Q. What is the chance of progression of herpes infection to encephalitis?

Answered by
Dr. Dilip Meena
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Nov 29, 2020

Hello doctor,

I had unprotected sex with my partner about five months back. We both went for HIV tridot tests, VRDL tests, HBsAg tests after four months. All came back negative for both. Our medicine specialist did not advise herpes screening. We both have no lesions or bumps at all. Also, I am told herpes is an extremely simple condition, but I am worried about if it progresses to encephalitis. Also, the chances of false positives scare me for the tests. What do you suggest?



Welcome to icliniq.com.

I understand that you are concerned. Routinely we advise HIV, HbsAg, HCV, and VDRL, and Herpes serology for sexually transmitted diseases.

Genital herpes is mostly caused by HSV 2 (herpes simplex virus) virus and oral herpes by HSV 1. In serology, the large population had past exposure to HSV 1, but HSV 2 is usually negative but can be positive in a small percentage of people. Generally, there is not much clinical significance of positive IgG HSV if no clinical lesions present. IgM indicates a recent infection.

Herpes encephalitis is usually seen in children and young adults and caused mostly by HSV1 and rarely ever by HSV 2 and sexually transmitted. Still, you can get it done HSV 1 and 2, IgG, and IgM and show me the reports.

Thank you doctor,

My partner and I have no lesions or bumps at all. We visited a dermatologist, and he told us the tests are optional but can be skipped as well.

My question is, what is the possibility of herpes (in case I get) turning into herpes encephalitis in a person with a good immune system? And what about the false positive people complaint on HSV tests?



Welcome back to icliniq.com.

It is very rare with a good immune system. False-positive tests can occur due to cross-reactivity with other viruses. When you do not have any lesions, there is nothing to worry about. In any case of sexually acquired herpes, it rarely leads to encephalitis, even if it is there. So relax and if you have any genital blisters or ulcers, then only go for tests.

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