Sexual Health  Mental Health 

Exposure to herpes, what does it mean?

Rich Mancuso Apr 19 2020

Exposure to herpes, what does it mean?

Ex·po·sure /ikˈspōZHər/

1. The state of being exposed to contact with something.

2. The fact of experiencing something or being affected by it because of being in a particular situation or place


One of the most important things you can do for yourself is to get regular health screenings. Part of this yearly health screening is the necessary but unpleasant experience of getting blood drawn. I know it's not fun, but it is one of the most efficient ways to observe and diagnose any underlying issues that may be taking place within your body. In addition to that (since you are already at the doctor's office), you can also request a full 10-panel STD test.

This test includes

  •  HIV
  •  Herpes-type 1
  •  Herpes-type 2
  •  Chlamydia
  •  Gonorrhea
  •  Syphilis
  •  Hepatitis A
  •  Hepatitis B
  •  Hepatitis C

STD screenings are not generally included within regular health screenings and it is essential to be aware that if an STD test is ordered, more often than not, the doctor will often omit Herpes Simplex. While I agree that it's good common sense to request this blood work when starting a new relationship, this test should include ALL ten of them. It is also a great idea to request that your new partner do the same. This is for their protection and your protection as well. It may be an uncomfortable conversation, but if your new partner is not concerned about their own health, why would they be concerned about yours? Just a thought...

Why do some physicians omit herpes from the ten panel STD test? 

Many physicians do this frequently. If a patient comes in for an STD test, some will omit herpes entirely from the panel, but if they do include it, and the patient is not complaining of symptoms, the physician {1} will often say over the phone "you're fine" or "you've been exposed, but you don't have it." This is a flat out lie. If you've been exposed—you have it. 

Here is a typical post from a Facebook herpes support group that I see twice a week.

I have wanted to get retested since I do not have any symptoms, and the hospital won't release my numbers. I spoke with my doctor, and she said is that even though it shows positive, it doesn't mean that I have it since I have never had any outbreaks. She said it just means that I have been in contact with herpes. She said I would not know if I have it until I have an outbreak. Has any other doctor or medical person told you this? 

First off, they are required by law to make available any or all medical information that pertains to YOU. On top of that, this physician is flat out lying to the patient. Whether they are doing so to make the patient feel better or they skipped virology class that day, I have no idea. I find statements like this very frustrating and confusing. Unless the test numbers were so low that the doctor is unsure? Still, without a one on one conversation with the physician, we will never get an answer as to why.

In the simplest of terms, a positive test number means you have been exposed to herpes. This means you have it, sorry. Here's why. When your body is exposed to a foreign bacteria or virus, it reacts to these antigens to protect you from infection and death. Your immune system is doing its job of protecting you. It sees these viral invaders, it then creates antibodies, T-cells, and B-cell responses, which in turn provide protection when or if your immune system comes in contact with these invaders in the future. However, there is a big difference when it comes to the virus, herpes simplex.

Let's discuss a common type of herpes infection of HSV-1.

  •  Most children are exposed to many of the herpes viruses before the age of 10, and herpes simplex is no exception. One common example of how this happens is from a kiss from a parent or grandparent who has HSV-1. 
  •  The virus is passed on to the mouth.
  •  It begins an amplification cycle.
  •  It enters the nerve fibers and is carried up through the nerve branch to the base of the brain.
  •  It enters its new home in the Trigeminal nerve cluster. 
Source; Earths Lab

While all of these actions are taking place your immune system is engaging with the virus and is creating an antibody response. So you see, exposure means your body has seen the infection (the herpes virus) and is responding to it. The difference between herpes and other viruses is that herpes creates a latent infection and remains hidden within your nervous system. This is why it can re-appear. This exposure remains with you for life. Even if you never see symptoms or outbreaks.

While it's true that the immune system can indeed control and remove the herpes virus once it emerges from its hiding spot in the nervous system, the infection in the neurons (where it hides) is life long. Exposure or testing positive to herpes means you have it. 

Why do doctors say you've been exposed, but you don't really have it?

Strictly my opinion here but I believe there are many reasons why this can take place, here are a few thoughts as to why Doctors are lying.

  •  Almost everyone {2} has herpes simplex and if you don't, eventually you will. 
  •  There is nothing in place to stop herpes.
  •  Some tests are expensive, and the current testing method is 50-70% efficient at best. (With exceptions to the western blot and if the PCR DNA swab test is performed in the proper time frame).
  •  Most of the population (80%of people infected) {2}, tolerates herpes very well and is entirely unaware, except for approx 100+ million. Most of whom have an autoimmune issue or are immunocompromised in some way.
  •  It has a very low mortality rate. 
  •  Telling asymptomatic people that they have it can be very devastating/life-changing.
  •  CDC does not recommend herpes testing for people without symptoms. This is because diagnosing genital herpes in someone without symptoms has not shown any change in their sexual behavior (e.g., wearing a condom or not having sex), nor has it stopped the virus from spreading. Also, false-positive test results (test results that say you have herpes when you do not actually have the virus) are possible.{3}
  •  The test numbers were so low, they are unsure and would rather say you don't have it.

