Confused.

Hello, Doctor.

Well, about two years ago I had unprotected oral sex with  a lady of the evening for about  minute or two before i put on a condom.It wasn't until  last week I noticed  something that resembled  a blackhead on  my scrotal skin.  Thinking of it as just a black head I squeezed it and it popped  and  there was some blood left behind. Worried I made an appointment with the doctor  and  the doctor examined the area  and  told me it  could have been cyst or anything  else. From there  he ordered some blood tests that was taken within the clinic  I was visiting and  he gave me a  time to come in.

This past  monday i was still worried about other STD's so I  went to http://www.tstd.org/ and got tested at one of the labs there and got the  seven  STD  Test panel which tested for HSV 1 and HSV 2.

I received  the results back from both tests back but, I am  confused  by  the results. According to the  tests that I took with the clinic I have  Genital herpes since they were testing antibodies. But, with the test that I took through the website   on the herpes test I had <0.90  and that the tests showed I was negative.

My question to you is  should I trust the  clinic that I visited on 5/26/09 or the lab I saw on 6/1/09? SHould I get retested at  either of them or should  I request a different test? Please help me out.

[Terri Warren, RN, Adult Nurse Practitioner]

If you test negative for both HSV 1 and HSV 2 by IgG, then you are uninfected.  Can you tell me how the two lab tests conflict?  What were the results of the clinic lab test?  Can you get a copy of the results and post them here and I will try to help you sort them out.

Terri

[mixedupguy]

Oh, the type of test that the lab gave me for detecting for HSV-1 & HSV 2  was  called  aB IgG tests on the lab paper

[mixedupguy]

I don't know about the conflict. I just had the  blood drawn at the clinic. It was tested and  From what the doctor told me I have genital herpes.

But,on the test  that i got from another lab(that i went through  on a STD website) I tested as negative on all STD's in the panel.

I'm just confused on which results should I trust? Should  Itrust the clinic or the lab?

[Terri Warren, RN, Adult Nurse Practitioner]

What I meant was, what was the actual result of the first test?  Was it a swab test, blood test?  IgG, IgM, PCR, culture?  

I don't know how to help you sort these results out and help you know which to trust if I don't know which tests you had done.

Terri

[mixedupguy]

Okay here are the  results from the clinic lab tests.  The tests were IgG

Herpes I IgG -  0.4 OD Ration <1.10

Herpes II IgG - 3.5 OD Ratio <1.10

[Terri Warren, RN, Adult Nurse Practitioner]

Well, that is quite a conflict.  Generally speaking, an HSV 2 test with a value of 3.5 should be considered a firm positive.  My recommendation would be to contact the online lab that did the test that showed a negative result and explain the situation to them, and ask for confirmatory testing to resolve the conflict.  My recommendation would be to get the herpes western blot from the University of Washington.  Your doctor's office can order that test through Quest labs, the code is 34534.  I could go with their test result as the final one.

Terri

[mixedupguy]

Wouldn't be just be best to get the Western Blot instead of contacting the lab? Cause it seems that this IgG tests seems inaccurate if both tests i took are so different.

[mixedupguy]

Also doc I have another question. After my incident with the lady of the evening. I found the love of my life and   she gave me unprotected oral sex briefly. If I did have Herpes at that time and i passed on to her through  unprotected sex. Wouldn't she have shown symptoms by now?

Also if we were kissing a lot  even after the oral wouldn't have I developed symptoms for Oral herpes by now?

But, according to the tests  that I got from both labs I am negative for Herpes I on both reports. So how could I have genital herpes if I am  testing negative for Herpes I? Even though that gential (genital) hepres can be transmitted whether  I have a flare up or  not.

[Terri Warren, RN, Adult Nurse Practitioner]

Contacting the lab would allow them to hear about the discrepancy and recheck their results.  It is unlikely to pass herpes through oral sex but possible, depends largely upon if you are actually infected.

This will be the last post on this thread.

Terri