new herpes exposure

The last time I had a herpes panel was 11/2015 and it was negative. I slept with one person last year and did not have a problem. I am with a new partner now and we have been sexually active for about 6 months now. We have had unprotected sex in the past and have regular protected sex. We had unprotected sex again on August 9th which I started feeling pain and nausea the following few days. I was having back pain and had the chills so I went to the urgent care Aug 12th. I did a urine test and I tested positive for group b strep. I was given amox for 10 days. I started noticing blisters on my vagina then followed up with my obgyn on Aug 15h. I had a slight fever of 99.3, chills, swollen pelvic lymph nodes that hurt to the touch and burning since I had cuts, blisters, and ulcers. She did a culture on the sores and popped them. She also stated that i was positive fgor bacterial vaginosis and I had it for 3 weeks. Anyways, my culture came back positive for HSV2. She prescribed me aciclovir and zovirax cream to help and the sores went away by August 23rd but I still felt funny after but the dr did not see any visible sores. On the 23rd I did blood tests and these were my results: I have had 3 or 4 doctors confirm that I have recently been exposed to genital herpes and that this is a new infection. I have never had an outbreak before and my body reacted crazy to the exposure. I am a chronic hives patient since I was 8 years old so I know my body reacts quickly to foreign exposures. I just want to get an opinion from those who have herpes and medical experts what you think about my lab results.

HSV 1/2 AB (IGM), IFA W/RFL TO TITER

HSV 1 IGM SCREEN - Positive HSV 2 IGM SCREEN - Positive

HSV 1 IGM TITER >=1:320 HSV 2 IGM TITER >=1:320 (negative is <1:20)

HSV 1/2 IGG,TYPE SPECIFIC AB

HSV 1 IGG, TYPE SPECIFIC AB <0.90 HSV 2 IGG, TYPE SPECIFIC AB 5.05 H

Welcome, @helpme9876! Yes....negative for HSV1 and positive for HSV2, so you definitely have the latter. The IgM tests are notoriously inaccurate (sad that they're so commonly used) and their results should be ignored.

Keep in mind that the IgG blood test can miss nearly 10% of HSV1 infections. Oral HSV1 is extremely common, and the majority of adults have it, even if they never have a cold sore. You might retest again in a few months to see if you get the same negative results for HSV1. Did the doctor ever say what the results of the culture was? Mostly likely HSV2, but I'd still be curious to know if I were in your shoes.

@hikinggirl yes the culture was positive for hsv2. All 3 of my doctors told me that I recently was exposed to herpes and that this was my first outbreak since incubation period is normally within a week.

@hikingGirl my igm was also positive for hsv2.

P.S. I corrected my post above to say the IgG misses nearly 10% of HSV1 infections (not "nearly a third"). I went back to my source to confirm and apologize for the misinformation and confusion!

@hikingGirl no problem. I am going to go back in a few months to retest for hsv1. I am just confused bc my hsv2 is positive for both igm and igg.

The good news here is that there really isn't any confusion. The IgM test should be ignored (it's a crappy, inaccurate test which many doctors are still using because they're not well educated about HSV--not because the test has some value), and the IgG is positive.

@hikingGirl ok thanks, well do my flu-like symptoms and swollen glands indicate new infection ?

Your IgG was positive which *typically* points to an infection that isn't so new, HOWEVER some people do start to produce antibodies to the virus more quickly than others and since your blood work was 2 weeks after the encounter you describe it is *possible* that this is a brand new infection. You could have also acquired it during a time when you had protected sex as condoms don't protect form HSV 100%. Your partner could very well carry the virus asymptomatically and have no idea that he has it. Most typical STI panels don't include HSV so even if he was tested he may not have know HSV wasn't included and assumed he was tested for everything. But as HikingGirl said, IgM is not a test to pay much attention to as it isn't reliable, which most doctors aren't well educated about when it comes to testing for HSV

@ash2018 ok thanks, well do my flu-like symptoms and swollen glands indicate new exposure/infection ? I mean my glands hurt so bad and I had the chills

I don't think they always do, the reason being that my first outbreak was in the beginning of June which my swab came back positive for HSV1. My blood IgG for HSV1 was over 9, I forget the exact number. Meaning it wasn't a new infection, just the first outbreak, but I had a swollen lymph node in my groin. That's what really put in my mind that it could be HSV. I'm engaged and have been in the relationship for over two years so it was quite a shock. But, those are pretty classic initial outbreak symptoms so its hard to say. These viruses are so complicated

I've seen someone ask Terri Warren (a clinician who specializes in herpes) if it's possible to build to an antibody level of 5+ within two weeks. She said no, that would indicate an older infection. How much older, I don't know, but older than two weeks. I think it's more likely your immune system was low from an unrelated condition and that prompted your body to express symptoms.

A negative test result in 11/15 would suggest you were negative through at least 7/15, so I'd guess you contracted this sometime between 8/15 and maybe 6/17? This is just a guess based on your testing history and most recent antibody levels. I'm not a medical professional.

In the end, it's important to note that HSV2 is very common. Most people who have it are unaware and therefore unable to give partners a heads-up, so it's difficult to avoid.

@optimist yeah i saw a post from @gracefromhhp and she wrote that half of herpes patients will come back positive at two weeks. I mean I have been with him for 6 months so who knows.

Some do come back positive early, but I was referring specifically to the antibody level of 5+ which would take more than 2 weeks to reach, according to Teri Warren. I thought you were trying to determine whether the encounter you mentioned that was 2 weeks prior to testing was when you became infected. But yes, it could absolutely fit within the timeline of your current 6 month relationship.

@optimist thanks. I would also like to point out that I have never had bacterial vaginosis test come back positive.. ever.