HSV-2 testing time

Dear Docs,
I was in a relationship with a women throughout September of 2009  during which we engaged in minimual sexual intercourse mostly protected (sometimes not). We broke up for the month of October then got back together in Novemeber. Upon getting back together in early November we decided to be STD tested because I was diagnosed with Molluscum Contagiosum. My results all came back negative except hsv-1, She came back positive for HSV- 1 and HSV- 2 with a 1.6. Her health care provider assured her she most likey has had HSV-2 for sometime (maybe years) and is probably asymptomatic.

She's never shown symptoms or experienced any signs that point to HSV-2 infection. She was retested 2 weeks later and it came back positive again, this time with a 2.5 . Since then i've been tested three times all still negative.
1st test - 9 weeks from first contact
(she tested potive on Nov 19)
2nd test - 15 days after second exposure
3rd test - 6 weeks after second exposure (Dec 29)

My question is when is a good time to finish testing and to believe that i'm still negative. I have never shown or experienced any symptoms and its now been 9 weeks since last exposure and a total of 19 weeks since first exposure. I believe my doctor and the clincs I've tested at were using the Herpesselect test which i've read is pretty accurate after 3 - 4 months. Do you have any advice for testing timelines or specific test?

[gracefromHHP]

This is not the doctor's forum - you have to pay to post there.

Actually  your gf needs to get further confirmatory testing done. I assume she's only had blood tests done and not any actual genital lesions? Her hsv2 result is still low and she needs a herpes western blot blood test if she can get it to confirm her status. once you know if she actually has hsv2 or not, then you can decide if it's worth any more testing on your part.

http://www.medhelp.org/posts/STDs/Confusing-Igg-Test-Results/show/771141  is a previous post with  more info on the low igg results and why they need confirming.

grace

[steven512]

thank you for the reply grace. She indeed has never had symptoms or lesions, she is reluctant to recieve another test due to the fact her levels increase from 1.6 to 2.5 in only a week. However i'm approaching the 16 week mark from my last exposure, If negative should I assume I dont have it for sure or should I wait til the 6 month mark just to be sure. I'm very worried about the time frame of testing based on the fact that this was not a single exposure and she is more or less confirmed positive.

two final question

1. What is the likelyhood of a male contracting HSV-2 from a low positive asymptomatic female? mind you we had sex maybe a dozen times, mostly protected.

2. Is the stat of 1 in 5 persons needs 6 months to stero-convert indeed that accurate or could I assured by the 4th negative test within the suggested 16weeks?

thank you

[gracefromHHP]

no need to wait and retest at the 6 month mark.

At this point she needs more testing done. even a 2.5 igg for hsv2 is a low positive and needs confirmatory testing done like the herpes WB.

1- can't ascertain your risk until we know if she is really infected or not.

2 - very few folks need more than 4 months. most clinics don't even recommend waiting that long but we err on the side of caution here.

grace

[steven512]

Thank you grace, She's expressed intrested in the Western Blot however still is skeptical about her need to retest. Would the WB be your only recommendation or would a reading less than 2.5 or 1.6 with the type specific herpesSelect be an indication of false positivity? I know a lower reading wouldnt confirm a negative but the test is cheaper and may be easier to sway her to give testing one more go.

[gracefromHHP]

typically I recommend anyone with a hsv2 igg under 5 without any obvious symptoms get a WB to confirm their status. It's not worth assuming you have something that you don't.

grace

[steven512]

thanks grace, she plannings on testing in a few weeks, however I'm probably going to test (since it'll be 16 weeks) before her. Just for the sake of nerves (it's be a long 4 months) I was hoping you could give me a few stats that may apply to our situation. I feel a bit selfish but I'm very curious as to my chances. From what i've read  3 false negatives (dec 29th was 17, 13, and 6 weeks from all possible exposures) sounds unlikely but I'd appreciate your opinion. I've had no symptoms associated with hsv-2, just things associated with molluscum (dry skin, etc) and worrying myself sick. I understand if you do not wish to speculate.

[gracefromHHP]

hard to wait but best you can do right now.

grace

[steven512]

so everything turned out fine, my 15week test was a 0.13 and her WB came back negative. I just have a few questions about the accuracy of the WB. I've read that it is the gold standard for resolving low positives like her first 2 test but i'm having a hardtime understanding why. She tested with the WB about 20-21 weeks last possible exposure which most sources say is past the point for clerical error.

I guess i'm just wondering how definative a single WB negative is given she's had 2 low positive (1.6 and 2.5) results with the HerpesSelect.

[gracefromHHP]

the WB looks at more parts of the igg response to herpes than other blood tests do.

congrats on the negative results!

[steven512]

thanks grace! i'm not trying to beat a dead horse here but Its hard to wrap my mind around 1 WB is definative proof of a true negative. Any stats or advice that could easy my mind?

as always thank you

[gracefromHHP]

low positives and a negative WB is  all you need to be confident in the results.

grace