Figuring out what to make of test results

[nodeals]

Hello,

I recently had a type-differential HSV blood test done and it came back positive for type 1, negative for type 2. At the time I went in for the test the doc told me that, if there was a positive result, the test might be able to give an idea as to when the contraction occurred. However, the nurse on the phone told me that that was not possible, and that it was just from some time in the general past. Could I ask for the iGG numbers to possibly get an idea as to when it was contracted?

I should give some background. I chose to get the test done because about eight years ago I had a fair-sized pimple on my foreskin (I'm uncircumcised). It was just one and it wasn't painful or itchy or otherwise physically irritating. I think it was gone in a week or so, maybe less. At the time it showed, I hadn't had sex (oral or intercourse) in over six months. And there hasn't been another one since. When I told the doctor about it after it had already gone, she said it was probably just from stress and to not worry about it. But it's just something that's stuck on my mind, and being single again after a few years, I figured I should get tested because I'd hate to give something to someone. My main question is, should I be concerned about this being a genital version of HSV-1?

I'm just trying to figure what, if anything, I need to bring up to prospective partners before having sex. I don't recall particular instances of cold sores, though I have had bad skin over the years and irritations around my lips that I figured were pimples or something else.

Anyway, the reason I was curious about finding out the approximate time of contraction was because if it was fairly recent I could rule out the possibility of that pimple on my foreskin being something to worry about.

Thanks for your time. Much appreciated.

[Edward W Hook, MD]

Glad to help. EWH

[nodeals]

Thanks. I appreciate your help with this issue---or as I put it in the previous comment---"crap." What a great word choice, eh. Take care!

[Edward W Hook, MD]

No, I would not bring it up with prospective partners.  In fact, to do so would be mostly confusing and irrelevant.  

Take care.  EWH

[nodeals]

Thanks for the quick response. Much appreciated. I take it then that this crap about the (what seemed to be a) pimple and the HSV-1 result isn't something I need to worry about bringing up with a prospective partner?

Thanks again.

[Edward W Hook, MD]

Welcome to the Forum.  I'll try to help with some information.

You cannot tell how long someone with a positive blood test for HSV has been infected or, for that matter, where they have been infected.  You can talk about statistical probabilities but that's about all that can be done.  People who tell you that there is an antibody test that can provide information about when an infection was contracted are wrong.  

Having said that, I think the chance that the "pimple" you noticed is miniscule and not something to worry about, nor to worry about in terms of possible sexual transmission to future sex partners.   There is no one reason I say this but rather, the cumulative effect of a number of facts.  Here they are, in no particular order.

HSV-1 is very common, occurring in about 60% of American adults and, of those with infection, fewer than 20% of those with infection know that they are infected.

Despite the fact that the overall proportion of genital herpes causes by HSV-1 has increased, most HSV-1 infections are acquired in childhood and are oro-labial (on the lips) in location.

The pimple you notices was unlikely to be HSV.  When people acquire genital HSV, the lesions appear within two weeks of exposure. Thus the fact that you had not been sexually active in months.

Even if your positive HSV-1 antibody test reflects a genital infection, there is little to worry about.  Genital HSV-1 is rarely transmitted to others because there are fewer recurrences, less shedding of the virus and thus few genital transmissions.  

I hope these comments are helpful. Please don’t worry about this test.   EWH