Actually Negative

[actuallynegative]

Firstly, I would like to say a big thank you to all the docs that make this site available - it truely is a valuable resource and does much to relieve those of us with anxiety with regards to our test results.  This actually is not a question but rather a self diagnosis when it comes to my HSV2 status, having taken into account all my research on this site pertaining to the herpes nightmare.

On October 11th 2008, I had unprotected sex with a young woman and again the following weekend.  That relationship didn't work out and we both decided to go our seperate ways.  Then, early January '09, I decided to do the responsible thing and get a full STD workup as I was just starting to see another person, who has in the past been very diligent with respect to her sexual health.  We had unprotected sex about a week prior to my first round of testing.

My first test was done on Jan 5th and at this point I had no symptoms of anything and actually had to ask the clinic specifically for the herpes tests as these are generally not done for routine std work ups.  Three weeks later (and having slept with my new partner in the interim), the clinic called me back and said everything had come back negative except for herpes 1 & 2 and that I tested positive for HSV1 and Equivocal/Positive for HSV2.  I was shocked to say the least.  She suggested that the equivocal result was due to a recent infection and that I come back for further testing in 8 weeks.  In the interim, I broke the news to my new partner, who I thought must have infected me recently (not really fully understanding the seroconversion rate) and suggested that she get herself tested.  Her test came back negative which meant that she didn't have it and therfore I couldn't have contracted it from her - it must have been my previous partner, the one from back in October of 2008, which means at this point, it is 12 weeks after my unprotected sex with her (and, unless I am one of the few in which seroconversion takes longer than normal), I should be showing positve results.  Anyway, after reading posts from this website and understanding that those of us with an established HSV1 infection can often have a low positve result for HSV2, I decided to call the lab and get my actual results.  They didn't give me my HSV1 results and I just assumed they were strong positive, however, my HSV2 results were as follows (they told me that an equivocal result is tested 3 times and the two higher numbers reflect the actual results).  The test was the Herpeselect test.

HSV2 = 1.034
          = .942
          = 1.177

So, 9 weeks later, March 9th '09 I go in for my follow up tests.  For the entire 9 weeks from getting my first round of test results, every little ache and pain I feel, I think it has to be one of the symptoms, sore lower back, headaches, malaise, not to mention all the anxiety caused by my positive results and my utter lack of confidence with the opposite sex.  Who could possibly want me now?  And lets not talk about the expense of the visit to my urologist because I "think" I'm feeling some symptoms and have bladder issues, frequent urination, abdominal pressure etc. (which now I put down to pure anxiety).

9 weeks later - I have the test and 2 weeks after that, I receive a call from the clinic to tell me the results are positive for HSV 1&2.  Having specifically requested my actual results at the time of testing, they don't have them.  So, as I did before, I call the lab and request the actual test results i.e. the numerical value.  The lady at the lab tells me that I am positive for HSV2 and that they diagnose samples based on their test manufacturers instructions that come with the test, and do not take previous test history and date into account - just negative, positive and equivocal - <.9 /.9< 1.1 respectively.  I argued with her and told her that if she didn't take the previous history into account, how can they give an accurate result?

This is how I understand it - 12 weeks after possible exposure, I test equivocal with an average result of 1.051 and 9 weeks later (21 weeks after possible exposure), I should be in the positives >3.5 (Herpeselect) but instead, I pick up my test results today and I find out that my positive result is 1.142 - which means that in 9 weeks, my seroconversion has increased a mere .091.  Thus, my self diagnosis is that I am actually NEGATIVE for HSV2.

All I can say is I am pissed and happy at the same time.  My advise is this, specifically for those of you who live in the Treasure Valley area in Idaho and who know that your blood sample is sent to the Idaho State Bureau of Laboratories for testing. DO NOT just accept their positive diagnosis without a second opinion.  Request your numerical HSV2 result and take into account time frames, dates, seroconversion rates and your sexual partners' results from the previous 6 months - to simply imply that your result is positive having not taken into account your medical/testing history means your diagnosis isn't worth the paper it's written on.

Once again - thank you docs for all the time you put into this site.  I can't tell you how much it meant to me to have this resource at my fingertips.  It is clear to me that Herpes and the testing process is not very well understood among many medical practitioners and I wonder how many people are actually living out there with false positives based on the "testing policy" adopted by other agencies like the one mentioned above.  And remember kids: condoms, condoms, condoms.

[kortal]

so u got positive hsv results continuously and ultimately it ended up being negative? i have a 1.4 hsv igg positive from an unreliable lab from asia....and am freakin out. never had any outbreaks. i have 2.4 for hsv1 and 1.4 for hsv 2. advice'?

[actuallynegative]

Firstly, let me start off by saying that I am not a doctor, I have just educated myself by reading as much about the whole herpes thing as is possible.

First off, I need some more info from you before I can give you my opinion.  What type of test did you have (by your numerical results I would assume Herpeselect?)  How long after possible exposure (be it sexual or oral) did you have the test?  And you had no symptoms or blisters or anything correct?  What prompted you to get the herpes test?

