Dr. V. Srikanth Reddy
Dermatology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I am reaching out regarding a situation last year when I developed a small genital ulcer and was diagnosed with genital herpes after consulting multiple doctors who held differing opinions. Alongside this, I experienced swollen lymph nodes. I underwent both blood (IgG and IgM) and swab tests at that time. The blood tests were negative for HSV-1 and HSV-2 (presumably due to recent exposure), but the swab/PCR returned positive for HSV-2.
I had my boyfriend tested, revealing HSV-1 IgG levels of 27.3 and HSV-2 IgG of 3.73, both positive, with the HSV-2 level relatively low. His IgM levels were negative. I started a daily Valtrex regimen and believed I had two subsequent outbreaks. I tested both times (blood and swab), with all results returning negative except for Mono, which showed positive in the IgG test conducted four months back. My most recent herpes test this week indicates IgG levels of 1 for HSV-1 (borderline negative) and completely negative for HSV-2 (below 0.5).
I am curious to know if you think there might have been a misdiagnosis, and if my boyfriend's HSV-2 result could be a false positive given his known HSV-1 oral status. Additionally, could mono have contributed to a genital lesion? Please clarify.
Thank you.
Hello,
Welcome to icliniq.com.
Once HSV-1 (herpes simplex virus) IgG antibodies are detected in the blood, they persist, signaling a prior herpes infection. There is a chance of HSV-1 causing genital herpes, especially through activities like oral sex. When you are not experiencing active lesions, continuous Valacyclovir usage may not be necessary. Suppressive therapy is typically recommended when you have more than 8 episodes per year. It is important not to let stress overwhelm you; maintaining a healthy lifestyle can help manage herpes effectively.
Feel free to contact me for any additional queries.
Thank you.
Patient's Query
Hello doctor,
I apologize for any confusion. My inquiry was specifically related to HSV-2, not HSV-1. Could you please revisit my initial question?
Thank you.
Hello,
Welcome back to icliniq.com.
I would like to clarify that typically, HSV-1 causes oral herpes, and HSV-2 leads to genital herpes. However, there are instances where the roles can be reversed. In your recent report, the borderline positive result for HSV-1 suggests an infection may have occurred through alternative routes, possibly from your boyfriend. Regarding your boyfriend's HSV-2 result, there is a possibility it could be a false positive.
I hope this provides clarity. If you have further questions, feel free to ask.
Thank you.
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