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How Is HSV Transmitted?

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Posted on Tue, 26 Aug 2014
Question: I just wanted to start off saying that I have been worrying my self so much that I have given myself anxiety over this for a year now. So It all started when my ex boyfriend told me he caught something from me last may. He told me he had chylmedia. I had no symptoms of that but I still wanted to go get checked. I came back negative for every std. I didnt stop there. I kept going to the doctor every two weeks for three months to get blood work down etc. They all came back negative. I let it go but wanted to just see one more time. I went in October 10 (Last time i went was august 8 and those results were negative) and my test results came back Positive HSV 1 iGg(positive) IGm Positive. I am STILL freaking out and the doctors i have haven't really been informative. WHen i asked what all this meant was the IGM shows I just acquired it since i have been getting tested left and right. but when i read the internet it says igg is a past exposure and IGm is a recent exposure. So did i not acquire this recently? She said that i am freaking out for no reason since i hadnt had sex or done anything since may and all my results have been negative until then. I get that HSV1 is SO common such as cold sores but im still freaking out. I have never received oral for anyone but i know you can get HSV 1 genitally as well but these results and my history arnt matching up. Am I just freaking out about a cold sore orally? Please help me cause this has literally caused me so much anxietiy for a year now
doctor
Answered by Dr. Bharatesh Devendra Basti (1 hour later)
Brief Answer:
IgM indicates recent infection

Detailed Answer:
Hi
Thank you for query.I am Dr Bharatesh D Basti answering your query
HSV 1 can spread by orally (by kisses)or sexually or even by skin to skin contact.
So you can think of all possibilities of contact you have got and possible method or person.
I do not see any reason for you to get too anxious for herpes simplex.
There is treatment for it just as other chronic diseases.
The presence of IG M indicates recent infection and IG G indicates a past infection.So you need not worry.The disease will be less severe as the days progress by.More so the disease as not manifested in you so far i suppose.
HSV1 can be infection in oral or genital or skin so the primary infection in your case is not clear.Probably it was milder it was not noticed by you.if you can recall it is good.
Allay the fears of HSV
you can get back to me for any clarifications
Thank you
Dr Bharatesh

Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Bharatesh Devendra Basti (16 minutes later)
I got tested a lot up until August 6 which all were negative and the. decided to et checked again October 8 which is when I saw the positive hsv1 igg&igm. I am just curious is to if I could have contracted it between August and October from sharing drinks, lipstick, etc. The last person I had sex with was May 11 last year. Do you think it's from him? All my results were negative up until October and it was igm that was positive. I just don't want this to be a sexual disease. I know condoms can't prevent this but we used a condom and I have NEVER received or given oral. Help me I'm so anxious and worried sick :(
doctor
Answered by Dr. Bharatesh Devendra Basti (3 hours later)
Brief Answer:
Not due to intercourse on May 11

Detailed Answer:
Hi
Thank you for follow up query.
As per the given dates of tests done, it can be said that the tests are positive at october 8.the infection would have been 4 -8weeks prior to the the result.So it is not possible to get infection from the sexual route as last intercourse was on may 11.so not due to sexual route.
It may be due to the sharing lipstick etc is a possibility.
So usually transmission do not occur sexually unless there is active lesions present in the area.
You have never had lesions at all so relax.There are treatment also if they do appear.
you need not worry about asymptomatic herpes . Allay all the fears and lead a normal tension free life.
You can get back to me for any clarifications else please close the discussion and rate.
Thank you
Dr Bharatesh

Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Bharatesh Devendra Basti (10 hours later)
So with my igg and igm from hsv 1, the timeline of my results indicate that it came after August?

Is contracting. Cold sores at 21 normal??
doctor
Answered by Dr. Bharatesh Devendra Basti (31 minutes later)
Brief Answer:
Yes.

