HSV 2 results

[confusedandscared4]

I am new to this community and scared and confused as heck and I have no where else to turn. I was just recently diagnosed with genital herpes 2 and I am in shock to say the least. Here is my diliema. Over the past 10 years I have had a blister that has popped up in between my bottom way far from my anus that starts as soon as you can open your cheeks. (sorry to be so detailed) It has always been on one side ALWAYS and no where else. I have been to the docotrs and they have all seen where it is. I have never had any sores in the vaginal or anal area at all. I was told by each of them that it was shingles and that it can come back to people who are very stressful (and that would be me). I have even mentioned to each of them that I have had the Shingles before. They didn't seem to worry and just said ok, let me see where it's at they look and "Oh yea, its shingles!" I take medicine everytime it has happened and it clears but ever since the first episode I have pain almost everyday and I know that is common with people who have had shingles. There isn't a day where I don't feel pain in that area. the pain can go from mild to severe. Recently I had a break out in July and went to see the doctor he asked if I had ever had a problem down south and I said "No, never!" he said ok good. I had another breakout in September and luckly I had a refill that he had given me just in case. Before this I hadn't had a breakout for 5 years. The years before that would be 3 years or once a year. It varied and only comes out when I am stressed. I recently went to the doctor to talk to her about my reccurrences because I have become very OCD as well. She asked me have they ever checked me for herpes? I said no. She said Why not? I was like I'm not the doctor I don't know! well here it is I am diagnosed with HSV 2. I am angry, scared and very confused. Why would doctors play like that with somebody's life, feelings after all these years!! I'm also confused about my results. I hope somebody can help me calm down and make sense of this. I am also going to see my OB in a few days. Sorry for this being so long.
HSVab+HSVIGM:
HSV I/II IGG 58.1 HIGH
HSV 2 IGG, TYPE SPEC 4.47 HIGH
HSV, IGM I.II COMBINATION 2.18 HIGH

HSV 1 AND 2 IGM Abs, INDIRECT:
HSV 1 IGM Antibodies <1:10 titer reference level < 1:10
HSV 2 IGM Antibodies <1:10 titer reference level <1:10

Hope somebody can help me make sense to all this.

I must add that I live with the pain everyday where the breakouts have been. There isn't a day that goes by where I don't feel pain, like a shooting pain in the area or itching.

[confusedandscared4]

Thank you Grace! =) I will keep you posted as to what has happened. I thank you for giving me a "peace" of mind.

[gracefromHHP]

if you have a quest lab near you, it's test #34534.  

you also can call the u of washington lab and have the kit sent to you and have your provider order the blood drawn and sent to the U lab for you from almost any lab.  

best of luck getting better answers :)

[confusedandscared4]

Makes total sense. So I should take that 'negative" result as a false negative. This is so confusing and overwhelming. So the best thing I can do is to stop doing blood tests, do the WB and do a culture when present right? When taking the WB do I need to stop taking the Valtrex ahead of time? If so how long before I take the test? I use labcorp and from what I read they don't do it, so how do I go about gettting one done?

[gracefromHHP]

yes, if you have it anywhere below the waist, you have it vaginally and anal too.

you will get different numeric results each time you test. both your results are still positives but both low enough to make it worth the WB.

yes you can detect herpes via pcr even when lesions aren't present but you have to be actively shedding it at the time. The odds of shedding it with an out of the blue one time swab are incredibly low since on average you only shed the virus 45 days out of the year. That leaves a lot of time the virus isn't active to be detected on pcr. make sense?

[confusedandscared4]

Here is the website I was talking about.

www.herpes.org
Here is where they say a lesions doesn't need to present.

[confusedandscared4]

Hi Grace,

So you are saying that if you have it on your bottom you have it vaginally no matter what. So you can't just have it on the bottom and then not in your vagina and vice versa. So if you have it vaginally you have it in the anus as well. If you have it in the butt you have it vaginally. It can't be one or the other, it's both right?

I'm still trying to make sense of this and you guys are the only ones who can help me without driving my husband crazy or calling the dr's office about questions.
1) Why did my hsv 2 index go from 4.47 to a 3.57? You said the medicine wouldn't be an issue since I have had sympotoms for so long. I used to take it just when I had a break out but when I learned I had it back in january I have been taking it as suppressive therapy.

