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xyz - 22 Oct 2003 21:31 GMT

I don't know if I have herpes, but it's looking like I might.

My wife and I recently thought perhaps we were in love enough and happy
enough that we could have open relationships, just for fun. The terms were
that we would always be 100% honest about anything we planned to do or did.
As far as I knew, my wife had not done anything with anyone. Then she went
to a clinic for "irritation" near her genital area. That was a week from
last Friday.

Today, she was told that she tested positive for herpes. They explained
there are two tests, one that will test positive for short-term infections,
and one that tests positive usually after long-term infection. She barely
made the cut on the short term test; the doctor said she was some
hundredths of a percent over the cutoff. The amount was also too small to
accurately type the virus. Nevertheless, it looks like she's got it.

Because the amount was so small, it seems probable that she was only
infected a short time ago. The only person she had had recent intercourse
with was another man. He used a condom, but we now know that that isn't
always enough. He also claimed to have been tested clean, but we don't know
if that's true or how recently it was.

And so here I am. I don't know if I'm infected, and probably won't for a
while. I've had HSV-1 via cold sores for as long as I can remember, but my
wife and I had not had oral-genital contact for a good couple months before
she was tested. I could be clear, or not.

So I have questions, perhaps too specific for any of the web sites I
visited. I don't have anyone else to talk to about this besides my wife, so
bear with me. The endless void that is usenet can be my proverbial
shoulder.

1. If she was only recently infected and was not having any outbreaks when
we had intercourse this past weekend, does it reduce my chance of having
contracted whichever HSV she picked up? We don't know if she was/has been
shedding, but the level of viruses might seem to reduce my risk.
2. Is it really true that millions of Americans have genital herpes, and
that a large portion of them do not know it? I have seen numbers as high as
50 million, and it just boggles the mind.

My other questions I'll probably have to answer myself. I'm living with
someone I've lived with and loved for 5 years, who just had extramarital
relations behind my back and may have infected me with genital herpes. I've
obviously got a long road ahead of me.

Thanks in advance for any assistance you can offer. If someone wants to grab
a beer in the Minneapolis area, I'd be willing. God knows I could use it.

- X

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Tim Fitzmaurice - 22 Oct 2003 23:00 GMT

> Today, she was told that she tested positive for herpes. They explained
> there are two tests, one that will test positive for short-term infections,
> and one that tests positive usually after long-term infection. She barely

Thats a split between IgM and IgG subtypes fo antibody usually.

> made the cut on the short term test; the doctor said she was some
> hundredths of a percent over the cutoff. The amount was also too small to
> accurately type the virus.

IgM is crossreactive as all anything. That's its job after all. Barely IgM
positive and no IgG....could be HSV1 still. Be useful to find out exactly
what test was done and what it could detect. But yes it does seem to
indicate recent - you might consider testing later to make sure the just
coming positive result really was once the full response has built up

> with was another man. He used a condom, but we now know that that isn't
> always enough. He also claimed to have been tested clean, but we don't
> know if that's true or how recently it was.

Probably was....it gets mentioned here a lot but HSV doesn't often get
covered in the 'full STD screen'

> I've had HSV-1 via cold sores for as long as I can remember, but my
> wife and I had not had oral-genital contact for a good couple months

Without knowing the type then its difficult to guess on this sort of thing
and what went where or how.

> 1. If she was only recently infected and was not having any outbreaks
> we had intercourse this past weekend, does it reduce my chance of
> contracted whichever HSV she picked up? We don't know if she
> was/has been shedding, but the level of viruses might seem to reduce

Avoiding outbreak would lower the potential exposure and so the risk - but
it won't eliminate it...however outside of outbreaks this thing is a bit
like pregnancy, while it can happen on the first go it usually takes a
number of exposures for all the right conditions to meet, hence the
typically quoted chances of transfer per year which is in the range of a
few percent for HSV2. HSv1 gets more complicated and les hard on the data.

> 2. Is it really true that millions of Americans have genital herpes,

Well they have HSV2. Genital herpes describes a disease outbreak that can
be caused by more than one virus so once you step outside of the HSV2 data
it gets slightly more difficult to tell....bloodtests tell you infection
but not location. With HSV2 you can reasonably use that as a guide for
genital infection, not so with HSV1.

> that a large portion of them do not know it? I have seen

About 80% don;t know based on the NHANES survey. THis is a feature of both
simplex viruses. Most people don;t get disease - but they do shed.

numbers as high as > 50 million, and it just boggles the mind.

Well that NHANES said 21% of the USA population carries HSV2 - thats
50million or so yes. Add to the 70% of adults with HSV1 and you have a lot
of potential exposure. About 1/3 of genital herpes cases presented at
clinics (ie disease outbreaks) are HSV1 these days in the USA.

HSV1 and 2 are very well evolved parasites.

Tim
--
When playing rugby, its not the winning that counts, but the taking apart
ICQ: 5178568

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suidaeh@yahoo.com - 23 Oct 2003 02:17 GMT

We're not positive what tests were done...it's all a bit of a blur. It
sounds like, from the broken details my wife has given me, that they did a
blood test and a cell culture.

From what you said, and from what I've read since, it sounds like IgM is the
early riser and IgG doesn't show until later. If that's the case, she
probably tested slightly positive for IgM and no IgG. She also thinks they
said the cell culture came up negative. She's going to check back in
another month for another round of tests.

