 6 months to develop antibodies... How rare is this? I have been positive for HSV I for years (my latest test showed a 6.56). Does having HSV I develop some immunity to contracting HSV II?
MEDICAL PROFESSIONAL
You're working far to hard to prove to yourself you were at serious risk of catching HSV-2 (you were not) and that you might have become infected despite all evidence.
The research you cite is a single study. The number of study subjects was small. Although a 73% rate was documented, the data statistics are consistent with real sensitivity as high as 95%; just like political polling results will describe a "margin of error of 5%", the margin of error for the HSV-2 seroconversion rate by WB in that study was +/-20%. The weight of other evidence -- from thousands of tests, not a hundred or so -- is that WB is positive within 3 months in 90-95% of people with new HSV-2 infection.
Whether Lab Express uses that particular HSV test doesn't affect any of this.
My judgment that you were not infected is not based solely on the blood test result, and yours should not be so focused on it. That's only one piece of the evidence. Taking in all factors, as I attempted to convey above, the probability you caught Hsv-2 probably is under 1 in a million.
That will be my last comment on this thread. I don't have time for people who argue when I'm trying to reassure them. Please read all my replies, take them to heart, and move on.
The research you cite is a single study. The number of study subjects was small. Although a 73% rate was documented, the data statistics are consistent with real sensitivity as high as 95%; just like political polling results will describe a "margin of error of 5%", the margin of error for the HSV-2 seroconversion rate by WB in that study was +/-20%. The weight of other evidence -- from thousands of tests, not a hundred or so -- is that WB is positive within 3 months in 90-95% of people with new HSV-2 infection.
Whether Lab Express uses that particular HSV test doesn't affect any of this.
My judgment that you were not infected is not based solely on the blood test result, and yours should not be so focused on it. That's only one piece of the evidence. Taking in all factors, as I attempted to convey above, the probability you caught Hsv-2 probably is under 1 in a million.
That will be my last comment on this thread. I don't have time for people who argue when I'm trying to reassure them. Please read all my replies, take them to heart, and move on.
http://www.medhelp.org/posts/STDs/HERPES-2/show/463636
This is one of the threads that states that at 3 months only 73% of people seroconvert by the 3rd month and 83% by the 6th month (with prior HSV I). These numbers worry me as even at 6 months it is possible for antibodies to not show in the blood. What is your take on this? I'm not certain if Lab Express (Specialty Laboratories, Valencia, CA) utilizes HerpeSelect - do you?
Thank you so much for your time.
This is one of the threads that states that at 3 months only 73% of people seroconvert by the 3rd month and 83% by the 6th month (with prior HSV I). These numbers worry me as even at 6 months it is possible for antibodies to not show in the blood. What is your take on this? I'm not certain if Lab Express (Specialty Laboratories, Valencia, CA) utilizes HerpeSelect - do you?
Thank you so much for your time.
MEDICAL PROFESSIONAL
I don't recall any episodes of define HSV acquisition despite condom use that were described on this forum. But rare things happen -- and when they do, one person's bad luck doesn't increase someone else's chance of it happening!
And it is wrong that having HSV-1 delays positive blood tests when someone catches HSV-2. For sure you didn't read that on this forum. The only potential effects of HSV-1 on later HSV-2 are described in my reply above.
Please accept the reassurance I have given at face value. Don't over-think it and don't go looking for reasons that you might really have caught HSV-2. You did not. You can move on with your life, without giving these events any further thought.
And it is wrong that having HSV-1 delays positive blood tests when someone catches HSV-2. For sure you didn't read that on this forum. The only potential effects of HSV-1 on later HSV-2 are described in my reply above.
Please accept the reassurance I have given at face value. Don't over-think it and don't go looking for reasons that you might really have caught HSV-2. You did not. You can move on with your life, without giving these events any further thought.
Thank you, kind doctor, for your thorough and prompt response. I appreciate it immensely. I have a few follow-up questions.