Detailed Answer:
Hi
Thank you for follow up query.
Yes it is likely for you to have got infected after august.
Though usually persons get infected with herpes simplex 1 infection at childhood because of kiss/contacts from adults.Adults do get infected with HSV1 even due to the routes mentioned earlier.It is quite normal .So do not worry about it now.
You can get back to me for any clarifications else please close the discussion and rate.
Thank you
Dr Bharatesh
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Bharatesh Devendra Basti (1 hour later)
I am very confused. I just got this messages from my OBGYN and at first when she first told me she said it was a recent exposure but she just sent this:


Our nurse XXXXXXX forwarded your message to me regarding your questions about herpes. No, it means that it is a previous exposure to the virus. There there are two antibodies that can be present when you have an infection. The IgM antibody is the first antibody that shows up when you are having a new infection or if you have an active infection (current outbreak). If you had never been exposed, the IgM antibody stays positive for up to about 4 weeks. The second antibody, known as IgG, shows up later after you have already been exposed to the virus. If IgM is negative and IgG is positive, the infection is considered dormant. If IgM and and IgG are both positive at the time of the bloodwork, it means that you have a current active infection (current outbreak) to and infection that you have already been exposed to. Your blood work shows only previous exposure to type 1 herpes.


What do I make from this:( I am so confused now.
doctor
Answered by Dr. Bharatesh Devendra Basti (14 minutes later)
Brief Answer:
Check with them for variations in report.

Detailed Answer:
Hi
Thank you for follow up query.
Your first question in our query was that Both IGM and IGG are positive .so we have discussed accordingly and even in the statement by OBGYN also says so if both positive.
But the last line in the message is confusing and is suggesting that you have only IGG positive .So you reconfirm with them which report is correct whether IGG only positive or both IGM and G positive.
If IG G only is positive it tells you have been infected in the past but your earlier tests were negative in August right.
If Only Ig G positive also you have been infected with HSV1 so your management do not change much with either reports as you do not have any symptoms of current infection .so no need to worry allay the fears and get the real report.
You can get back to me for any clarifications else please close the discussion and rate.
Thank you
Dr Bharatesh
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Bharatesh Devendra Basti (13 minutes later)
Yes with the reports I was given in October it shows igm igg both positive for hsv 1.

In August it was still ALL negative.
doctor
Answered by Dr. Bharatesh Devendra Basti (13 minutes later)
Brief Answer:
Check for variations in second message recieved

Detailed Answer:
Hi
Thank you for follow up query.
So we will go with written report.
your management do not change much with either reports as you do not have any symptoms of current infection .so no need to worry allay the fears and get the real report.
You can get back to me for any clarifications else please close the discussion and rate.
Thank you
Dr Bharatesh
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Bharatesh Devendra Basti (6 minutes later)
What exactly do you mean? Sorry I'm very confused ha
doctor
Answered by Dr. Bharatesh Devendra Basti (7 minutes later)
Brief Answer:
Confusion clarification

Detailed Answer:
Hi
Thank you for follow up query.
So we will go with written report.
The message you received had in the last line which bothered me about variation:
"Your blood work shows only previous exposure to type 1 herpes". which means no IGM was found.
your management do not change much with either reports (whether only IGG or Both positive)as you do not have any symptoms of current infection .so no need to worry allay the fears and get the real report whether both positive or not.
Hope the confusion by the message is clear for both of us
You can get back to me for any clarifications else please close the discussion and rate.
Thank you
Dr Bharatesh
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Bharatesh Devendra Basti (9 minutes later)
The lab results I got back from the lady said igm igg positive.

I guess what scares me is her saying it's a previous exposure which I don't want cause I'm freakingg out that it's a sexual disease but before she said that, I went into her office in January and she said it was a recent exposure. So I'm just confused
doctor
Answered by Dr. Bharatesh Devendra Basti (7 minutes later)
Brief Answer:
we will go with written report.

Detailed Answer:
Hi
Thank you for follow up query.
So we will go with written report. And you have had a recent infection.

