Dr. Atishay Bukharia
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 a 35-year-old male. No episodes of herps except chickenpox in childhood. No Infection of HIV, clinically tested every six months for the last seven years. My partner and I both are not having HIV (clinically tested). I had a bacterial or fungal infection with pus and redness in the genital area. So I have done the blood test. HIV is negative. HSV-1 IgG 4.5 positive. HSV-1 IgM 0.29 negative. HSV-2 IgG 0.45 negative. HSV-2 IgM 0.69 negative. As HSV-1 is mostly non-genital infection. I did not have any episodes of HSV-1 type herps in my life. I never had HSV-1 type herpes anywhere in the body. I am straight and have a relationship only with my spouse. How can blood show HSV-1 IgG positive without any symptoms? Dermatologist says it is due to past infection and not about present infection. Doctor told I should take antiviral dose Acyclovir for 20 days for HSV-1 IgG past infection. Is it useful to take antiviral dose for the past HSV-1 type infection? Will it reduces IgG level in the blood? Is HSV-1 IgG is false positive?
Hi,
Welcome to icliniq.com. First understand the situation, IgM indicates recent infection and IgG indicate chronic infection. Since you have both the IgM negative, it means that there is no recent infection. Secondly, about 70- 80% of US population is HSV-1 (herpes simplex virus) positive, it means they are infected once in a life time and antibodies will remain for throughout life. But it does not mean that 80% of US population should start taking Acyclovir. There are no guidelines for taking Acyclovir until you are symptomatic. So do not think too much about this figure. If you had any other problems, you can revert back to me.
Patient's Query
Thank you doctor,
History:- My penile glans infection is cured already by antibiotic treatment and HSV-2 is negative HSV IgM is negative. My questions are, HSV-1 IgG is past infection but there is no history of episode or symptomatic reaction of herpes in my body. Can HSV-1 cause infection to the spouse in nonprotected intercourse? At present, HSV-1 IgG is 4.5 with past infection. Will this IgG level remain the same? I wonder how could I be infected with HSV-1 in the past without any symptoms of any herpes? Is it useless to take Acyclovir as I do not have any prevalent infection to my genitals? Is this HSV-1 is infectious by general skin to skin contact or any other way?
Hi,
Welcome back to icliniq.com. My answers to your questions are: You do not necessarily have to get symptoms if you are infected. You can have this infection in childhood which not even you and your guardian can give the answer. The most common manifestation of HSV is fever, blisters around or on lips, which almost everybody suffers in their childhood. It does not necessarily, depend on the body immune status and status of B-cell to synthesize IgM. Yes, it is useless to take Acyclovir, and for your kind information herpes is never curable. Only what we can do is to decrease the course of the symptomatic period. Recurrence is a rule in herpes.
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Dermatology
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