Doctor's Forum

[worriedfromabroad]

Hello,

Does anyone know why the expert forum is not accepting new questions?

[worriedfromabroad]

So, I've got my results back -- both tests that I initially did came back negative. It's been 7 weeks of mental torture and I can finally move on without worrying about every itch, tingle or blemish in the genital area. I also definitely understand why general screening isn't recommended by the CDC -- a false positive is really traumatic.

@ukmale52: From what I've read on this forum, most of the GUM clinics in the UK do have the blood tests available. Find one that does them, and good luck -- you shouldn't be convinced that you have herpes without definitive proof.

A big thanks to Life360, Fleetwood and Grace for their continued support on this forum.

[ukmale52]

I know how you feel mate , ive been going through this for 3 years now although ive never been tested , for one there is nowhere to get a private blood test and the uk gum clinics don't do the blood tests , actually ive been that stressed about it the gum clinic said that I probably do have hsv2 based on the fact that I have had multiple partners and I explained that my partner is aware of my worries but isn't overly worried about it , and there reply was : oh that's good then , just carry on having unprotected sex as she seems to be aware of the risks : !!!!!!!!! , ive been with my current partner now for 12 years and never had any problems until 3 years ago when I stupidly got a handjob ( yeah just a handjob ) of someone else and since then ive never been the same , burning penis glans , lower back ache , left thigh burn and small rashes on the back of my right thigh but never any visible blisters , and unfortuneatly I have convinced myself 100% that I caught herpes from this encounter , needless to say that this is really putting a strain on my relationship which I value a lot because I dare,nt have sex with her :-(

[worriedfromabroad]

For the benefit of all those freaking out like I am, I'm posting an update - I decided to redo both tests I had done at the lab against the recommendation of the lab tech and doc who's managing the lab. I'll keep everyone posted on the results. For some reason, I'm not very optimistic since I've had too many rashes, itching, bumps, what I thought were pimples, etc in the thighs, buttocks and anal area at some point during my life (anal itching being the most recurrent) As far as obvious blisters go, I don't think I've had one before, but again, I can't be sure --  and since I have type 1, it's entirely possible that they were too mild to notice.

[worriedfromabroad]

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[worriedfromabroad]

Thanks for your input Fleetwood; much appreciated.

Grace, any thoughts on my questions above?

[Fleetwood20]

No need to be concerned. If you'd had herpes for years you'd have recorded a clear positive for antibodies. I know the test and it is reliable, you do not have HSV2.

[worriedfromabroad]

Hi Fleetwood20,

Thanks for your input.

My worries mainly stem from the fact that over the years I've had many non-specific symptoms - itching, rashes, what I thought to be pimples etc.

As far as the tests, the first one I was told was IBL and had a different cutoff (greater than 1.2 positive and less than 0.8 negative)

The second one was not a Euroimmun, but Alegria, which is also an ELISA, and manufactured by a Germany company. There's just not much there about it, so I'm wondering if it's reliable.

Link here for info in case you want to take a look or have some input:

http://www.orgentec.com/index.php/en/produkte/alegria?cat=20&product=201


Thanks again.

[Fleetwood20]

Just to add a few thoughts.

1. Your original low positive result had a high chance of being truly negative. The fact that you appear to never have had genital symptoms in terms of a lesion supports this very strongly. You look to have had a Euroimmun test second time around which is very reliable and accurate but equally sensitive and produces false positives. The fact that you are a clear negative by the Euroimmun is conclusive.

2. There is no need for any further clarification on your testing, it talks for itself. If you were positive, most likely you'd test well over 70 u/mL.

[worriedfromabroad]

Grace, thanks very much for your continued support in this forum.

A couple of follow-ups, if I may:

1. You said that the 2nd test being negative pretty much confirms the first one as being a false positive. Does the fact that this was done with a different ELISA test have any influence on your opinion?

2. I'm outside the U.S. (very far out), and where I live, the medical community is pretty much clueless when it comes to herpes. (My urologist went so far as to say that asymptomatic shedding "absolutely does not" occur). Is there any way that I can get in touch with Dr HHH or EWH? Their opinion on my situation would obviously alleviate some of my fears should they share the same stance of me not being infected.

3. Would you recommend any further testing knowing that I probably can't get the Western Blot given my location?

Thanks again, your help is truly appreciated.

[gracefromHHP]

There is a relatively  high rate of false positives with the hsv2 igg testing unfortunately. Your 2nd test being negative pretty much confirms that you had a false positive initially.

things that you usually wouldn't think twice about often take on increased significance when you start thinking herpes. When you read about herpes it seems like anything and everything could be herpes unfortunately.  Pimple-like things in the anal area are normal! those are your oil glands that help keep the area moist like we have on our  lips too. any irritation makes them look bigger. I think the Europeans have something right with bidet's on their toilets for better cleansing of our anal genital area!!

