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Avatar universal

low hsv results

thanks of taking my question. i have posted on the herpes forum but still have additional questions that cant seem to be answered.
I was tested for hsv2 in feb and got a low positive, the dr gave me valtrex and insisted i had this, so i decided to get re tested at a different lab which the results came back even higher, so still not believing the results i was tested again and the results were even lower than the first time. my husband of 11 years didnt have it, he had hsv 1, my recent ex also was tested and he didnt have it just hsv 1. i was with 2 people both with condoms and i have not contacted them yet. i do not have hsv 1
here are my results,
2/19 1.59 hsv igg 2 lab corp
3/5 4.82 hsv igg at quest labs
4/15 1.32 hsv igg 2 lab corp
so my questions are, why would my level increase that high then decrease that low? do levels usually stay high if you are indeed positive?
is it possible that i am in the false positive range and are the chances of having a false poitive better if you have hsv 1?
my ex bf was checked and he said on his lab paper it just says hsv 1 igg out of range positive and hsv 2 igg in range negative, when you are checked with igg isnt it a numbers value range?
if i am indeed pos, and i have not transmitted this to anyone is it possible to not pass it? i just dont understand that my husband wouldnt have this.
what are the chances i was with 2 people once, both with the use of condoms, of me getting it from them? i was with both of them in january.
i have never had an outbreak in my life that i can recall, once i thought maybe it was something so dr did a culture and it was negative. i am getting a WB test done this week.
also heres a little history, when i was 16 i had the epstein barr virus, i have had the chicken pox as a kid, and when i stopped taking the valtrex i have been breaking out in hives about once a week or once every couple weeks, i took valtrex for 2 week and stopped it back in march.
thanks so much
11 Responses
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239123 tn?1267647614
MEDICAL PROFESSIONAL
Welcome to the STD forum.  I reviewed your thread on the herpes forum as well.

My main advice is the same you had from Terri Warren:  have an HSV Western blot test.  All the discussion and hints that you or I could come up with, based on symptoms (or lack of symptoms), the nature of your exposures, your HSV-1 test result, previous Valtrex treatment, past EBV/mono and chickenpox, and the variable numerical results on your HSV-2 ELISA (IgG) tests are never going to sort this out with certainty.  You may or may not have HSV-2; the WB will show definitively whether or not you do. All the rest is just wasted energy at this point.

Since two ELISA tests have given similarly low values, the high value of 4.82 might be falsely high.  Like many kinds of blood tests, the HSV-2 ones aren't perfect and sometimes give atypical or aberrant results.  However, your situation is confused a bit because of testing by two different labs, which use two different HSV-2 IgG ELISAs (Trinity Captia test for Labcorp, Focus HerpeSelect at Quest).  Although very similar tests, they don't always give identical results.  For HerpeSelect, values of 1.3 to 1.6 (if those reflect your true results) usually turn out to be false; but this hasn't been well studied for Captia.  Taking all your test results together, I'm exactly on the fence:  I think there is a 50:50 chance you have HSV-2.

For these reasons, answering your specific questions won't get you any closer to the answer you want.  Please see your health care provider and arrange for an HSV WB.  When you have the result, please return to let me know the results and we'll take it from there.  I'm sure Terri would be interested in hearing the result as well -- so you can get two expert opinions when the time comes.

Regards--  HHH, MD
Helpful - 0
Avatar universal
thanks for answering! i have an appt tomorrow to get an order for the WB.
are you able to answer about the risk of transmission with condom usage. guess im a little confused to as if you can get it being with someone once and using protection.
thanks
Helpful - 0
239123 tn?1267647614
MEDICAL PROFESSIONAL
Even without a condom, if one partner has HSV-2, the average likelihood of HSV-2 transmission probably is around once for every few hundred episodes of vaginal sex, maybe as low as 1 in 1,000.  With a condom it's at least 10 times less likely.  So this could happen but it probably did not.  If your WB comes back positive for HSV-2, you'll have to look to some other exposure to explain it -- and most likely you would never know when and where you caught it.