No, my partner was not on antiherpetic therapy; however, we had sex only once. Typically I would not be paranoid; however, I've read on this forum (and others) about the stories of individuals who were infected with HSV II by one act of PROTECTED sex, and in my case, it was unprotected. Can I assume that it is extremely rare for one act of sexual intercourse to result in HSV II transmission and - in their case - they were just extremely unlucky (for a lack of a better term)?
Also, I've read on this forum that in an individual with HSV I, the HSV I can slow the development of detectable antibodies for HSV II; subsequently making it imperative to test pass the 3 month mark after exposure. Is there any validity to this claim?
Again, thank you so much for your time and dedication to this field. We need more doctors like you. God bless you.
No, my partner was not on antiherpetic therapy; however, we had sex only once. Typically I would not be paranoid; however, I've read on this forum (and others) about the stories of individuals who were infected with HSV II by one act of PROTECTED sex, and in my case, it was unprotected. Can I assume that it is extremely rare for one act of sexual intercourse to result in HSV II transmission and - in their case - they were just extremely unlucky (for a lack of a better term)?
Also, I've read on this forum that in an individual with HSV I, the HSV I can slow the development of detectable antibodies for HSV II; subsequently making it imperative to test pass the 3 month mark after exposure. Is there any validity to this claim?
Again, thank you so much for your time and dedication to this field. We need more doctors like you. God bless you.
MEDICAL PROFESSIONAL
Welcome to the forum. I'll try to help. The news is good: the bottom line is that you can be certain you don't have HSV-2.
You may not know this, but the large majority of people who have sex with partners with genital herpes, whether due to HSV-1 or HSV-2, do not become infected -- even after several years of unprotected sex. The duration of your relationship with your infected partner, how long it lasted, and whether he takes antiherpetic therapy are not clear from your question, and any of these would affect the risk of transmission. But even if all these factors fell on the high risk side the odds remained strongly in your favor. Also,your lack of symptoms also suggests you weren't infected; although asymptomatic HSV-2 infection is common, most people with known exposure, on the lookout for even minor symptoms, would notice a new infection.
And your blood test results seal the deal. Most people with new HSV-2 infections have positive blood test results within 6 weeks, and just about everyone would have a positive result by 3 months, when you were tested. As you seem to have learned in your research, a few percent of infected people never develop measurable antibody. However, considering all the factors I just mentioned, you can be absolutely certain you escaped infection. You can go forward with no worries about this. You do not need any more testing at any time.
In reply to your closing question, people with HSV-1 tend to have milder symptoms when they catch HSV-2. The data are conflicting on whether prior HSV-1 actually gives partial protection against catching HSV-2. Most likely yes, there is some protection (my personal judgment of the uncertain research results), but only a little bit. So your HSV-1 might haves worked to help protect you, but not very much.
So all is well. You don't have it.
Best wishes-- HHH, MD
You may not know this, but the large majority of people who have sex with partners with genital herpes, whether due to HSV-1 or HSV-2, do not become infected -- even after several years of unprotected sex. The duration of your relationship with your infected partner, how long it lasted, and whether he takes antiherpetic therapy are not clear from your question, and any of these would affect the risk of transmission. But even if all these factors fell on the high risk side the odds remained strongly in your favor. Also,your lack of symptoms also suggests you weren't infected; although asymptomatic HSV-2 infection is common, most people with known exposure, on the lookout for even minor symptoms, would notice a new infection.
And your blood test results seal the deal. Most people with new HSV-2 infections have positive blood test results within 6 weeks, and just about everyone would have a positive result by 3 months, when you were tested. As you seem to have learned in your research, a few percent of infected people never develop measurable antibody. However, considering all the factors I just mentioned, you can be absolutely certain you escaped infection. You can go forward with no worries about this. You do not need any more testing at any time.
In reply to your closing question, people with HSV-1 tend to have milder symptoms when they catch HSV-2. The data are conflicting on whether prior HSV-1 actually gives partial protection against catching HSV-2. Most likely yes, there is some protection (my personal judgment of the uncertain research results), but only a little bit. So your HSV-1 might haves worked to help protect you, but not very much.
So all is well. You don't have it.
Best wishes-- HHH, MD
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