To be clear, I'm not saying all of these are great reasons and these may upset those who have frequent symptoms caused by herpes simplex, I'm just saying that these are only a few reasons as to why doctors will dumb down herpes. 

Exposure to herpes = herpes positive.

Sorry...

References

{1} Harms of Early Detection and Intervention

Based on evidence on potential harms from a small number of trials, the high false-positive rate of the screening tests, and the potential anxiety and disruption of personal relationships related to diagnosis, the USPSTF found that the evidence is adequate to bound the potential harms of screening in asymptomatic adolescents and adults, including those who are pregnant, as at least moderate.

USPSTF Assessment

The USPSTF concludes with moderate certainty that the harms outweigh the benefits for population-based screening for genital HSV infection in asymptomatic adolescents and adults, including those who are pregnant.

The USPSTF does not recommend serologic screening for genital HSV infection in asymptomatic persons.

{1} https://jamanetwork.com/journals/jama/fullarticle/2593575

{2} Prevelance of herpes 

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0140765#sec007

Genital herpes infection is common in the United States. CDC estimates that, annually, 776,000 people in the United States get new genital herpes infections. {1} Nationwide, 11.9 % of persons aged 14 to 49 years have HSV-2 infection (12.1% when adjusted for age).{2} However, the prevalence of genital herpes infection is higher than that because an increasing number of genital herpes infections are caused by HSV-1. {3} Oral HSV-1 infection is typically acquired in childhood; because the prevalence of oral HSV-1 infection has declined in recent decades, people may have become more susceptible to contracting a genital herpes infection from HSV-1. {4}

1. Satterwhite CL, Torrone E, Meites E, et al. Sexually transmitted infections among US women and men: prevalence and incidence estimates, 2008. Sex Transm Dis, 2013. 40(30):187-93

2. McQuillan G, Kruszon-Moran D, Flagg EW, Paulose-Ram R. Prevalence of herpes simplex virus type 1 and type 2 in persons aged 14–49: United States, 2015–2016. NCHS Data Brief, no 304. Hyattsville, MD: National Center for Health Statistics. 2018

3. Xu F, Sternberg MR, Kottiri BJ, et al. Trends in herpes simplex virus type 1 and type 2 seroprevalence in the United States. JAMA, 2006. 296(8): 964–73.

4. Bradley H, Markowitz L, Gibson T, et al. Seroprevalence of herpes simplex virus types 1 and 2—United States, 1999–2010. J Infect Dis, 2014. 209(3):325-33.

https://www.cdc.gov/std/stats/STI-Estimates-Fact-Sheet-Feb-2013.pdf

https://www.cdc.gov/std/Herpes/default.htm

Herpes simplex virus (HSV) infection is one of the most common viral sexually transmitted diseases worldwide. The first time infection of the mother may lead to severe illness in pregnancy and may be associated with virus transmission from mother to fetus/newborn. Since the incidence of this sexually transmitted infection continues to rise and because the greatest incidence of herpes simplex virus infections occur in women of reproductive age, the risk of maternal transmission of the virus to the fetus or neonate has become a major health concern. On these purposes the Authors of this review looked for the medical literature and pertinent publications to define the status of art regarding the epidemiology, the diagnosis, the therapy and the prevention of HSV in pregnant women and neonate. Special emphasis is placed upon the importance of genital herpes simplex virus infection in pregnancy and on the its prevention to avoid neonatal HSV infections.

https://www.researchgate.net/publication/230584598_Herpes_simplex_virus_infection_in_pregnancy_and_in_neonate_status_of_art_of_epidemiology_diagnosis_therapy_and_prevention

How many people have herpes?

Even though numbers can fluctuate from year to year; depending on many factors, these numbers are still pretty staggering. The prevalence of HSV type one is almost more than 80% of the worlds population. Almost everyone has herpes. 

https://www.webmd.com/genital-herpes/news/20081001/half-a-billion-have-genital-herpes

Genital herpes infection is common in the United States. CDC estimates that, annually, 776,000 people in the United States get new genital herpes infections

Thats over 2000 a day in the United States alone. https://www.cdc.gov/std/herpes/stdfact-herpes-detailed.htm#ref1 

Satterwhite CL, Torrone E, Meites E, et al. Sexually transmitted infections among US women and men: prevalence and incidence estimates, 2008. Sex Transm Dis, 2013. 40(30):187-93

https://www.ncbi.nlm.nih.gov/books/NBK525769/

{3} https://www.cdc.gov/std/herpes/screening.htm


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