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Contradictory HSV Serology and PCR test results
In Novembr, my new girlfriend and I were both screened for STDs. Mine came back positive for HSV-1 and HSV-2. I never had any symptoms that I recognized and thought it was a mistake. I've read that some of the serology tests such as the ELISA test can be inaccurate if the readings are low, so I followed up with a specialist. The specialist repeated the serology test and received the same, positive results. He then ordered a PCR viral load (for HSV 1 and 2) test which came back negative. I know that the PCR test is much more accurate than the serology tests, but my question is, does this mean I'm negative for HSV 1 and 2, and if so what would be causing the high IgG and IgM levels? I have confirmed in the past that I have had EBV, but that was 10 years ago, and the specialist even indicated that an infection 10 years ago wouldn't cause high IgM levels. He doesn't have a very clear-cut answer for me, but was pretty confident that I'm "OK". Yet at the same time, he said I can take a 14 day trial of Valcyclovir and repeate the PCR test later, just to confirm (that list bit made NO sense to me, if he thought I was "OK"!!).
even an LP isn't going to be helpful. It isn't detected in LP's unless it's a brand new infection or you are one of the few folks who shed the virus in your csf with recurrences.
Thank you for your input. It sounds like WB lis the way to go. I spoke with some poeple close to me, one a doctor, the other a CRNP and they both stated that PCR from an LP is the only other way to test for the actual infection, but its kinda overkill for the situation. And, I don't really feel like having an LP done for this, so if the WB can give me a more definitive answer on the HSV-2, I'm all in. Thanks again Grace and Petal!
your regular provider can order it for you.
it's not available through labcorp.
we test for the antibodies to herpes infection, not actual infection.
it's not available through labcorp.
we test for the antibodies to herpes infection, not actual infection.
So, do I have this test ordered by my gp, specialist, or just go to Labcorp and ask for it there? Also, it may be a silly questions, but if HSV is not blood borne like you said, how will it show up in a Western Blot blood test, and not a PCR?
herpes is not a blood borne infection so doing pcr testing on blood for herpes is pretty much a waste of time and money. I totally agree that the specialist you saw wasted your time and money and wasn't very knowledgeable about herpes testing :( I'd write a letter of complaint to the clinic!
Your hsv2 igg is a low positive and needs confirmed with further testing. A herpes WB blood test is the best test for this. If your regular provider uses quest labs, it's test #34534. It's a send out for all quest labs so if your local quest lab seems confused, make them look into it further as a send out.
Most adults have hsv1 so not too surprising that you tested + for it. Even if you can't recall ever having had cold sores, odds are your hsv1 is oral.
grace
Your hsv2 igg is a low positive and needs confirmed with further testing. A herpes WB blood test is the best test for this. If your regular provider uses quest labs, it's test #34534. It's a send out for all quest labs so if your local quest lab seems confused, make them look into it further as a send out.
Most adults have hsv1 so not too surprising that you tested + for it. Even if you can't recall ever having had cold sores, odds are your hsv1 is oral.
grace
Test results were:
HSV 1 IgG Type specific: 6.61
HSV 2 IgG Type specific: 1.57
HSV IgM 1/2 combination: 1.22
HSV 1/2 PCR:
HSV-1 DNA: Negative
HSV-2 DNA: Negative
I was under the impression that a skin swab was only for a viral culture. I've not heard that a PCR from a blood draw is worthless. I'm a little more confused now than ever. My partners going back over a 5 year period are all negative for both HSV 1 and HSV 2.
HSV 1 IgG Type specific: 6.61
HSV 2 IgG Type specific: 1.57
HSV IgM 1/2 combination: 1.22
HSV 1/2 PCR:
HSV-1 DNA: Negative
HSV-2 DNA: Negative
I was under the impression that a skin swab was only for a viral culture. I've not heard that a PCR from a blood draw is worthless. I'm a little more confused now than ever. My partners going back over a 5 year period are all negative for both HSV 1 and HSV 2.
http://www.cdc.gov/std/treatment/2010/STD-Treatment-2010-RR5912.pdf
Page 20 - 23
If a blood PCR - worthless. Only a viral PCR (as in swab of skin) is valid for herpes testing.
Page 20 - 23
If a blood PCR - worthless. Only a viral PCR (as in swab of skin) is valid for herpes testing.
I will post numbers when I am home and can access my records. I do k now the PCR test was qualitative, not quantitative. Will post more later on when I have more info. In the mean time, can you point me to the specific page you're talking about on the CDC website? The page I found merely says "eh, I dunno that there's any really good tests.. soo.. yeaaahhh".
Your specialist isn't very knowledgable about herpes testing if he/she ran an IgM and PCR blood test - both are pretty much worthless for herpes testing. He/she can read the CDC 2010 herpes testing guidelines. You should have had an IgG type specific blood test. If you had that, find out what the numeric results were for each and post them here for Grace to interpret.
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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.
