Do I have herpes? So confused...

[riverstyx]

Ok, so out of pure curiosity about my status I recently got a herpes blood antibody test, and to my shock, the result came back positive for herpes simplex, type 2 (negative for herpes simplex type 1). The test was a HerpeSelect ELISA, and I had a low-positive value (2.6), and anything below 3.5 is notoriously prone to error. Plus, the test came out equivocal, or indeterminate, the first time they ran it. Only when they ran it again a minute later did it come out in the low-positive range. The result was subsequently confirmed in a new test I had a few days later, although the lab report did not mention what type of antibody test was performed, or whether my test was definitively positive, or merely in the low-positive range again.

 

I spoke to a couple of national experts on herpes. I told them that I have had only one sexual partner, and that was almost 10 years ago. I have "fooled around" with a couple of other women, but we never had sex. I told him that in 10 years, and indeed for my whole life, I have never had symptoms of genital herpes. I told him that I am very conscientious about my health, and even minor symptoms I would've noticed, and probably gone to the doctor to get them diagnosed, but that I have truly not had any symptoms. This one expert said there is a lot of false information on the internet, especially some stating that "most people" never get any symptoms. He said it is not true that "most people" never get symptoms. Most people DO get symptoms, only they never connect them to a possible diagnosis of genital herpes at the time of their occurrence. Plus, after being told they have genital herpes, most people are able to recall symptoms and incidents that may have been manifestations of this condition. The only symptom I ever had was burning urination, once, several years ago, and that cleared up immediately after I started antibiotics. Plus, the doctor had done a genital exam at the time, and everything was normal. He said that my lack of symptoms was clinically significant, and should factor into any opinion on whether I had genital herpes, or didn't have it, especially since a standalone blood test is hardly the preferred method of diagnosing this condition.

 

I also spoke to my primary care doctor, and he said he didn't think I have genital herpes. He stated that more men than women manifest symptoms, because when women have breakouts, the blisters and lesions can sometimes "hide" in the vagina, on the cervix, etc. He said that since I only had one sexual partner, ever, that I am extremely low-risk for this condition. Yes, she had had more partners than me at the time we were dating, but then again, she and I had only dated on and off for about a year. All in all we had sex probably less than 40-50 times.

 

Nonetheless, I still can't shake the feeling that I might have genital herpes. Yes, I have never had symptoms. Yes, I have only had one partner. But I have two positive tests. What I personally think, is that I have oral hsv-2. That would make the most sense, and even though oral hsv-2 is rare, having that diagnosis can more easily be reconciled with the other problems concerning a genital herpes diagnosis. I know that maybe 2% of all hsv-2 cases are oral, but if you consider that my odds of getting genital herpes from this girl were roughly 2%, especially since we never had regular sex for the year or so we were dating, i think the case I am trying to make is more than reasonable.

 

Do you think I have genital herpes, or oral herpes type 2? Do I have to disclose any of this to any future partners? What would I say? It seems unfair and presumptuous to say "I have genital herpes," especially when the doctors are truly on the fence about that diagnosis. But I don't know what to say that would do justice to the predicament I am in.

 

 

 

 

[HerryTheHerp]

Well, I hate to burst your bubble, but you are HSV2 positive. Given the length of time that's elapsed since your last partner, your results are definitive. Could you have it orally and genitally? Possibly, but regardless, it won't change your test results.

 

Your primary care doctor is wrong; more women than men manifest symptoms, and women tend to notice their symptoms with far greater frequency than men. Yes, women are more susceptible, and 1 in 4 in America have it, but still, 1 in 10 men have it and gave it to them. Happens. As far as symptoms appearing, your doctor is partially correct; but for most people, the symptoms are very mild and generally go unnoticed.

 

You didn't have regular sex with your partner? 40 to 50 times a year is pretty regular for a lot of people. That provided plenty of opportunities for you to acquire the virus. Of course, not knowing what you did with other people, you could have acquired it from them; herpes doesn't require penetrative sex to transmit, and frottage (rubbing), laying in bed naked and fooling around, oral sex, and so many other ways can transmit it.

 

A blood test is the preferred method of diagnosing for someone in your situation. Swab tests are ideal during a primary infection when someone hasn't yet developed antibodies that are detectable. For most people, a blood test at between 12-16 weeks is conclusive; you're at, well 10 years, so 520 weeks, which unless you're doing gubment math is conclusive.

 

You only had sex with one partner? There's a lot of folks in that club, and it's not uncommon. It happens, and can happen if you've had one or one hundred.

