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HSV2????
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HSV2????

Hello. Here is my question. I have been tested every year for STD's when I go to my annual exam and usually only worried about the HIV result and when all came back negative I didn't pay much attention to anything else. I have now heard that just because you say you want STD testing they don't always (or didn't used to) test for HSV. I was pregnant in 2009 and miscarried 2nd trimester and was never told anything about being positive for HSV. Then I had a baby 12/2010 and again was never told I was positive (only assuming they tested me). I was with a couple men after that and in 6/2011 I started itching and assumed I had a yeast infection as I am prone to them. I called the doctor and made my annual appointment and also told them I needed to be treated for what I though was a yeast infection. A couple days later I noticed 1 single pimple type bump on the inner labia. Since I had an appointment in a couple days I just dealt with the itch with soon turned to pain. When I got in to see the ARNP she said it looked like Herpes but did not look like an initial outbreak because it was very mild. She said it was already an open sore and wanted to do a culture and labs. I had never to this point had anything even remotely resembling this so didn't understand how it could not be the initial outbreak if I was in fact positive. The culture results came back positive for HSV2 stating "Herpes simplex type 2 isolated in cell culture and confirmed by FA staining." However the labs came back negative. The results stated:

HSV I IgG <0.9
Negative <0.9 -   Index

HSV II IgG <0.9
Negative <0.9 -   Index

HSV IgM abs I/II EIA <0.9
Negative
(note)
Significant cross-reactivity exists between type 1 and type 2 Herpes
antibodies.

The ARNP put me on Valtrex daily which I have been taking and I have had no other symptoms or outbreaks. Is there a chance that the culture could be wrong and should I go have another blood test done?

Thanks for your time and responses.
Tags: HSV-1, Herpes
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6 Comments Post a Comment
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101028_tn?1348750963
how long prior to these symptoms had you last had sex? was that partner someone you are still with for them to get tested to know their own status?

grace
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Avatar_f_tn
Hello Grace. I had started sleeping with someone within a month of symptoms starting but I am not seeing him anymore. He states that he has been tested since I found out and that his results were negative but I did not see them myself to confirm that he was being honest.
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101028_tn?1348750963
at this point you know what you have and where you have it which really is the only info that is important. from this point forward you can make educated decisions with any future partners about what precautions to take which is really all that matters.   hard to tell if you are one of the low percent who doesn't test accurately on the igg tests or if this really was a newly acquired infection for you. since you aren't with that partner any longer, really doesn't matter.
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Avatar_f_tn
Hi Grace. So I was doing research and found something interesting. I am going to post part of the info below.

"Molluscum contagiosum virus
(MCV) can cause a cytopathic effect
(CPE) in some tissue culture lines,'
although this is not widely known (and
indeed was not initially known to us).
In our laboratory we have observed
that MCV can cause a CPE in both
MRC5 and monkey kidney cells; both
cell lines are used in the isolation of
herpes simplex virus (HSV). The CPE
of MCV disappears with first passage
but that of HSV evolves more rapidly
and can be passaged. HSV type 2
generally produces more marked
ballooning of cells when compared
with HSV type 1 and MCV. Our
laboratory does not routinely perform
serial passage, immunofluorescence
(IF) or electron microscopy (EM) on
specimens causing a herpes-like CPE.
In an attempt to determine how
often MCV produced a CPE we
swabbed classical molluscum lesions
over a 3 year period. Swabs were sent
to the laboratory in transport medium
requesting herpes virus culture. The
specimens were inoculated onto tissue
culture, the laboratory worker being
unaware of the diagnosis. Nine of
19 swabs yielded a CPE and were
reported as "herpes simplex virus
isolated".
We present a case history to illustrate
how misdiagnosis might arise
from swabbing atypical lesions.
A 22 year old female with no past
history of genital herpes or molluscum
presented with a slightly tender vulval
lesion of two weeks duration. On
examination an indurated crusted
lesion 0 5 cm in diameter was present
on the left labium majus. A swab was
taken for herpes culture. The
laboratory reported the isolation of
herpes simplex virus from observation
of a CPE but did not perform confirmatory
tests on the cytopathic agent.
The aetiological agent of the lesion in
this patient may have been MCV or
HSV.
It is important that misdiagnosis
between HSV and MCV is not made.
It has been suggested previously that
specimens producing a CPE that will
not serially passage should be submitted
for further confirmatory tests.2 In
our laboratory resources are limited
and therefore it is important that the
clinician states on the request form
whether the appearance of a lesion is
atypical so that the laboratory can
selectively investigate further any
CPE to confirm or refute HSV. This
should avoid potentially serious misdiagnosis."

After reading this I thought I would go get retested since it has been 4 months since my testing was done and I figured if I was positive then the blood tests would show the antibodies by now. I am on valtrex 500 mg once daily but the nurse in my doctors office told me this would not change my results and that I did not need to stop taking it before testing again. I got my results back today and got the exact same results as the first time

HSV I IgG <0.9
Negative <0.9 Index

HSV II IgG <0.9
Negative <0.9 Index

HSV IgM abs I/II EIA <0.9
Negative   <0.9 Index

So should I then assume that the initial culture result was inaccurate?

Thanks
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Avatar_n_tn
Taking daily Valtrex right after initial infection might delay antibodies production. Or, as Grace said, you might be one of the few that will test false-negative on the current tests.
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101028_tn?1348750963
you have no reason to suspect your culture was inaccurate.

feel free to pay to ask Terri Warren's opinion, our herpes expert here on medhelp too.
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