I'm just very confused and angry because I can't get any answers from anyone. I have seen on another site by a Dr.H that said you can pick up dna from a pcr test if no lesions are visible. Not sure if this is the same Dr. H that is on here, he also interviewed Terri on his site.
Thank you for your time!

[gracefromHHP]

you would have to be actively shedding the virus when they did the pcr.  you aren't actively shedding 24/7/365

no, lesions aren't always just where you had a point of contact - they can occur anywhere in the entire boxer short area regardless of what sort of sex positions you've ever practiced.  if you have hsv2 on the buttocks/anal area, you also have it vaginally.

get the WB just to be sure about your hsv2 status and go from there. every time you have a recurrence of your symptoms, be seen within 48 hours for a lesion culture or ask to have the pcr supplies at home to do it yourself.  you've had symptoms for a long time so being on valtrex won't affect the results.

[confusedandscared4]

Hi Grace,

So I recieved my full panel of STDs and blood work.Everything came out negative. I was told we don't know what is on my bum. We don't know because I tested positive for HSV I and HSV II. These were type specific for each one.
HSV I 5.01
HSVII 3.57

Here is where I am confused still. I have read over and over and have gone through so many sites and have done my research and still don't feel "reassured". I was also told I don't have vaginal herpes because they have done the Herpes subtype (hsv I,hsvII) real time PCR testing and came out negative. I did turn out to have a BV infection. I told her that I thought you couldn't do a swab if no lesions are current. My gyn said the tests have come far since a long time ago and they swabed my cervix and my vagina and there was no finding of either herpes. I was also told that probably the cause for my location of blisters was the original point of contact. Here are my questions:
1) I have never had sex in the anus so why is it that is where the "point of contact" being? The last two dr.s haven't seen where my blister has been.

2) Can they test for the virus if no lesions are present? I have read that you can because the PCR is DNA findings of the virus and if you have a discharge it could be that you have a "active" lesion that is causing the discharge. I also saw on here a poster but that they also had no signs of lesions present when they were checked for the PCR but had discharge and they were negative as well.

3) Does taking valtrex have an impact on test results? I am on suppressive therapy for about a 1 month almost a month and half. I ask because I have read on here that it can but not dramactically. If you notice I have had a score from a 4.47 and now at 3.57 and I also know my Hsv I score which I didn't before.

4) Can having a high HSV I index influence my hsv II index. I have learned that I have had Hsv I since I was small.

Sorry for such a long post and I hope you can shed some light here. Even if my doctor says I should if anything feel "reassured" I don't have it vaginally. Help!!

[confusedandscared4]

Hi Grace,
I just wanted to stop by and say thank for all the information you have given me. It truley has helped and I thank God there is this site for us to come to.
Thanks again and keep up the GREAT work!!!

[gracefromHHP]

unless someone has had a + lesion culture, confirming all hsv2 igg's under 5 is never a bad idea.  The rates of false positives get lower over the 3.5 range but still worth confirming.

[confusedandscared4]

Ok, I hope to get better more "clear" results next week.

My other question is, what is the highest index number to be "positive" for HSV 2? I only ask because i see people but on here that have results higher than mine and took the WB and came back negative or I have seen that that the index is >5 could be a false positive. I know I have read over and over that it is anything below a 3.5 is considered a "false positive"

[gracefromHHP]

many labs default herpes igg testing is to do the combined test and if it's positive, then do only a hsv2 igg.  It's a very poor way of reporting results and your provider ( or their clinic staff ) should learn to order only type specific testing as well as should stop ordering herpes igm testing on pt's.

[confusedandscared4]

I did post them on my very first post. I posted all my results on here. Here they are again:

HSVab+HSVIGM:
HSV I/II IGG 58.1 HIGH
HSV 2 IGG, TYPE SPEC 4.47 HIGH
HSV, IGM I.II COMBINATION 2.18 HIGH

HSV 1 AND 2 IGM Abs, INDIRECT:
HSV 1 IGM Antibodies <1:10 titer reference level < 1:10
HSV 2 IGM Antibodies <1:10 titer reference level <1:10

Ok, now I'm just totally confused now. I guess they didn't give me a HSV 1 result. I have the paper work here and this is what it says. I'm assuming that they just saw the HSV I/II IGG test and was a high 58.1 and then just did a type specific to see which one it was. Can you help me out here? I posted the results on here exactley the way the paper shows. Why no routine blood test while on herepes antivirals? She is checking for other stds as well.