[worriedfromabroad]

Hi Grace,

Thanks very much for your response.

Are you saying that the second negative test is reliable and the first one is definitely a false positive? Are true positives usually expected to always show on different test kits?

Until the first low positive test, I never really thought that the itching in the anal area could be herpes, but I do get that quite often. I guess the governing logic in my mind was that the buttocks area is subject to all the same dermatological issues that other parts of the body are (if not more, since it's a sweaty covered area) and never really paid much attention. Is this logical flawed? But now with the first low positive, I wonder if those are recurrent outbreaks and upon close inspection, I see some pimple like things.  

Basically, i'm worried that I've had it all along and gave to my partner and she hadn't had time to seroconvert yet. Unfortunately, the testing was done after a few episodes of sex.

[gracefromHHP]

medhelp is no longer operating the paid doctor's forums. hopefully they will come back soon :)

really no reason to doubt your test results as being hsv2 negative. You've had no symptoms other than irritation ( that you might even be making worse with your poking, prodding and looking at ).

Great that you and your partner were responsible and got full std testing that included herpes testing prior to sex :)  Takes so much of the worrying out of the way as well as less chance of surprises later!!

Now go enjoy your new partner ;)

grace

[worriedfromabroad]

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[worriedfromabroad]

Forgot to mention, some insight from Grace would be much appreciated!

[worriedfromabroad]

There was no suspected exposure. It was just routine testing. My partner tested negative and I hadn't had sex with anyone before her for 4 months.

Are you confirming the reliability of the Alegria test? It just seems there isn't much info about it.

My concern is whether I may have missed the primary outbreak a long time ago and my recurrent anal itching and/or burning urination are actually recurrent outbreaks (they don't occur together, but I've experienced them on many occasions throughout the years). I had never been tested for HSV before.

Thanks again for your insight.

[Life360_Dave]

Hi it does appear that the first test for hsv2 was a false positive and was confirmed negative with the second test. It is very reliable.
What was the time between testing and sexual exposure?

[Imsorry23]

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[worriedfromabroad]

Seems like the scores were cutoff. Trying again:

First round of tests:

HSV 1 106.4 u/ml, Neg less than 20, 20 -25 borderline, greater than 25 positive
HSV 2 1.58 H, neg less than 0.8, borderline 0.8 - 1.2, positive greater than 1.2


Second test:

HSV 2  2.9 u/ml, Neg less than 20, 20 -25 borderline, greater than 25 positive

[worriedfromabroad]

Ok, thanks for trying to help. Well I'm a 30 yr old male and decided to do a full battery of STD tests since I'm seeing someone new. Everything came back negative except HSV 1 (which I knew I had as I've gotten the occasional cold sore) and HSV 2 which shocked me.

My scores were:
HSV 1 106.4 u/ml; Negative 20;
HSV 2 1.58 H; Negative 1.2

Of course, after extensive research, discovered the false positive issues with HSV 2. I contacted the lab and asked them what test kit they used and for HSV 2 it was IBL; for HSV 1 it's Alegria. Some online research showed that Alegria is also an ELISA, manufactured by a German company called Orgentech, and part of the test is automated based on some proprietary technology I believe.

I decided to redo the testing, and the doctor at the lab said that cross-reactivity with HSV 1 is not uncommon and suggested to confirm by using the other test. In the case of HSV 2, since the first test was IBL, the second test I did was the Alegria. Results were 2.9 u/ml with negative 25.

The doctor at the lab assured me that I was ok provided that I had no symptoms. I was relieved for a while but my paranoia from all the research showed that many people who are diagnosed with HSV end up recognizing symptoms afterwards. I then recalled the many things that may or may not have been due to HSV 2 - burning urination, itchy pimples on the buttocks, itchy rashes and so on. Extensive examination on a daily basis revealed some "symptoms". The first was burning urination again. I inspected the opening of my urethra and noticed one side visibly redder than the other and it stung a little. Lower back pain, groin/lymph node pain accompanied it. Herpectic Urethritis? My urologist didn't think so. Redness has gone down in the last few days.

Now, my most recent symptom was a sudden itch inside my buttocks yesterday, which I scratched vigorously. Upon inspection, it now it looks like a papercut lesion, although it could look like the skin was scraped off. I now recall this location being troublesome in the past, which seems to point to herpes.

As to my questions:

1) Any idea if the IBL test has the same sort of false positive issues as the other ELISAs?

2) Any idea about the reliability of this Alegria test? It did pick up my HSV1 (and my partner's) so that's somewhat comforting.

3) Do any of the new symptoms suggest herpes? I know that collectively, they're unlikely, but individually, it seems that they might.


Thanks in advance for any insight; truly appreciated.

[Life360_Dave]

No, but maybe we can help you here.