Igg Testing

[mam295]

I am 53.  I've had 5 partners total, including my ex ---I tested positive for HSV2 in 9/09 by a culture. I was with a new partner on 9/13 and  9/18.  On the 13th the sex was somewhat rough but not on the 18th (He complained of achey legs the 18th). On 9/20 I started symptoms of what I thought was a severe yeast infection.  After days of  vaginal pain, pain upon urination, fever, headache, legs hurting, crampiness,--I literally could not sit down.  I called my OB/gyn.  She saw me on the 28th.  She stated that she was sure it was a primary herpes outbreak and asked if I had a new partner.  She swabbed the lesions and sent away the sample but did not order a blood test.  I took Valtrex til I ran out and started to get better then I started symptoms again and went through another round of valtrex before my symptoms subsided.  My  new partner tested positive for HSV1 but not HSV2 through an Igg test --no numeric values.  He tested again with the same results in April. He was newly divorced and confessed to "messing with someone with herpes but no sex" previous to me as well as anal sex with someone and at least one - 1-night stand ) I went for an Igg test in April  and tested positive for HSV 2 @ 1.85 and negative for HSV1.  Over the spring and summer I had 3 or 4 more outbreaks where I needed to take the valtrex.
This November, I went to a new GYN--she had the same opinion as my former doctor. I went for another blood test and again tested positive for HSV2 @ 1.58 and negative for HSV1.  

Is it possible that I had herpes 2 before this new partner? (I've not had a yeast infection since my divorce in 05.  One UTI confirmed by urine sample.
With the fact that I do not have herpes 1 - HOW would I not break out as soon as I was infected?  
Is it possible that he has it but has not developed enough antibodies yet?  If so, what test would you recommend he get?  Up until what time frame?


Thank you for reading this long post.

[Terri Warren, RN, Adult Nurse Practitioner]

I would say that most tests are about equal sensitivity - that is, they are all about as likely to pick up infection.  I would say that some might have higher false positive rates than others, based on what I hear from patients here on the boards, but that isn't your issue here.
yes, it is possible that you could have had this prior to your most recent partner and didn't know it, though given all that you describe, that seems a less likely explanation.  
I still think the mostly likely explanation is that he isn't making antibody detectable by this test.  Unfortunately, that means he may infect someone else before this gets sorted out.  I still think a western blot would be good for him to pursue.  But that depends totally upon his interest in finding out the truth here, which is something neither you nor I can control.

And you are most welcome.

Terri

[mam295]

This will be my last post to you.  I just want to clarify your answers so I can present valid facts to this past partner to make sure he has gotten the proper testing.

All Igg tests are accurately the same - the results shown might be shown in a different way because labs are different and they report results out differently

It is possible that I could have had this virus before this past partner - you can acquire it and it is possible that it shows no symptoms, then once it "comes out", the symptoms can be much more noticeable

It is possible that he has not had an accurate test;  is just one that takes longer to show antibodies, or, in a very small percentage, will not show antibodies

I am going to these measures  because I would not want someone else to have to be in my shoes if I could have prevented it.

I greatly appreciate  your continued work with this virus and all of the time you have put into this.  

[Terri Warren, RN, Adult Nurse Practitioner]

The Levoquin wouldn't affect anything - its an antibiotic not an antiviral.  And yes, people who don't have HSV 1 first and then acquire HSV 2 tend to have more noticeable symptoms, for sure.  Your partner's heart medicine would have nothing to do with the test.  Yes, some tests only look for antibody, they don't given an index value, like the immunoblot, for example, and the western blot.  Some labs do the test and get an index value but don't report it out, they only report out positive or negative.  I think the most likely thing here is that he isn't making detectable antibody to HSV 2 OR that he had an IgM test, not an IgG test.  It is also possible that you were infected prior.  You could ask that partner to be tested, yes, but if he is negative, will you wonder if it was the partner before him?  It might be hard to sort this out.  

So you know that you have HSV 2, and you will live with that successfully, I"m sure.  The question is, does your September 09 partner have it.  I'm not sure how much time you want to invest in that question.  he doesn't seem too eager to find out, does he?  The western blot would be good for him, yes, I do think so.  

Terri

[mam295]

Yes - It was positive for HSV2.

I am waiting for your response before contacting him.  
I wanted to add that my original doctor only wrote me 1 script with 1 refill for Valtrex originally.  She said "unless you are in a relationship, don't take the Valtrex the first year and see if you have noticeable outbreaks and call me if you need more.  Now I know why she suggested I do this.