[gracefromHHP]

no need for any routine blood testing while on herpes antivirals.  

you didn't post any hsv1 results.   can having hsv1 cause a false positive result on the tests? yes they can.

[confusedandscared4]

Can having a high index of HSV 1 interfere with the result of a positive HSV 2 result?

Also when you are taking valtrex do they do blood test to make sure your kidney levels are fine since I have read that it can affect the kidneys.

[gracefromHHP]

you can transmit it through naked skin on skin contact but the risk of such is pretty low. Just naked spooning isn't going to transmit it. Being naked with someone and doing everything but actual penetration is a risk albeit a small one.

your provider really needs to read up on lysine so she stops giving out wrong information! It's the valtrex giving her patients results, not the lysine!!!

she also is wrong about herpes and the vaginal area. the response I gave you is the correct one.  

[bobrope45]

Very unlikely. The virus requires to be vigorously massaged into the skin to infect the cells. A simple contact most probably won't do it.

[confusedandscared4]

Another question. I was also told by her that you can get this just by close contact. That my area was probably moist and thats where it resided. How common is it to catch just by contact say, just by cuddling. I thought it was a small percentage but can you please clarify? Thank you.

[confusedandscared4]

Good for you!! I totally agree with you!! It has really upset me with the standard tests. If this is considered an STD then test for it!! It's as simple as that! You are sending the patient out to do tests then add this one too!!

Shame on them!!

[confusedandscared4]

I hear all of you! I can't believe that it isn't part of the STD screening nor in the prenatal blood tests. If this is soo common and "silent" they should indeed screen for it ALL THE TIME!! Don't dr.s realize that they are messing with people's lives and other people's lives that they are with. They shouldn't just not feel like "dealing" or having the patient just to "deal" with it either!

I just went to my GYN and told her my story and got a full STD screening. More blood work done, not sure if she checked again for HSV. I did ask her though about shedding. I asked her if I shed through the vaginal area, her response is if only I have it there. They did a culture for that. She aslo did say that my ob won't spread since it has been there this whole time but a possibilty. I get results in 2 weeks.

She also did say that lysine and the combination of valtrex helps people as well. There is soo much info out there and misconceptions too. It is a very scary thing and I hope to GOD that it stays where it's at.

I appreciate all of you responding and giving info on the topic. Keep it coming. The more I educate myself the better I feel. =)

[gracefromHHP]

you don't have to have had anal sex to have herpes symptoms there. when you are infected with genital herpes, it infects the entire sacral nerve ganglia and can cause symptoms anywhere below the belt. Typically ob's are limited to what we call the "boxer short area" but they can happen other places below the waist too. it's not the virus "moving", it's the normal way the virus works.

the virus sheds from the entire anal genital area though regardless of where your ob's are. So for instance if you only have ob's on the lower back, the virus is still active from the vaginal and the anal area and you need to take full precautions with a partner.  Same goes if ob's are on the thighs or buttocks too.

keep asking questions!

[bobrope45]

yes, absolutely. the virus usually has a favorite general spot but it can all of a sudden change its outbreak location, yes. in the future you might have outbreaks in the vaginal area, for instance. it can go anywhere in the boxer area.

[Janis1966]

^^I too an stunned that HSV2 is not included in routine testing. When I asked to be tested for "everything" last October, I expected HSV2 to be included. Although I truly feel my infection was recently acquired in the last month, I can honestly say that I have no medical evidence to prove otherwise and I'm disgusted with the powers that be in the Canadian medical community for not including HSV2 testing with routine testing. I'm going to do something about it, because the statistics overwhelm me with regards to this virus! Current screening practices are unacceptable by both US and Canadian standards.

[zarzamora]

I'm in total shock that in this day and age plus the fact that Herpes is SO common (with many people having it without knowing it as well) - that some docs don't want to discuss it with their patients.  Then what are they docs for?  Isn't it their duty to discuss probs with their patients and make sure they get the best testing and treatment possible?  I got a full STD panel done (which DID include HSV AND HIV).  One would think that would be automatic - but apparently not.  We're in 21st century America for heaven sake!  After all, docs have to discuss cancer diagnosis and other life threatening diseases with their patients.  And surely ALL sexually transmitted diseases should be tested for and treated too.  So WHY NOT HSV??  Would some docs discuss and test for Gonorrhea (for example), but not HSV?  No logic in that whatsoever.  If there is any section of the general public who should be ''immune'' to discussing stuff with so called ''stigmas'' attached to them, then it should be the DOCS!