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Who Gave What to Whom?

By Terri Warren, RNAugust 14, 2008
From the WebMD Archives

I very frequently see a patient who has had only one partner for a long time, and they have newly diagnosed genital herpes. Their first question is, “Has my partner been cheating on me?” They often have read somewhere on the internet that symptoms show up within 2-10 days of new infection, and they KNOW they’ve never had these symptoms before so this must be new!

But the reality is, 90% of those with HSV 2 infection don’t know it, so most people completely miss their first infection. Many times, new symptoms aren’t new infection, but infection that’s been there for years and symptoms are just newly recognized, not newly present.

Do you see the difference there? A person could have genital herpes for 40 years and never know it, and then, for some reason, the symptoms become noticeable, and they immediately blame their current partner for infecting them.

So if you have new genital herpes symptoms, there are some ways to sort it all out.

If you have a positive swab test from a lesion for HSV 2, for example, and you have a negative HSV 2 IgG antibody test, then you have new HSV 2 infection – you have virus present on your skin, but not enough time has passed for you to have made antibody.

If you have a positive swab test from a lesion, and a positive HSV 2 antibody test, you’ve been infected sometime in the past. However, if you wait 3 weeks from the first time you notice the sore until you get a blood test, you could have made antibody during the 3 week period, so it could get confusing. But if you have an antibody test right away when you notice the sore, and it is positive, then it is very likely an old infection.

If all you get is an antibody test, make sure it is an IgG test. If it is positive (at greater than 3.5), then you have old infection.

If your partner gets an antibody test, and they are negative for HSV 2 and you are positive for HSV 2 on an IgG antibody test, then you didn’t get it from them.

If your partner gets an antibody test and they are positive for HSV 2 and you are negative for HSV 2, then they didn’t get it from you.

There are many possibilities, and you may need help sorting out the combinations and permutations of antibody and swab testing, but I hope this helps a little.

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