CHLOE'S CASE CONTINUED
So three days later Chloe’s herpes tests results arrived from the lab by fax. She was called to return to clinic to discuss the results.
“Hello,” I said as I entered the room.
“Hello,” she replied.
“Well, it looks like the plot has thickened,” I said as I took my seat at the small table.
She looked at me without saying anything. Waiting to hear the results.
“Okay, what we tested for was the presence of antibodies to either of the HSV viruses, one or two. The antibodies are tiny cells that our body makes when we are exposed to a germ, a microorganism, whether it be virus or bacteria. It simply tells us that, if present, that that particular germ was present in our body at some time in our lives. In your case we’ve tested for the presence of HSV antibody. Well, it turns out that you are positive for both HSV-I and HSV-2 viruses. The HSV-1 virus being the “above waist” virus, and the HSV-2 virus being the “below waist” virus. And the type of antibody you have is IgG, indicating the remote presence of both viruses. That means at some time in the distant past you were exposed and/or infected with the HSV-2 antibody, the genital herpes, as well as the HSV-1 antibody, or the fever blister-type of antibody.”
She adjusted herself in her chair. “Okay. Well, does that mean I don’t have an HSV infection now?”
“Well, the type of antibody that’s present is from an older infection, not a more recent one. So in light of your history, and your sexual contact’s history, it’s unlikely that you have an active infection now, especially since you don’t have any lesions or blisters. But if he, your sexual contact, were to be tested negative for the genital herpes, then you can be more assured that his and your herpes status is inactive. That would be the best we could say in this instance.”
“Well that’s a little reassuring.”
“But,” I added, “not to muddy the waters any, but it is possible to have only a single herpes lesion, not the typical cluster, and still have an active infection. But since you do not have the presence of acute, or current, antibodies, it’s unlikely you have an active infection now.”
“So he and I are both in the clear and unlikely to have passed the herpes virus on to each other.”
“Well, not exactly,” I said. “Because you have had the infection sometime in the past, the virus is lying dormant, more or less, in you. Current studies and surveys indicate that a small percent of women, on the order of about 10%, will shed the virus even in the absence of an active breakout. That means during sexual intercourse that even though there’s no lesions or blisters or pain that the virus can shed and be passed on to your sex partner.”
She said, “Are you serious?”
“Well, that’s what the latest science tells us.”
“How can I stop this shedding? Would cleansing with some sort of agent eliminate the shedding? she asked.
“The best one can do to prevent the transmission of the virus is to have protective intercourse.”
“You mean like using a condom.”
“Yes. Every time you have intercourse.”
“So, if I ever decide to marry again, which I can’t imagine I ever will, you mean to say that in order for my husband to be protected that…”, she grimaced, …we would have to use a condom?”
“I know how crazy that sounds, but if your objective is to be absolutely sure that you don’t pass the virus on to him that yes you would have to use a condom.”
There was an audible sigh.
She looked up and said, “Is there any other way to get around this?”
“Do you mean get around the fact about the virus shedding?”
“Well,” I said, “not really. But it is recommended that if you are having frequent breakouts that taking a prophylactic dose of anti-virus medicine, like acyclovir or Valtrex, on a daily basis can significantly reduce the breakouts, both in frequency and in intensity of pain. But as far as eliminating the shedding of virus, I’m not certain about any studies or science that shows it can eliminate that 100%. I’ll have to check in to that.”
Another audible sigh.
“Is there anything else I can help you with today?” I asked.
She hesitated, then said, “No, I guess not. I’ve heard enough for one day.”
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