 

 

[riverstyx]

Thanks for the comments, I appreciate them. The only thing I am saying is that I might have oral hsv-2 *instead of* genital hsv-2. So that was the issue: I was confused about which one I had. If I have "just" oral hsv-2, I think that is something I can deal with. Genital hsv-2 just seems so unlikely at this point.

[HerryTheHerp]

I think you're confused. HSV2 is genital herpes. It doesn't matter if you have it on your pee pee or your lips. HSV2 is HSV2 regardless of where it is on your body.

 

 

[riverstyx]

Ok, so hsv-2, whether it occurs on the lips or on the genitals, is the same hsv-2. So my two different doctors don't think I have hsv-2 on my genital region. They think I have it on my lips only.

[HerryTheHerp]

HSV2 is the same, regardless of where on the body it presents itself. HSV2 prefers the genitals (hence the reason it's called genital herpes) and HSV1 prefers the mouth (hence the reason it's referred to as oral herpes). However, you can get either in either place.

 

You're right on the stats of HSV2 presenting orally being about 2%. Personally, I think that's a low number.

 

Why would your doctors think that? Have you had a swab done on an open blister on your lips? Honestly that's the only way to know whether you have HSV2 orally. So, the next time you have an OB, get into the doctor right away and get a swab test done and make sure they do an antibody specific test.

 

If you do, there's pros and cons. Pro: You won't have very many OBs because HSV1 and HSV2 tend to be quieter when they're out of their preferred regions (see above.) However, it also means you can, although rare, pass that to a partner via kissing, which would be a major bummer. Thus, if you do have HSV2 orally, you may want to move your disclosure discussion up to a point prior to any time you might want to go out and go smooching.

[riverstyx]

I see your point about disclosing an oral infection with hsv-2 to any future potential partners. To be honest, I hadn't thought of the possibility of it passing to them.

 

My doctors think it might be oral herpes mostly because of the stuff I was saying in my earlier posts, and on the basis of that they just don't think I have hsv2 in the genital region. But they have two lab reports saying that antibodies to hsv2 are in my blood, and so they need to make sense of those reports (although one of the doctors said of getting a second lab test done, that "more is not better"). Since an antibody test doesn't tell you *where* you have hsv2, only that you have it *somewhere*, they figured the next logical place for it to be located is in the mouth region. But I guess it's possible I could have it anywhere, although if you ask me, that would be pretty weird. Personally, I know that I had the shingles a few years back (was diagnosed by my doctor), which means I had the chicken pox when I was younger, and so I'm wondering if the antibodies to the chicken pox, increased to fight my shingles, might be throwing the tests off. I think it's a long shot.

 

Right, the ideal would be for them to take a swab of an open blister on my mouth to diagnose hsv2 orally, and they feel the same about diagnosing hsv2 genitally: the best would be to take a swab of a sore or blister in my genital region, but since I've no outbreaks, or at least, none that I could ever discern, they don't really have that option. So I'm kind of stuck in this no man's land between hsv2 oral and hsv2 genital. But yeah, now that I think about it, they really shouldn't just default to the explanation of the antibody tests as "oh well, that's just hsv2 orally." Seems kind of sloppy.

 

Either way, I know I wouldn't want to give this to any future partner, no matter where it is located, and no matter how small the risk, so I think disclosing is the best thing. Plus, I'll feel better about doing it. Starting off a relationship by lying isn't really the way to go.

[WCSDancer2010]

@Herry..

 

HSV2 is genital herpes

 

Uh my friend, have to correct you here. HSV2 is the variety ... if it's on the mouth, its ORAL HERPES .... The best way to classify each is by variety and then location (HSV2 Gentital, HSV1 Genital, etc) Back when we believed that H2 was ONLY found in the genital region, it was called Genital Herpes but now that we know better we have had to change how it's described/classified ... we HAVE to re-define them if we are going to get people educated that H1 can head south and on the rare occasion, H2 can head north ;)

 

@riverstyx

 

Your best bet if you want a definite answer of whether you have Herpes is to get the Western Blot test - the problem will be in getting a Dr and Lab to deal with it...but the info is below. It's the Gold Standard of testing and if it comes up positive, you have it...period. Now, WHERE you have it will be anyone's guess. Did you think to try to contact the past partner to see if she is H+?

 

"You can have your blood tested with a Western Blot at the University of Washington Virology Lab. To do this, have your health care provider call #206-598-6066 to request the HSV Type-Specific Serology information packet. "

www.depts.washington.edu/herpes

[VirusEnhanced]

Cases like these always interest me.

[riverstyx]

@WCSDancer2010

 

Yes, I contacted the University of Washington Department of Virology. They sent me a kit for the collection of a blood specimen that can be shipped to them overnight. They will perform the Western Blot on the blood sample. So I will definitely be sending it out soon.