[Terri Warren, RN, Adult Nurse Practitioner]

Hi again,
I forgot to ask you a question, and if I missed it along the way, sorry about that.  You mentioned that your doctor did a swab test - was it positive for HSV 2?  That will help me answer your other questions.

Terri

[mam295]

Dear Terri

I wanted to give you more information and ask you the following before I contacted the person I was with before I was diagnosed with HSV2:

I also should have mentioned (in case it affected my culture results) that when I first thought I might have a yeast infection, a doctor friend gave me one levaquin and I took it on the 20th, after a couple days when it still didn't subside I called the doctor's office and they called in a medicine (the one you inject internally), I did that for a few nights---and when it still didn't go away, that's when I made the appt and saw her on the 28th.  Would "any" medicine affect test results--culture or blood?  

I would like to know if any data has been kept on people that do not have herpes then become infected with HSV2--is there a larger chance they would show obvious symptoms sooner rather than later because they don't have antibodies to keep it at bay or can the virus hide for a time period (years) then erupt into an outbreak even in that situation?

Do you think I should recommend the Western Blot or find out first  if my past partner had the correct igg test done?

I'd really appreciate any guidance you can give me.

[mam295]

Thank you, Terri, for responding --especially on a weekend!

Yes, I am "now" aware of the fact that a blood test should have been ordered the same time as my culture. That is one of the reasons I switched doctors.  She had been my doctor for 30 years.  I think she was "so sure" that she only ordered the culture to confirm her diagnosis and now it leaves me "wondering". She still insisted when I told her his test results that it was him and that he just might never show antibodies.  It could have saved me a lot of heartache (and hours researching) if a blood test was ordered, believe me.

He did show me two tests, the one he had done in September and then again in January (mine was in April - my mistake).  I think his were Igg but they didn't have numbers like mine did---does that make a difference?  I've read some Igg tests (from certain labs) are not as "sensitive" as others--is that true?  What is time enough---4 months?...6 months?...one year?!!

I actually ended it with him because, at the time, I was so afraid that I might pass it on to him.  Sex was just not the same---I couldn't relax anymore:-(  and I could see the fear in him. Then I would get angry because in my gut I felt he "infected" me.  Then after reading information and then experiencing more outbreaks,  it made me more sure that it had to be him.   Thinking back---I thought it odd also, that when I first told him that I had an outbreak and the doctor was sure it was herpes, his first response was "I am so sorry--I am so sorry"; then once his doctor showed him his tests and said that he could not have possibly given it to me with him only having HSV1, the mystery began.

When I first found out I had this virus and went online and communicated with Grace, she told me about your books.  I bought The Good News About the Bad News and also downloaded The Updated Herpes Handbook.  I also took them into my (former) doctor's office and asked the nurse to please not ever let anyone walk out of that office again without information to go to.  They gave me nothing the day I found out!  My new doctor already knew about you:-)

This new doctor was also very skeptical of his results so just last week, I e-mailed "the new partner" the test # for Lab Corp 164905 that is in your handbook and asked him to see if his doctor ordered that test.  He responded that he will see his doctor in a couple of months and he will ask him. (disappointed that he is waiting that long)---  He has a heart condition and might be on medicine--that would not make a difference in his test results---would it?  Do you recommend Western Blot over the above test?

Also, I am curious because not much is written about it----would "most" people who do not have HSV1 be more apt to have obvious signs of herpes when initially infected than those that already have HSV1 or can the virus hide for a time period, then erupt into an outbreak?  

thank you again for responding so quickly:-) --I will certainly let you know what comes of any new testing on his part.

  

[Terri Warren, RN, Adult Nurse Practitioner]

Very interesting case indeed.  I can see why everyone has questions about this situation.  Had you had an antibody test with the first symptoms, we likely would have no question to ask.  If you had been antibody negative at that time, we could be quite sure that that was your first infection and that your partner is not an antibody producer.  If it was positive, we would have know that you were infected prior to this encounter.  

It's been plenty of time for everyone to have made antibody to HSV 2.  I would recommend that he get a herpes western blot antibody test.  This can be done through Quest labs, the code is 34534.  I'm a little surprised, quite honestly, that he is antibody negative at this time.  Are you certain that he had IgG antibody testing?  Have you actually seen it?  

Let me know, OK?  This is an interesting case that make sexuality for those involved a bit confusing.  Are you still with him?
Terri