Also from my reading, it sounds like a high IgM might not be a perfect
indicator. If I had the exact number, I'd give it to you. Is it possible
for her to have a high IgM from something else, or just a high normal level
of IgM?

So maybe I'm just being too logical, but I'll throw the following guesses
out there:

1. It's probably not oral HSV-2. Everything I've seen has said that's pretty
rare anyway, and she hasn't done anything oral with anyone recently.
2. It could be genital HSV-2. She would probably have picked it up from the
other fella, however, since from what I hear it's not terribly common to
have oral HSV-1 (which I've had for years) as well as genital HSV-2 (so I'd
be less likely to HSV-2). Of course it happens, but it reduces the
likelyhood it was me.
3. It could be oral HSV-1. If she picked up oral HSV-1 recently for the
first time, that could show up on the blood test, yes? Would a more
conclusive result be returned by doing a saliva culture along with the next
round of tests? She could have picked that up anywhere, from me or the
other fella.
4. It could be genital HSV-1. Again, this could be from either of us. From
what I've heard, it's less likely to recur and less likely to shed than
genital HSV-2, but it's still there. I've always been over-paranoid about
even kissing when I've got a cold sore, so I'm guessing (hoping) if this is
it, it wasn't from me
5. Could it be an anomaly? The physician didn't seem to think that the
results could be off, but also was very nonchalant about the whole deal.
Perhaps that's how they're trained to act...perhaps it really isn't a big
deal. I don't know. At any rate, it's such a low positive, we don't know
what to think.

I'm a paranoid by nature. This kind of logical babble is the only thing that
ever lets me sleep at night.

I appreciate your help.

- X

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Grant - 23 Oct 2003 11:05 GMT

Well, just because you need to be able to sleep at night.. :)

Keep reading below for my comments:

> 1. It's probably not oral HSV-2. Everything I've seen has said that's pretty
> rare anyway, and she hasn't done anything oral with anyone recently.

I would suggest not worrying about where and when she picked it up. These
Elisa tests can be really a pain to figure out. I suggest getting the
Herpes Specific Western Blot test. We can help you with specifics. If it
is done before 12 weeks of infection, she may test negative. Having another
test run after 16 weeks of infection will tell you both for certain what she
has. Just not where she has it.

Yes, it's rare to have type 2 orally. But it does still happen.

>2. could be genital HSV-2. She would probably have picked it up from the
> other fella, however, since from what I hear it's not terribly common to
> have oral HSV-1 (which I've had for years) as well as genital HSV-2 (so I'd
> be less likely to HSV-2). Of course it happens, but it reduces the
> likelyhood it was me.

Nothing reduces the likelihood that it was you except for a blood test
saying that you are negative. People can carry the HSV virus for years
without ever having an outbreak.
Lots of people have both type 1 and 2 so really don't believe that type 1
protects you from getting type 2.

> 3. It could be oral HSV-1. If she picked up oral HSV-1 recently for the
> first time, that could show up on the blood test, yes? Would a more
> conclusive result be returned by doing a saliva culture along with the next
> round of tests? She could have picked that up anywhere, from me or the
> other fella.

Saliva cultures won't do you any good. The virus doesn't live in saliva.

> 4. It could be genital HSV-1. Again, this could be from either of us. From
> what I've heard, it's less likely to recur and less likely to shed than
> genital HSV-2, but it's still there. I've always been over-paranoid about
> even kissing when I've got a cold sore, so I'm guessing (hoping) if this is
> it, it wasn't from me

You'll never know for sure if she tests positive for type 1. Type 1
genitally can be just as awful as type 2 for the first few years. But the
long - term effects are better.

> 5. Could it be an anomaly? The physician didn't seem to think that the
> results could be off, but also was very nonchalant about the whole deal.
> Perhaps that's how they're trained to act...perhaps it really isn't a big
> deal. I don't know. At any rate, it's such a low positive, we don't know
> what to think.

And that's why we just don't like the Elisa tests. The Herpes Specific
Western Blot is the gold standard yet many doctors don't know anything about
it. It will tell you for sure AFTER infection has been in the body for 12 -
16 weeks. An early negative test and a positive later test will tell you
that it was a new infection.

Take care,
ar

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M.L.S. - 24 Oct 2003 01:24 GMT

<snip>

>5. Could it be an anomaly? The physician didn't seem to think that the
>results could be off, but also was very nonchalant about the whole deal.
>Perhaps that's how they're trained to act...perhaps it really isn't a big
>deal. I don't know. At any rate, it's such a low positive, we don't know
>what to think.

From all you've said it doesn't sound like an anomaly to me. There
was the extracurricular sex, there was the "irritation", there was the
test result. But yes, despite the thoughts running through your head
now, it really isn't that big a deal. The few doctors I've talked to
about herpes have been very nonchalant, too, and I bet just as many
doctors as other people have the thing, too.

You could wait a few weeks, give the body time to adjust itself to
whatever is going on with, more time to build (or not) more
anti-herpes antibodies, and have another test, but in the meantime you
sort of have to believe that your partner has herpes.

Of course, you may be one of the many millions yourself, who have it
(and just don't realize it because the virus hasn't announced itself
to you). It's not a very exclusive club, I'm afraid, and flashing
your membership card won't entitle you to any privileges or benefits,
but you can still become a valued, productive member of society, if
you so desire. ;-)

Take care,

Mike

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