 

I did contact my previous partner, and I told her about the positive tests, and frankly, she was shocked. She says she has always been "careful," and that, since she has an IUD, she regularly goes to her gynecologist for checkups. Whether those checkups include regular screening for genital herpes, is anyone's guess. I do know that standard STD panels do not usually screen for herpes unless you specifically ask for that test to be included. But I personally don't think it would be likely that she would've asked for herpes specifically or known that herpes tests are not typically included, since most people generally don't know this information.

 

But from the conversation I had with her, it seemed to me like she would make an appointment with her gynecologist to get checked, so hopefully when she does, that will shed some light on this.

[WCSDancer2010]

She says she has always been "careful

 

That comment always makes me laugh. People think they can "tell" if someone has an STD, or that if they ask the person they will tell the truth if they have one (IF they know they have it), and most people think condoms protect you from everything. The only way to be "careful" enough to avoid STD's is to remain celibate ;)

 

Yup - odds are she was never tested ... so you may want to ping her again and tell her that, and let her know that it will help you to know if she's H+ or not. But the WB will give a definite answer too..... so get onto that and let us know what the result is

 

Peace

[riverstyx]

WCSDancer2010:

 

I am definitely sending the Western Blot out shortly. I spoke to my ex and she said she has an appointment with her obgyn on June 9th. Personally, I don't think her test results will mean much, or allow me to resolve this, even if they do come back positive. She and I dated a long time ago, and she has....how should I say this....she has been in circulation with other partners for quite a while. So it is definitely possible she didn't have the virus while we were dating, but later ended up with the virus from one of her many other partners since we broke up. Although if she ever had any kind of symptoms "down there," she would've gotten tested for sure. I know that about her. But the fact that she has never had symptoms to speak of, plus the fact that women generally have symptoms more often and more severely than men, makes me think that she just might come up negative. In which case, I have a real mystery on my hands.

[Guest]

I'm sorry, but "she has been in circulation for quite a while"? That's the kind of mythology around this condition that perpetuates the stigma. HSV doesn't care if you're promiscuous or have had one partner. It doesn't care about your income, gender, education, where you live, nothing. Please don't lay this at the feet of your ex-girlfriend for having had more partners than you. I've had ~30 partners in 14 years, all exclusive when we were together, all tested. It was my last partner who didn't understand HSV testing and who insisted she had the test done who gave it to me. Does that put me in the same category as your ex-girlfriend? Because I've been extremely smart and safe about my sex life for over a third of my entire life, and I still managed to get HSV because someone else was poorly informed and insisted she knew what she was talking about. If you want to place blame, place it at the feet of the medical community and pharmaceutical industry. They are the ones permitting this scourge to continue through refusal to educate, test, and put enough money into researching treatments.

[riverstyx]

ThisIsMeNow

 

Excuse me, but I am not "placing blame." I am simply stating what happens to be established fact: the more partners you have, the more likely it is that you will test positive for herpes. ALL statistics on herpes acquisition demonstrate this. Yes, hsv can infect someone who has only had one partner, but people with genital herpes who've had only had one partner represent less than 2% of all cases of genital herpes. As the number of partners goes up, so too does the risk of acquiring genital herpes. This is basic, clear, unalterable fact. So no, someone who has had sex with one partner does not have the same risk as someone who has had 100 partners.

 

If you would have read my post more carefully, you would have noticed that I am not "laying this at the feet" of my ex-girlfriend. I am simply saying that, since she has been with other men since the time we were together, it is entirely possible that she will now test positive for hsv, even if she was negative at the time she and I were together: something which reflects basic scientific fact.

[riverstyx]

My ex texted me the other day, and said she has an appointment to see her ob/gyn on June 9th. I have a sinking feeling the results are going to come back positive, but like I said in earlier posts, this may not be the end of the story, since if her test does come back positive, this could mean that she contracted hsv-2 from one of the many partners she had with whom she didn't practice safe sex after me, even if she would've tested negative when she and I were together. Who knows.

 

It's all just so depressing. I wish I had never gotten a blood test in the first place. I wish I had read the Centers for Disease Control guidelines that recommend squarely against blood testing for herpes in the absence of symptoms. I spoke to my doctor, and he said that, regardless of what my ex's herpes test says, I will most likely have to get used to living with the uncertainty surrounding my diagnosis, unless and until I have an outbreak genitally, or somewhere else on my body, that can be swabbed for a viral culture, or tested by PCR. But, he said, since I haven't had any noticeable outbreak in the 10 YEARS since we were last together, and since I pay very close attention to my health (my family thinks I'm a hypochondriac), it is unlikely that I will have an outbreak anywhere on my body, anytime in the near-term future, or maybe even the long-term future as well. Is it a possibility that I have genital herpes? Yes, he said, and it will always be a possibility. Is it a possibility that I have herpes simplex, type 2 somewhere else on my body? Yes, that is also possible. We just don't know, and will likely never know.

