HSV2 positive and paranoia

Hello,

Thank you for choosing DoctorSpring.

May I know why was the test done in first place ?
Do you have a history of un protected sexual intercourse ?
Also do happen to know what kind of test was it ?

This information will help me in forming a solid and learned opinion.
You can reply as a followup
Thank you

Absolutely. The test was taken 1 week ago, because 2 weeks prior (1/4) I had a high risk sexual encounter with a stranger while on vacation. The condom broke, and we did not stop. I took the test for peace of mind, though showed no symptoms. The doctor specified that the virus identified could not have been received within the last 3 months.

I do have a history of unprotected heterosexual sex. I was in a committed relationship for 3 years, we had regular unprotected sex. When she saw her gynecologist in December 2012, she didn't test positive for anything. Since we parted ways, I've had unprotected sex with 2 people, one of which is the above case. Prior to my long term relationship, I had unprotected sex with 3 other individuals dating back to the beginning of my sexual activity (about 8 years). Never have I experienced symptoms of any STI.

I'm not sure specifically what the test was, but it was an STD Panel. They took 1 vile of blood, tested for all possible viruses and bacteria, and told me to come back in 1 week. That was today. I tested negative for everything except HSV-2.

The reason to my question is there is a chance my ex-girlfriend and I get back together, and I would never want to put her at risk. In addition to my question, would you please let me know if you agree/disagree with any of the claims made by my doctor (understanding you didn't see the test, but you are an expert vs a generalist).

Hello,

Thank you for the additional information.

Let me put down my thoughts as a list for clarity.

1. The HSV - 2 test is not done routinely (as screening test). So first step make sure (and probably discuss with your Doctor) that the tests is Type Specific Test (the test that can differentiate between HSV 1 and HSV 2)

2. If the test indeed was a Type specific, approved and a standard test - still there is 4% chance that the test was false positive.

3. So I would recommend a repeat testing after 1 month

4. Before repeat testing a clinical examination of your genital area has to be done . IF there is any suspicious lesion a PCR test can be done.

--

5. In case if your diagnosis is confirmed - you will be having what is known as an asymptomatic HSV 2 or Genital herpes . Even though there are no symptoms , an individual can shed the virus and infect the partner , unfortunately (unlike what your Doctor told you).

6. So if the diagnosis is confirmed you should consider informing this to your partner. There are methods like using Condoms, anti viral medications etc which can prevent the transmission to your partner . But this may be practical at all times.

7. I understand this can be overwhelming and frustrating. But you should know that 20-30% adults can have HSV 2 positivity. It is just that communication to your partner that is very challenging. There is a very good chance that you will never manifest any symptoms and live a trouble free life. Even if outbreaks occur there are simple and effective medications.

So to conclude : -
A diagnosis of HSV 2 is a lifelong diagnosis. So it has to be confirmed. I recommend getting in touch with a STD / ID specialist who can choose a correct test for you and followup it up.

Hope this helps
Feel free to ask followups
Thank you

Got it. Unfortunate, but thank you. I'm extraordinarily bothered that my doctor said I cannot pass this without symptoms, and even more bothered that he doesn't encourage testing patients unless they are showing symptoms, "because 40% of people live with this but are unaffected and do not affect others". Disturbing that he's either uninformed or careless.

Follow up questions:

1.et's say the virus is shed from me to someone else. Will they show symptoms? That is, is the asymptomatic virus I have a characteristic of the strain of the virus, or, is it a characteristic of my body's response and immune system?

2. Is there any progress in research for a permanent cure?

3. Do you have any recommendations for how to find an in-network STD specialist?

4. One day I will get married. Does this mean unless my wife is willing to potentially contract the virus, we will have to permanently wear condoms?

5. I read intercourse with and HSV2 carrier while pregnant in the 3rd trrimester can risk the baby's life. Is this true, even in the a symptomatic case?

6. Is there an accurate figure/percentage of a symptomatic carriers who shed? Or a percent of times the carrier sheds after x sexual relations?

Obviously questions 4 and 5 are much longer term... I just want to have data when I have the conversation with my partner after being tested again in a month (do I need to wait another month?). Thanks in advance.

1. The asymptomatic nature is part a character and small part the result of your immune system. So if the virus she to someone else - she /he can manifest the disease or more likely not manifest it.

2. Yes there is active research.

3. Sorry, not much information here. But HSV is a common disease . You can opt to consult a Infectious Disease / STD Doctor in your locality

4. Yes - ofcourse permanent condom is an option always. First of you need to confirm the diagnosis. So if you indeed have the infection there is high chance you will remain symptom free for like , and your partner .

5. Yes . It is better to avoid sex in third trimester.

6. There is no accurate figure here. (there are some date from observational studies, but not reliable ) But asymptomatic carries do shed as evidence by partners developing HSV2 infection.

Do get a confirmatory testing and then only need to inform your partner. I would also recommend a HIV test also. Do not worry, as it is not dangerous as it sounds. In worst case if there is an outbreak it can be well contained. And most likely you will never have an outbreak. Do get a confirmation test anyway.

Hope this helps
Feel free to

Thank you for all your help.

1. If I did receive an outbreak, would the location of this be indicative of the location of an original infection? Or can the outbreak happen anywhere on the genitals?

2. Is it true that severity of outbreaks decreases with time?

3. How soon do you recommend I have a follow up test, and are there any specific tests you recommend?

4. Because of having HSV, does this make me more prone to catching HIV?

Here are the answers :

1. No specific location.
2. Yes severity may decrease over the time. But this is not the rule always
3. You can get a repeat HSV (Type specific antibody test) in 4 weeks. Westernblot is the 100% confirmatory test, but it is not available everywhere. Alternatively if there is a genital lesion you can go for a PCR test. Your Doctor will be the best person to decide on this depending on availably and clinical features
4. HSV mainly occurs from unprotected sexual intercourse. So does HIV and naturally there is an increased risk. So it is better to get tested.

Hope this helps
Thank you