Your management does not change, since you do not have any symptoms of a current infection.

so no need to worry, allay your fears.
Hope your confusion is cleared.
You can get back to me for any clarifications else please close the discussion and rate.
Thank you
Dr Bharatesh
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Bharatesh Devendra Basti (15 minutes later)
Can you explain how you. Came to that conclusion though? I just want to know how so I can stop over analyzing
doctor
Answered by Dr. Bharatesh Devendra Basti (13 minutes later)
Brief Answer:
Explained.

Detailed Answer:
Hi
thank you for follow up.
I came to it because your all tests were negative in august so infection is after that only.
Do not ponder again over it .you will get confused as you want to trace source.
Relax stop worrying.
You can get back to me for any clarification else please close the discussion and rate.
Thank you
Dr Bharatesh
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Bharatesh Devendra Basti (24 minutes later)
One last one I swear doc. Ok so I have read that it takes time for antibodies to form , could these igg igm be from May? Or is that too far from exposire
doctor
Answered by Dr. Bharatesh Devendra Basti (4 hours later)
Brief Answer:
IGM would not last long

Detailed Answer:
Hi
Thank you for follow up query.
I again went through your dates.there was some confusion in year
When was the last test done.what was the report.
If october 2013 was last test then IGM would not last till now and now you will have only IGG so it is previous infection currently and you will have only IGGif test done now .
And if between august and october 2013 last year(what we discussed so far) is two tests we are correctly discussed for those days .and you would have got infection between august and october last year.

did you get any tests this may or this year 2014 also.it will be only IG G and NO IGM.
It would not last that long for almost year.Once IGG takes over IGM will come down within 1-2 months.

You can get back to me for any clarification else please close the discussion and rate.
Thank you
Dr Bharatesh
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Bharatesh Devendra Basti (31 minutes later)

This was the last response I just got:


I looked at all the bloodwork that was done. We drew a lot of STD blood tests in the past year. In regards to the herpes blood work, here is a detailed summary of the results:
6/27/13: HSV IgM negative; HSV1 IgG negative; HSV 2 IgG negative
This means that you did NOT have an active infection at the time of the blood draw on 6/27/13 and that you were NOT previously exposed to either strain of the herpes virus.
7/22/13: HSV IgM negative; HSV 1 IgG negative; HSV 2 IgG negative
Again, this still means that you did NOT have an active infection at the time of the blood draw on 7/22/13 and that you were NOT previously exposed to either strain of the herpes virus.
8/5/13: Oral swab for herpes negative for HSV 1 and HSV 2
You had requested testing our mouth for STDs at the time but did not have any symptoms at the time. No infection with herpes in the mouth were found at the time of the swab since the test was negative.
10/8/13: HSV IgM positive; HSV 1 IgG positive; HSV 2 IgG negative
Because the IgM was positive on that day, you were having an active outbreak at the time of the bloodwork. Because the IgG antibody for type 1 herpes was positive, it also meant that you had been previously exposed to the virus. This could have happened anytime between July 22nd and October 8th of last year, but there is not a test that could pinpoint the exact time or day that you were exposed to that strain of the virus. Since the IgG antibody for type 2 herpes was negative, you did not have previous exposure to that strain of the virus and do not have type 2 herpes. Hopefully, that is more clear. When I saw you in October, I told you that it was a relatively recent exposure since your bloodwork in July was negative (meaning you did not have the infection at the time). Again, because the IgG antibody for type 1 herpes was positive at the time of the blood draw, it meant that you had been exposed to the virus for at least a month before the blood was drawn, therefore "previous exposure" is the appropriate term.
In regards to a sexual encounter on May 11, do you mean May 11th of this year or last year? If it was last year, I can tell you that the infection was not due to that encounter since your bloodwork from 6/27/13 and 7/22/13 were negative. Does this make sense? I am not sure of any clearer way to explain this. Please come in to see us if there is any further concerns or if you have any suspicous lesions that you want to evaluate if you are in town.