 

 

 

 

 

[riverstyx]

And part of the reason this is so depressing is NOT KNOWING. I've become so accustomed to being able to find out anything I want by just typing a search into Google, that I'm just not equipped to deal with chronic, long-lasting uncertainty. I simply cannot believe---cannot believe---that in the absence of an actual outbreak, that there is not other means of bringing this to a definitive resolution.

[WCSDancer2010]

The Western Blot WILL give you a definitive result. It's the Gold Standard of Herpes tests. So get it done and put yourself out of your misery. ;)

[Guest]

The user and all related content has been deleted.

[riverstyx]

Actually ,I think this whole thing will come to a resolution sometime soon. Like I said, my ex is getting tested, and that should shed some light on things. I'm sending out the Western Blot tomorrow after I get the blood and physician requisition form, and that will be back in about 2-3 weeks, so that will definitely tell me whether I have it. And as much as I hate to admit it, if my ex tests positive, then that most likely means I have it genitally. I mean, yeah, it's possible that she got it after she was with me, but if the Western Blot tests positive and she comes back positive too, it just seems like two big pieces of the puzzle will have fallen into place. If she comes back negative, then I have something of a mystery on my hands. But ultimately, it is pretty likely that she will come back positive.

[riverstyx]

I mean, think about it: I've been deluding myself this whole time into thinking that, while I have hsv-2, I have it orally, not genitally. Now, just how likely is that? -Astonishingly *unlikely*. There is only one person I possibly could've gotten it from, and yes, she and I did everything but sleep together, but still, she never slept with anybody before, so the chances that she had it genitally are next to zero. That leaves kissing. I hear oral hsv-2 sheds around 1% of all days, which means that the chances that I received oral hsv-2 from her from kissing are likewise next to zero. *By far* the most plausible explanation is that I got normal hsv-2 from normal sexual contact. That's it. That's the end of the story.

[WCSDancer2010]

I've been deluding myself this whole time into thinking that, while I have hsv-2, I have it orally, not genitally.

 

Uh - ya think????? LOL

 

*By far* the most plausible explanation is that I got normal hsv-2 from normal sexual contact. That's it. That's the end of the story.

 

That's what we have been trying to tell you the whole time ;) Glad you are finally just accepting what's so ... so you can start to move forward in a *positive* way :)

 

(((HUGS)))

[riverstyx]

And like I said, the only hope is that my ex does not test positive for it. But the chance that she will test negative is basically zero. If she does test negative, then this is really something.

[riverstyx]

But to be honest, part of what was fueling the denial was that some pretty knowledgeable people around me didn't believe, and still don't believe, that I have it. So I was working against that all the time. My shrink doesn't believe I have it, and she keeps saying "I have no reason to think you have this." My DOCTOR doesn't think I have it, and I spoke to him twice. He told me to "forget about" the two positive tests and to "discard" them. My family doesn't think I have it, or at least, my parents don't think so. So, that had been giving me some false hope for a while, and plus things I looked up on the internet had helped some, but I now know that basically anything you want to find on the internet, you can, meaning that if you want to read something positive about your chances, then you can find something positive. If you want to read something negative, there will be negative things on the internet too. So you can't really count on it.

[riverstyx]

So I had some trouble trying to send the Western Blot out. While I got the requisition form just fine, I couldn't get any laboratory to draw my blood, spin it, and give the serum back to me. It really was frustrating. I didn't bother with Quest or Labcorp as I know they would never do that (and I confirmed that with both), but I also called a bunch of smaller, independent labs and they all said the same thing: no way, we don't draw blood for outside laboratories. Someone was nice enough to talk about it with me and said that my best bet would be to try some different hospitals that are nearby, that one of them would most likely be willing to do it for me. It was later in the day so I didn't get outpatient services at any of the other hospitals. But is that true? That hospitals are the ones most likely to help me out? I don't want to drive around tomorrow for nothing....

[WCSDancer2010]

Somehow I'm not surprised but what a pain in the arse. I have no idea if the hospitals will do it for you though.

 

Your other option is to contact UW and ask if they know a lab that will do it, or if they have any advice ... but you probably won't get anyone till Monday there.... :(