Questions on blood work results and next steps...

Hi everyone,

Thank you all for your contributions here. I can’t describe how helpful it has been to read many of these posts to get a better understanding of H.

A quick background on my situation. Low 30s male and I’ve been hooking up with this girl for the last 3-4 months who had disclosed to me before we ever got intimate that she has HSV-2 and had likely been infected at least a few years ago. She has never had any visible outbreaks or symptoms (so assuming it’s genital) and is taking Valtrex daily. I enjoy being with her and so figured that it was worth the risk based on everything I’ve read (suppressant + condom + no sex during any outbreak reduces the risk meaningfully even if not 0). I had gotten tested earlier this summer, came out IGG negative and we've had sex a total of 4-5 times.

About 2 weeks ago, I noticed a pimple and a little redness on my penis and wanted to get confirmation. Early last week, I got blood work (should have gotten a swab which was stupid of me) and received the result on Friday that I was 1.6 IGG HSV2. Just in time for me to freak out all weekend. Outside of the pimpled, I’ve had 0 symptoms.

Earlier this week (6 days between the two tests), I went to a different location to get re-tested with blood and swab. I know there is a chance of a false positive between a 1.1 and 3.5 reading and so needed to put my mind at ease. Since then, the swab has come back negative and new IGG for HSV2 came out to 0.063. I guess it is a relief but still, just beyond confused.

The first location (a doctor’s office) sends the blood work to Enzo labs and the H testing is done by Labcorp. The second location (dermatologist) uses ELISA Reagent and runs the test in-house.

I am very confused and do not know what to think anymore in the event the first reading was accurate, making my anxiety worse. Also it is worth noting that the doctor (a dermatologist!!) at the second location shocked me when he said 1) even with positive 1.6 reading, it does not mean I have HSV2, it just means I’ve been exposed to it, 2) I would not need to disclose to anyone about my 1.6 IGG until I have an outbreak, and 3) you do not have H for sure until you actually have an outbreak. I was flabbergasted to hear a doctor say this. Like seriously?!

I guess my questions are:

• Within a 6-day window of taking a test, should one expect to see results with such a large difference? The weekend before my first test, I was doing a lot of partying so was not sure if a slightly compromised immune system may affect the results one way or the other.

• Is the ELISA Reagent a good quality test (I know Western Blot is “gold standard) or is it less able to detect certain levels of antibodies than what they would be using at Lab Corp? (I’ve read through this forum that the ELISA test is actually better than the Western Blot at detecting antibodies earlier on, but again, was not sure if the quality of the test is as good as a Labcorp).

• Should I wait another 4-6 weeks and get retested to be sure? It’s all I think about these days and I find it hard to have to wait another 3 months…

• Should she not perform unprotected oral sex on me since I do not know for sure that she has HSV2 genital and in the small off chance she has it orally?

• Should I hold off on being intimate with anyone else for 1-2 months until I have more concrete results? My biggest concern if I do have H is not about me, but more about the risk of passing it on to anyone else in the future as I would feel understandably horrible.

Finally, I have ordered Terri Warren’s book (The Good News About the Bad News). Regardless of my diagnosis, I want to be as educated on the topic as I can as it still shocks me that medical professionals are so out to lunch on Herpes.

Thank you in advance to anyone who has advice/suggestions on my questions/situation.

Hi, @helloholabonjour. I think you’ll enjoy Warren’s book. It’s thorough, straightforward, and really informative.

In response to your questions and to the best of my knowledge....

1. Maybe, maybe not.....everyone is different. Virtually no one gets a zero on the IgG just because of the way the test is run (that’s explained better in Warren’s book).

2. Yes, the ELISA is a good test.

3. Yes, wait a couple of months and retest. I know it’s excruciating not to know, but try to keep in mind that a red pimple on your penis does not always equal herpes. There are a million things that cause skin inflammation. FWIW, most cases of herpes transmission happen within the first three months of a relationship.

4. That’s a judgement call only you can make. Personally speaking, if you want to continue seeing this girl, I say enjoy the oral. Transmission of oral HSV2 to the genitals is very rare. You’ll learn more in the book, but the majority of adults in this country have oral HSV1, which is far more likely to be transmitted to the genitals, yet no one is stopping the action to ask, “Hey, have you ever had cold sores or been tested for HSV1?”

5. Again, only you can answer this one. In reading your post and seeing how concerned you are, perhaps it would help to ask yourself what you would want if you were the “anyone else.”

No matter how it pans out, I think it’s really awesome that you’re willing to get educated about herpes so that you can make better decisions in the future about what kinds of risks you’re willing to take (or not take).