In response that message se just sent, I know I recieved a few other lab test I don't think she marked but they were also negative and those were between July and August. I guess I'm just curious if she could be right that this isn't a std cause I know igg can take months to form so how does she know this isn't from May? Or am I just over analyzing and std free??

doctor
Answered by Dr. Bharatesh Devendra Basti (3 hours later)
Brief Answer:
Getting too anxious.Not STD

Detailed Answer:
Hi
Thank you for follow up query.
I again went through your detailed history
So it is most possible that you have acquired the infection between 6/27/13. and 10/8/13 last year(what we discussed so far). As it was negative for IGM and IGG earlier and present in the august sample.For one person,IG G could take just a few weeks, while it could be few months for another.
Presence of IG-G is more confirmatory for HSV than IG-M as they can be negative in many and be present in recurrent infections also.
So STD is most unlikely in your case as may is too old.
Now you are unnecessarily getting anxious and thinking of the past.So be calm relax forget about the episode .Do some yoga or meditation get involved in any activity which you enjoy and be busy.
You can get back to me for any clarification else please close the discussion and rate.
Thank you
Dr Bharatesh
Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
doctor
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Follow up: Dr. Bharatesh Devendra Basti (37 hours later)
So you don't think these antibodies from my May 11 encounter formed to make it posiive in my October blood test? That's what I keep pondering that I have read online that high and igm can take months to form and ok scared that these just formed for the October blood test making these the std. Can you explain this out for me?

Like I see igg can form in months and I'm scared that these took awhile to form and that's why they didn't show on my blood work till October
doctor
Answered by Dr. Bharatesh Devendra Basti (54 minutes later)
Brief Answer:
yes not due to encounter may 11

Detailed Answer:
Hi
Thank you for follow up query.
IgM forms first and goes of first but variations occur in that hey also can occur in recurrence.it usually appear within weeks.may take months sometimes .but dissapears within months.
Ig G forms later and lasts usually through out.so it will be positive even now if you take test.
So you have got infection after may 11 episode.so it is not std.
You can get back to me for clarification Else close the discussion and rate
Thank you
Dr Bharatesh

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Bharatesh Devendra Basti (8 minutes later)
But would these antibodies be a result of my sexual encounter since igg takes a whole to form? I'm just confused with all of this igg igm stuff. Like I get igg is ine forever but for me to have gotten something from May 11 would that have formed right away or later on in months resulting in my current bloodwork. Please explain
doctor
Answered by Dr. Bharatesh Devendra Basti (25 minutes later)
Brief Answer:
explained

Detailed Answer:
Hi
Thank you for follow up.
It is formed only in October and was not found in earlier tests in July august (both).
So both appeared at October test.
So it should be later to may only.
So a person without antibody gets both acute and late antibody
So not from may encounter
So do not bother at all about std route
Sleep peacefully on it
You can close the discussion and rate if no clarification needed
Thank you
Dr Bharatesh
Note: Consult a Sexual Diseases Specialist online for further follow up- Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Bharatesh Devendra Basti

Dermatologist

Practicing since :1998

Answered : 1764 Questions

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How Is HSV Transmitted?

Brief Answer: IgM indicates recent infection Detailed Answer: Hi Thank you for query.I am Dr Bharatesh D Basti answering your query HSV 1 can spread by orally (by kisses)or sexually or even by skin to skin contact. So you can think of all possibilities of contact you have got and possible method or person. I do not see any reason for you to get too anxious for herpes simplex. There is treatment for it just as other chronic diseases. The presence of IG M indicates recent infection and IG G indicates a past infection.So you need not worry.The disease will be less severe as the days progress by.More so the disease as not manifested in you so far i suppose. HSV1 can be infection in oral or genital or skin so the primary infection in your case is not clear.Probably it was milder it was not noticed by you.if you can recall it is good. Allay the fears of HSV you can get back to me for any clarifications Thank you Dr Bharatesh