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herpeselect vs. WB update
Hi, I am a female in my early 30's. I am originally not from US.
On 8/24/05 I had complete STD testing done. I (or any of my partners) never had any problems, I just wanted to have complete physical. All tests came back negative. Except HSV-1 4.2, HSV-2 1.8 (ratio is negative <0.9 on both). I had cold sores since I was a kid and my cold sores were kind of aggressive at the time of testing. BUT HSV-2 was a shock. My doctor said that testing is 100% accurate and I took his word for it.
Just a few days ago, I read on this site about low-positives (between 1 and 3) and chance of false positives. So I got retested. Results 7/19/06 HSV-1 4.5, HSV-2 1.3 (ratio is negative <0.9 on both, this time I made sure it was herpeselect). A year later HSV-2 even lower positive again??? BTW I already ordered Western Blot, it will be here in 2 days.
So once again:
8/24/05 HSV-1 4.2, HSV-2 1.8
7/19/06 HSV-1 4.5, HSV-2 1.3
1. Do you think that all labs have updated herpeselect test by now? (I used labcorp)
2. Does new herpeselect test still has issues with false positives?
3. In my case, do you think that I could be the false positive?
4. What should I do if WB will come back indeterminate?
5. Which test results, the two Herpeselect or last WB should I consider to go by?
There is some info on the web that Herpeselect is better then WB, that WB is NOT as sensitive. Clearly if I have HSV-2, I
On 8/24/05 I had complete STD testing done. I (or any of my partners) never had any problems, I just wanted to have complete physical. All tests came back negative. Except HSV-1 4.2, HSV-2 1.8 (ratio is negative <0.9 on both). I had cold sores since I was a kid and my cold sores were kind of aggressive at the time of testing. BUT HSV-2 was a shock. My doctor said that testing is 100% accurate and I took his word for it.
Just a few days ago, I read on this site about low-positives (between 1 and 3) and chance of false positives. So I got retested. Results 7/19/06 HSV-1 4.5, HSV-2 1.3 (ratio is negative <0.9 on both, this time I made sure it was herpeselect). A year later HSV-2 even lower positive again??? BTW I already ordered Western Blot, it will be here in 2 days.
So once again:
8/24/05 HSV-1 4.2, HSV-2 1.8
7/19/06 HSV-1 4.5, HSV-2 1.3
1. Do you think that all labs have updated herpeselect test by now? (I used labcorp)
2. Does new herpeselect test still has issues with false positives?
3. In my case, do you think that I could be the false positive?
4. What should I do if WB will come back indeterminate?
5. Which test results, the two Herpeselect or last WB should I consider to go by?
There is some info on the web that Herpeselect is better then WB, that WB is NOT as sensitive. Clearly if I have HSV-2, I
A related discussion, I believe I have a false positive results on Herpselect Test was started.
MEDICAL PROFESSIONAL
I'm not aware of HSV testing problems for people from Eastern Europe.
You can just name the nearest major metropolitan area or the state where you live. I don't think that would risk your confidentiality. Or send a message to the med help administrator (home page, "contact us").
HHH, MD
You can just name the nearest major metropolitan area or the state where you live. I don't think that would risk your confidentiality. Or send a message to the med help administrator (home page, "contact us").
HHH, MD
Doctor, I just got my WB results -- It is Indeterminate for HSV-2 and positive for HSV-1... So how do I "cross this bridge"? Doctor you said that "indeterminate WB is rare; in fact true indeterminate results may not occur at all". What should I do next? I know that I have oral HSV-1 from childhood. So now I have:
8/24/05 HSV-1 4.2, HSV-2 1.8
7/19/06 HSV-1 4.5, HSV-2 1.3 by Herpeselect (very low positive)
8/3/06 HSV-2 Indeterminate by WB
There were never any symptoms. There is no possible exposure in the past 2 years. And even before I never heard of HSV-2.
I keep spending money to get firm "yes" or "no" answer to HSV-2. But as you see it keeps going down the drain, and most importantly its huge anxiety and stress.
PLEASE HELP!
8/24/05 HSV-1 4.2, HSV-2 1.8
7/19/06 HSV-1 4.5, HSV-2 1.3 by Herpeselect (very low positive)
8/3/06 HSV-2 Indeterminate by WB
There were never any symptoms. There is no possible exposure in the past 2 years. And even before I never heard of HSV-2.
I keep spending money to get firm "yes" or "no" answer to HSV-2. But as you see it keeps going down the drain, and most importantly its huge anxiety and stress.
PLEASE HELP!