Without knowing the above answers, I would say at this point, if you haven't had any symptoms - QUIT STRESSING ABOUT IT.  Both your numbers are very low and there has been quite a lot of research with regards to where test cut off's should actually be.  It really does all depend when last you were in a situation where you could have contracted the virus.

In my case, I had no symptoms either and just decided to get a full screen for everything.  My results for my type 1 were very high so there is no question that I have type 1, but my first batch of tests came back and equivocal/positive for type 2.  I waited two months and went for type 2 testing again and it came back positive @ 1.142 (which was actually lower than my one result from 2 months before).  At this point I should have been above 3.5.  So while the lab tells me I'm positive, they don't take into account my history.  Had they done that, they would see that things just don't add up.  I guess I could do a Western Blot test to absolutely confirm my negative status but I'm really not concerned since I'm almost 100% sure that I am fine.  I will reconsider this option prior to my next physical relationship.

Let me know the answers to my previous questions and I can better help you.

[kortal]

im in asia right so..well i got my testing done from some weird lab in asia....called samkyung lab corp. so no its not the accredited herpesselect. wb. or biokit..etc. my results came back 1.4 for hsv2 and hsv1 was 2.4 i never had a cold sore ANYWHERE on in my body. im freakin out everyday. i wont be back in america til next year. no blisters, no sores, so pain, no irritation, no rash, no tingling, no omg its painful i cant walk type thing, no popped things on my mouth or ANYWHERE. my last 'encounter' was about 4 months ago. andi just got the test done. i dont know what to do. i just spent well over 300 dollars. i first got a combined testing of hsv1 and hsv2 igg igm and that came back positive for 10.0 and the doctor reassured me its probably hsv1. but not like that grey area and knowing igg and gim resutls are outdated and not to mention CHEAP -for the doctors hence why they resort to it- i decided to get retested. and so the results came back positive for both. with all the staff lookin down upon with shock. bc supposedly hsv2 is not prominent in asia which is why they do not have advanced testing readily available. anyayz being a perfectionist by default...THIS TESTING IS making me freak out. i cant help but to think why i tested positive on BOTH HSV1 AND 2. could i be negative for both? i could be positive for both? could i have hsv1 and be false positive for hsv2? does hsv1 usually cause hsv2 to be false positive? i mean i dont know what to think to do. im just confused. please help.

[kortal]

so u never actually received a negative result. u just self diagnosed urself as negative????

[seasian]

are u in korea?

[kortal]

in japan.........but do u have any suggestion besides where askin where im located at

[actuallynegative]

Sorry for the delay - I don't check this often.  OK, so about 4 months after your last encounter, you had the test done and your results were 2.4 for HSV1 and 1.4 for HSV2.  Without actually knowing what test they did, these numbers still look like a herpeselect test or something that uses a similar calibration for displaying your results.  My opinion would be that after four months, these are still very low positive results and after that period of time, they should be much higher.

Now, not really understanding what you wrote above, I am assuming that the value 10 that you mentioned above was (a) your first test of the two you've had and (b) was just for a generic test that tested for the presence of HSV antibodies in your system.  Asssuming it was and it came back positive, it probably was detecting the presence of HSV1, simply because most people have it.

If you have experienced no symptoms, I would continue life as normal (and if you have additional sexual encounters ALWAYS use a condom) and try put all of this behind you until you get back to the States or you can find a place that does either the Western Blot (you probably wont find that other than here in the US), the Biokit or the Herpeselect.  Also, if you have not had any sexual contact for at least 4 months prior to taking any of the above mentioned tests, I would stick to the Biokit or the Western Blot.  I say this because:

I both times had the Herpeselect test and both came back with extremely low positive results for HSV2 - lower than yours.  The Herpeselect test has been known to give low positive results for HSV2 in the presence of HSV1 (yes, even the newer version of the test).  My first was 3 months after the last encounter and the second was about 5.5 months after the encounter and my second result was actually lower than the positive test of the first test, so actually there was a decrease in the result.  The lab where I got tested told me that they just issued results based on the manufacturers recommendations and that's it.  They don't take medical history into account.  If they did, they would realize that the results that were 2.5 months apart and things didn't add up.  In reading all the doctor's blogs on this site - I realized that many health professionals out there really have no idea what they are doing when it comes to herpes.  So, taking into account all that I have learned on this site - there is a 99.9% chance that I am actually negative UNLESS I am one of the very few who's antibody count stays very low and I doubt that.

So yes - I self diagnosed myself and I am confident that I am right.  Any doctor on this site would agree with me although I didn't pay to post so they will not post a reply, and that is ok, I am not worried in the slightest.  I hope this helps

[Said43]

So where did you get the information that results should go up over time  My H Select test results came in positive and went down substantially, 50%... to equivocal after 20 months.  I am awaiting WB results taken earlier this week....It was my intuition that numbers should be stable or go up over time. IN my case its been almost 20 months between tests.  I have read that if you are positive for HSV1 that it can skew the validity of HSV2 results under 3.5 for HSelect test results.  My results were 50% less of original numbers!  The only real confirmation is WB....

