Just had a STD Panel blood test. My results are confusing

[curtinmd]

Just had a STD Panel blood test.  My Herpes I Ab.(IgG) came back with a normal result of 0.17. Anything below .90 is negative the way I understand it.  My Herpes II Ab.(IgG) came back as 4.08 High.

These results confuse me.  I have never had a genital outbreak that I am aware of.  I have had cold sores on very rare occasions a long time ago. (Years ago).

Ive read a 4.08 reading is considered a "low positive" result.  So does that mean there is a good chance the test is incorrect?

These results are confusing because i would think they would be the opposite.  Since I have had what I assume are cold sores on rare occasions I would assume i would be positive for Herpes 1.  But its negative.  And im positive for Herpes 2 but have had no symptoms down there.  So does this mean I have Herpes 2 in the oral area and not the gential area?

Thank you

[auntiejessi]

The hsv1 IgG misses about 30% of hsv1 infections. If you're sure what you've had are cold sores, you can assume you have hsv1, and it missed your infection.

You can have oral hsv2, but it's rare, and when it happens, it typically doesn't recur.

The only way to know for sure is to get an oral sore cultured and typed to see what it is. A blood test can't tell you where you have hsv1 or hsv2.

Typically, if you have hsv1 already, it can make hsv2 milder, so you don't have symptoms, or have really mild symptoms you wouldn't likely attribute to herpes. A 4.08 isn't low enough to need a confirmation test, but if you want to confirm if you have hsv1, you can get a Western Blot test, and at the same time, do a WB hsv2 test.

Your doctor can order this test, or you can go through Terri Warren at the Westover Heights Clinic, but you'll have to self-pay. https://westoverheights.com/getting-a-herpes-western-blot/

There's no right or wrong decision. You have to do what you feel comfortable with. If you don't get oral sores frequently enough that you can get an answer soon, a WB might be a good idea for you.

[curtinmd]

Thanks for your comments.  Does the 4.08 HSV 2 number give an indication of how long ago i was infected?  Im 42 years old now and was pretty sexually active in my mid to late 20's.  So does this reading give me an indication whether I was infected decades ago or a year ago for example?

Is is a good idea to get on the suppressive medication Valtrex if i have never had symptoms and was infected years ago?  What are the odds that I will never get any symptoms?  If the odds are high not sure it would make sense to go on suppressive therapy.  Thoughts?

[auntiejessi]

No, the number doesn't indicate anything except that you have it. It can take up to 4 months to develop antibodies, which is what the test detects, but some people can as soon as a few weeks. All we know from the test is that you've had it at least a few weeks.

It won't tell you how infectious you are, how many outbreaks you'll have, or won't have, etc.

We do know that people without symptoms are still shedding the virus at the same rate as those who have symptoms. If you are concerned about transmission, suppression might be a good idea for you. If this isn't a concern for you, there's no reason to go on suppression if you aren't having outbreaks, and there's no reason to suspect you'll suddenly start to get them.

If for some reason you do start to get outbreaks, you can go on Valtrex at any time. Some reasons you may start to get outbreaks are stress, other illnesses, serious fatigue, etc. Your body is doing a great job of controlling it now, so unless something happens, I would expect it to continue.