I won't have anything more to say until the WB result is available.  Good luck on that -- I hope it's negative.
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Avatar universal
wb results came back postive for HSV 1 and 2. i ws tested for 1 and it was negative. is the wb really accurate? and what are the chances of spreading hsv 2 through oral sex if no outbreaks are there? also if there was oral then kissing could i get this on my mouth and then spread it to my child? i am truley devistated by this, have never had an outbreak ever, my ex bf and ex husband are both negative and there has been 2 partners each one time with condom use. i just dont get it, and how do you explain to someone you have just met or do you give up completly on relationships
Helpful - 0
239123 tn?1267647614
MEDICAL PROFESSIONAL
Thanks for reporting your WB results.  I'm glad you got tested, even if the results aren't what you hoped for.  But it isn't the end of the world.

Your positive HSV-1 result is not atypical and not very surprising, since half of all adults are infected and 10-15% them have negative tests by ELISA.  So the answer is yes, you definitely have HSV-1. But if you haven't been having oral herpes outbreaks (cold sores), you probably never will; and transmission to other people isn't very common.

Transmission of HSV-2 is pretty much limited to genital intercourse.  HSV-2 uncommonly infects the mouth and rarely transmitted by oral sex, kissing, or any other exposure involving the mouth.  

As for explaining HSV-2 to new partners and impact on sexual relationships, that's the single most important reason people react with consternation, fear, or even horror when first diagnosed with genital herpes.  But don't panic about it.  The quick answers are 1) it definitely is not necessary to "give up completely on relationships" and 2) although it seems daunting to start, most people find it's not as big a deal as it first seems.  It would take a book to address these issues in detail.  Fortunately, exactly such a book has been written -- in fact, two of them.  One was written by Terri Warren, moderator of MedHelp's herpes forum (http://thegoodnewsaboutthebadnews.com), the other by Charles Ebel and Anna Wald, a health educator and herpes research expert, respectively (http://www.ashastdwebstore.org/managing-herpes-living-amp-loving-with-hsv1.html).  Also, you can participate in MedHelp's herpes community forum for excellent advice from expert herpes counselors.

Best wishes to you.
Helpful - 0
Avatar universal
thank you so much for your help on this board! getting these results is like being told all over for the first time, but i have to say i have never had a genital outbreak in my life, so is it possible to take this as being a carrier and not a passer? my ex husb of 11 years is neg and my ex bf of 3 months was neg. and being i was only with 2 other people once each protected i wouldnt think it came from them. not knowing where something comes from is just hard to take in. thanks so much!
Helpful - 0
Avatar universal
i need to ask one last question, my ex boyfriend had hsv test done that just says igg hsv 1 positive and 2 negative, isnt there always values to these? what type of test could this be? thanks
Helpful - 0
Avatar universal
ok, heres exactly what the test says hav1/hsv2 AB sep/rate determination, is it safe to say thats negative, pos for 1 neg for 2.
Helpful - 0
239123 tn?1267647614
MEDICAL PROFESSIONAL
It sounds like you ex-bf might have had a non type-specific HSV test, which does not accurately distinguish HSV-1 from HSV-2.  He needs to have the right kind of test.  He could ask his doc or clinic to be sure a specimen goes to one of the two large national labs, Lab Corp or Quest.  Both do accurate, type-specific HSV blood tests.
Helpful - 0
Avatar universal
would there be anyway to email you a copy of the labs for you to look at? because it does say hsv 1 pos and hsv 2 neg, sep rate determination. wouldnt that mean that it is seperate
Helpful - 0
239123 tn?1267647614
MEDICAL PROFESSIONAL
There are tests on the market that claim to accurately distinguish the types but do not.  But I can't help further; we don't provide direct medical care.  You're going to have to rely on the lab or your own health care provider (or his).

In any case, I see no reason for you to be pursuing this.  As I understand it, your relationship with your former partner has ended.  The only possible explanation for your HSV-2 is that you acquired it from him.  He has that information and what he does with it is now his responsibility, not yours, including protection of his current or future sex partners.  In my view, you have no right to insist that he get a definitive diagnosis just to satisfy or confirm your curiosity about the issue.  He may go through life denying that he has HSV-2 and firmly believing he didn't infect you.  So be it; no harm to you.  I suggest you drop the subject.

That will be all for this thread.  I won't have any further comments.
Helpful - 0

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