[actuallynegative]

First off, I always start by stating that I am not a medical professional).  I believe you are correct in saying numbers should remain the same but only if you have an established infection that was way positive to start with - I would say anything higher than 5 but normally around the 8 mark.  In reading many blogs on this site, Dr. Hunter Hansfield points out that if you test equivocal or even a low positive and you wait a couple of months for a retest, you should be strong positive - above 3.5 for sure but probably around the 5 mark.  My opinion would be that if your result came down from a low (<3.5) positive to an equivocal and you had waited for that two month window (or 20 months in your case) since your previous test - that is dubious enough to suspect that your first test was not accurate.  I would also have followed up with a Western Blot just to make sure but I would see this as a positive indication that you are probably positive for Type 1 but negative for Type 2.  I would like to point out that in rare occasions, people can have a low positive for Type 2 with consistent testing and actually be positive but this is too rare to concern yourself with.

Having an established type 1 infection has been known to skew the test results for Type 2 and although tests today are better than they used to be, they are by no means perfect, in fact, another interesting bit of info I found on this site and I believe it was from Dr. Hunter Hansfield, was that about 50% of those people that tested low positive <3.5 (and had established Type 1 infections) were actually negative.

Hope that helps out and I would be interested to know what your Western Blot results come back as.  Also, what prompted you te be tested in the first place.  did you have any symptoms or was it just part of an STD screening?

[Said43]

No symptoms at all, but my GF got a yeast infection and is now seriously questioning the long term relationship and how HSV fits... She is negative for both.  Basis my findings, I am quite skeptical about my initial results and hope to get a definitive status with the WB.  Each day of waiting is eternity, but I have already been living with this for almost two years.  Regardless of the outcome, I hope that it has not ruined my current relationship.  
Like you, I have read alot,  but never found this forum until just recently! I did my initial look and my quest for new information, risk/rewards etc led me to new testing and information.   I have been consumed by reading all the posts, answers and am quite impressed with the professional, versus the ranting, replies of highly experienced, educated and ethical STD practitioners. It is by far the best site for real information and a very good platform for getting specific answers to individual issues.  Basis my particulars, it may be an interesting individual case study on testing, validity of results and the unmeasurable psychological impact HSV has on both sides of the aisle.....  
Thanks for your comments.   I will look for that posting....50% not infected under 3.5....  

[actuallynegative]

Yeah, I hear you on the validity of the test!  It is tough to deal with, not that it's a serious virus, but just that you have to disclose it to you future partners.  And, like in my case, without actually taking the WB test, I actually believe I am negative.  It is for this exact reason that most places will not suggest you have a HSV test as a routine STD screening and only recommend it as a confirmation to a swab test when actual blisters/lesions are visible.

I had my tests done at the local health dept and upon receiving my second positive result at 5.5 months past exposure (1.142 - which is way too low for post 5.5 months exposure) I declared that I actually knew more about Herpes than they did.  What really bugs me is that they didn't look at my history despite the fact that both tests were done through them, and rather, encouraged me to start taking prescription medication to treat something that I don't have.  Crazy!!!

Another thing to consider with your GF is this:  If you have HSV1, be it orally or genitally, it is possible to pass it off to your GF such that she contracts HSV1 genitally - although this seldom happens.

[Said43]

HSV1 exposure is another topic and has its own set of  similar but different issues.  While genital HSV1infection is remote, say 20% of cases, and discounted to those of us and in the medical profession, it is a real concern and should be thouroughly discussed with your partner.  
While no studies actually confirm exposure potential, most DR's believe that shedding is materially less in HSV1, especially over time of infection and they only can suspect that Valtrex will reduce infection risk similar to HSV2 transmission. I believe under all of these conditions, from what I have read, that a conservative estimate would be less that .05% unprotected.  That being a 99.5% probablility that you would get nothing. It has also been recently suggested and debated that the use of Valtrex by an unifected partner could offer some additional protection and assuming cost issues are not of concern....but no clinical study...

I take comfort in acutal practioners belief by actual, non-emotional and professional clinical finindings...."real experience",  that  oral sex, kissing etc should not be avoided as long as an educated discussion of risk/reward is accomplished.  I also take addtional comfort that the overwhelming majority, have only one occurance or so for the rest of their lives.  Again, a good risk/reward ratio as compared to gential HSV2.  Lastly, even HHH's assessment that he has not seen such a case in his considerable STD history adds even more credability to counter the often heratic discussions that take place. HSV1 risks are real and it is not to be taken for granted and risks should never be minimized as "everybody has it" so it should not be a problem.  But at the same time its risks should not be overinflated as to what it is, how it manage and deal with it effectively.

This does not denegrate the small number of cases that actually happen and have more serious symptome but is directed at the serious majority of cases and what one should expect from genital HSV2.

I would love to see real percentages outlined in all combinations for positive male to negative female, and visa-versa, for all combinations and other topics.  This should be a "sticky file", like the directions before posting at the beginning of the forum's thread section.  Search functions will continue to be very helpful but are cluttered with alot of information.... I understand this would take considerable effort by the Dr's but would be well worth the effort to all visiting the forum.  Hey, I got my own rant in.......