Index Values Must Mean Something / Oral HSV2?? No symptoms downstairs

[DazedandKonfused]

My IGG Index was 12.80 for HSV2. HSV1 IGG was less than O.91. Then my HSV1/HSV2 Comb was 2.85. If the index values mean nothing then why is there an index to begin with? So if someone has an IGG index value that's considered in the "negative"range does that mean that person had absolutely no antibodies to either HSV 1 / 2? Obviously the value is picking up something. I was just diagnosed with HSV2 I felt like my doctor just gave me the news and walked away. No in depth conversation about what to do next. Most of the information I know I've Googled. I had no clue I had HSV2. None. I'm 33. I've never had something on my genitals that looked anything like what the internet shows. After my diagnosis I did have a small rash on my cheek that my dermatologist gave me a topical for and my lips had a small rash that was barely noticeable and I now have fordyce bumps around my lips and I had tingling all over my body but the sensation was very very persistent around and on my mouth. I've actually had that small rash on my lips previously and that spot on my cheek appear a few times in the past, but when I've Googled Oral hsv2 there's nothing there...it basically doesn't exist. My gynecologist told me that I'd experience tingling in the area that I was exposed to the virus.... never had tingling in my genitals. I'm married, been with my husband for 12 years, he hasn't been tested yet but if he comes back positive then I'm almost certain that I have oral hsv2. My index value supposedly means my exposure is not recent so what if those symptoms are my bodies way of either having prodrome or an outbreak? Was my rash just anxiety because I was and have been so stressed out? Then my gynecologist told me she would only give me meds if I get an outbreak bc the meds are tough on your liver. But what about the prodrome stage? Do the meds work for that? Anyone else only have hsv2 and oral symptoms?

[optimist]

It's very complicated for the following reasons:

 

- A very small percentage of HSV2 cases *are* indeed oral. In these cases, if there is an initial outbreak, that's usually the only outbreak that ever occurs and it looks just like oral HSV1. Oral HSV2 tends not to recur and sheds virus very rarely, much less often than oral HSV1. So if you have recurring oral symptoms, much less likely to be HSV2. If you ever have symptoms again, perhaps you can request a swab test to confirm, if that matters to you. The good news is that oral HSV2 largely protects against contracting oral HSV1 and genital HSV1 and genital HSV2.

- While IgG tests are good at identifying HSV2 (95% of people test positive after 12 weeks), they are not so great at picking up cases of HSV1. 70% of infections are picked up while 30% return a false positive.

- Most people with HSV2 do not have recognizable symptoms. A minority (10-20%) have obvious symptoms and the rest are asymptomatic or have symptoms so mild they don't notice them or mistake them for something else. This is even more likely if someone has contracted HSV1 before contracting HSV2. The body tends to react more strongly to the first HSV infection contracted which is more often HSV1. The photos on the Internet are misleading in that a minority of people experience that type of outbreak, and those who do have severe primary outbreaks typically only experience that type of outbreak once and then may or may not have recurrences, almost always less severe than a primary outbreak. Think in terms of how you have seen cold sores present and it's the same thing. Maybe you know one or two people who get lots of cold sores at once or frequent sores, but most people get a tiny sore once in a while, or maybe they haven't had one in years. Same deal with genital herpes. And many people with HSV1 and HSV2 get no sores at all.

 

The doc may be acting in a dismissive way because about 80% of women your age have HSV, including about a 1/3 with HSV2, yet it's usually only a medical concern for the minority who have significant symptoms. Some people also struggle with the stigma but doctors are sometimes not attuned to this aspect and maybe even less so if a patient is already partnered.

 

So maybe you have oral HSV2, or maybe you have asymptomatic genital HSV2 which would be more common. And maybe you even have oral HSV1 but are among the 30% who test false negative. If you feel a need to know, you might want to look into a Western Blot test which is more sensitive. But you might want to first talk to your husband about what these various test results will mean for you both. Maybe they won't mean anything and you will continue the same as before. If so, maybe it's unnecessary to escalate to swabbing and Western Blots. I don't know, just something to think about.

 

[DazedandKonfused]

Thanks so much for your response. I really appreciate it. I've told my husband of my diagnosis and he's just fine with it, I'm the one still shell shocked. I'm just feeling like I don't know enough and that's causing my anxiety. I just need to stay off Google because I've literally read every website that has any information on herpes and I'm still left with just the same questions. I truly won't know unless I have a blister pop up and get it swabbed. My husband is going for testing tomorrow and I hope he is negative but if he is positive this will reduce my anxiety by more than half. I'm just afraid I have some other underlying issue caused by the virus or that I'm in a constant state of prodrome and won't know and potentially infect our children.