MEDICAL PROFESSIONAL
Sorry that the confusing results continue. I would find out what lab did the Western blot. If University of Washington is where the test was sent (where the WB test was developed and perfected, and which many primary labs nationwide use for WB reference), you or your provider can call and likely learn more detail about the likely explanations. Often more information is available than simple "indeterminant" as on the official report ("likely HSV-2, just can't tell for sure"). They also probably will advise on alternate or additional testing. If another lab was involved, you could do the same thing, but then you're probably not dealing with real experts. In that case, making sure that specimen (or another one) is sent to UW might sort things out. Another option might be to communicate with Focus Diagnostics, the HerpeSelect producer. For a while, they were offering free special testing for persons with consistently confusing results with their product. And if not yet done, a quick and simple step would be for you to have the BiokitUSA test. In this circumstance, it might not be a definitive tie-breaker, but it will at least give a strong clue to the truth.
Only now did I focus on your opening statement that you're not from the US? Are you from Africa by chance? For reasons that are as yet unknown, indeterminant HSV-2 tests are particularly common in persons from subsaharan Africa. If that applies to you, definitely make sure your WB was done at University of Washington or a new specimen is sent there.
Finally, if not yet done, have a consultation with an STD or infectious diseases specialist to help sort this out, and to run interference with the lab(s). Even if an ID specialist in your area isn't especially up to date on these issues, s/he will be able to quickly get up to speed. This is likely to be more efficient than relying on your primary provider and local laboratory. If you will tell me where you live, I might be able to help find someone suitable in your area.
Sorry on your behalf you're one of the atypical ones. I hope this helps. Good luck--
HHH, MD
Only now did I focus on your opening statement that you're not from the US? Are you from Africa by chance? For reasons that are as yet unknown, indeterminant HSV-2 tests are particularly common in persons from subsaharan Africa. If that applies to you, definitely make sure your WB was done at University of Washington or a new specimen is sent there.
Finally, if not yet done, have a consultation with an STD or infectious diseases specialist to help sort this out, and to run interference with the lab(s). Even if an ID specialist in your area isn't especially up to date on these issues, s/he will be able to quickly get up to speed. This is likely to be more efficient than relying on your primary provider and local laboratory. If you will tell me where you live, I might be able to help find someone suitable in your area.
Sorry on your behalf you're one of the atypical ones. I hope this helps. Good luck--
HHH, MD
MEDICAL PROFESSIONAL
I'm not aware of HSV testing problems for people from Eastern Europe.
You can just name the nearest major metropolitan area or the state where you live. I don't think that would risk your confidentiality. Or send a message to the med help administrator (home page, "contact us").
HHH, MD
You can just name the nearest major metropolitan area or the state where you live. I don't think that would risk your confidentiality. Or send a message to the med help administrator (home page, "contact us").
HHH, MD
Doctor,
Thank you for such fast reply.
Yes, I sent my specimen directly to University of Washington.
I mentioned that I am not from US, because I read about studies in different countries. I am from Eastern Europe (not sure if that shines any light on my situation).
I really want your recommendation for specialist in my area, but I am not comfortable to disclose my location here. Is there any other way (e-mail, etc.)?
I am also thinking to ask the lab in UW to revisit my test, and/or contact Focus for inhibition assay.
Thank you again.
Thank you for such fast reply.
Yes, I sent my specimen directly to University of Washington.
I mentioned that I am not from US, because I read about studies in different countries. I am from Eastern Europe (not sure if that shines any light on my situation).
I really want your recommendation for specialist in my area, but I am not comfortable to disclose my location here. Is there any other way (e-mail, etc.)?
I am also thinking to ask the lab in UW to revisit my test, and/or contact Focus for inhibition assay.
Thank you again.
Doctor you sound like my Mom here "Cross that bridge if you come to it." :-) Thank you very MUCH!
MEDICAL PROFESSIONAL
You were right to have the Western blot test. You also could have had the Biokit USA test, which according to recent research, is a pretty reliable test to sort out borderline HSV-2 results by HerpeSelect.
1) I haven't heard any recent updates on the timing of the revised HerpeSelect test. 2) The false positive problem is supposed to be lessened, but most likely it won't completely eliminate them. 3) Yes, it is a good bet your result is false positive; the WB may be negative. 4) Cross that bridge if you come to it. Indeterminate WB is rare; in fact true indeterminate results may not occur at all. You can expect the result to be positive or negtive. 5) People in your situation should rely on the WB result, whatever it is.
I hope this helps. Best wishes-- HHH, MD
1) I haven't heard any recent updates on the timing of the revised HerpeSelect test. 2) The false positive problem is supposed to be lessened, but most likely it won't completely eliminate them. 3) Yes, it is a good bet your result is false positive; the WB may be negative. 4) Cross that bridge if you come to it. Indeterminate WB is rare; in fact true indeterminate results may not occur at all. You can expect the result to be positive or negtive. 5) People in your situation should rely on the WB result, whatever it is.
I hope this helps. Best wishes-- HHH, MD
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Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
