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Knowledgeable Help Needed for my Saga
Hi Terri,
Thank you for offering this service. I have a very frustrating saga that I would like your informed help with. Thus far in my journey I have encountered many health professionals who are either not very knowledgeable about herpes or have the wrong information.
To start, I don't know if I have herpes or not. I will run through my story and see what you think.
Background: 27 yr old male
Prior Health Problems: Acid Re-flux - take protonix daily
Sexual History - 1 partner (besides the girl in the story below). Sex only with long-term girlfriend and only a few times and always protected. Unprotected oral sex fairly regularly. I am confident she has never been with anyone but me. She has recently tested completely STD free.
All dates are 2012
April 5 - I gave a female stripper oral sex for approximately 20 seconds. She grinded on my boxer covered penis for a few minutes and she also simulated oral sex over my boxer covered penis for a few seconds. No direct genital to genital contact occurred.
April 6 - I felt an odd feeling of dry mouth/very slight shooting pain in my inside left cheek only
April 7 - Full STD panel (except HSV) - all negative. Given drugs for Chlamydia and Gonorrhea to be safe. Mouth swab for HSV negative
April 27 - Full STD panel including HSV - positive for HSV2 on IGG with 1.59
May 2 - Tested again - positive for HSV2 on IGG with 1.68
May 4 - Given 2 2000 mg doses of valtex to see if it helped symptoms
May 28 - Full STD - positive for HSV2 on IGG with around 2.21
July 10 - Negative for HIV
August 8 - HSV test - positive for HSV2 no value given
August 20 - Full STD - negative for ALL. IGG and IGM for HSV 1 and 2 were given a combined value of 0.49
August 27 - HSV test - NEGATIVE for HSV 1 and 2 - combined value of 0.66
August 27 - WB sent out - 3 weeks later INDETERMINATE. Doctor said that means negative, I called the lab and they said proteins bonded that were not consistent with HSV 1 or 2 so it's indeterminate
Thank you for offering this service. I have a very frustrating saga that I would like your informed help with. Thus far in my journey I have encountered many health professionals who are either not very knowledgeable about herpes or have the wrong information.
To start, I don't know if I have herpes or not. I will run through my story and see what you think.
Background: 27 yr old male
Prior Health Problems: Acid Re-flux - take protonix daily
Sexual History - 1 partner (besides the girl in the story below). Sex only with long-term girlfriend and only a few times and always protected. Unprotected oral sex fairly regularly. I am confident she has never been with anyone but me. She has recently tested completely STD free.
All dates are 2012
April 5 - I gave a female stripper oral sex for approximately 20 seconds. She grinded on my boxer covered penis for a few minutes and she also simulated oral sex over my boxer covered penis for a few seconds. No direct genital to genital contact occurred.
April 6 - I felt an odd feeling of dry mouth/very slight shooting pain in my inside left cheek only
April 7 - Full STD panel (except HSV) - all negative. Given drugs for Chlamydia and Gonorrhea to be safe. Mouth swab for HSV negative
April 27 - Full STD panel including HSV - positive for HSV2 on IGG with 1.59
May 2 - Tested again - positive for HSV2 on IGG with 1.68
May 4 - Given 2 2000 mg doses of valtex to see if it helped symptoms
May 28 - Full STD - positive for HSV2 on IGG with around 2.21
July 10 - Negative for HIV
August 8 - HSV test - positive for HSV2 no value given
August 20 - Full STD - negative for ALL. IGG and IGM for HSV 1 and 2 were given a combined value of 0.49
August 27 - HSV test - NEGATIVE for HSV 1 and 2 - combined value of 0.66
August 27 - WB sent out - 3 weeks later INDETERMINATE. Doctor said that means negative, I called the lab and they said proteins bonded that were not consistent with HSV 1 or 2 so it's indeterminate
MEDICAL PROFESSIONAL
Has your regular girlfriend been tested specifically for herpes? If she tests negative for HSV 2, then I believe you are having false positives on the ELISA. The indeterminate western blot is not all that uncommon in people who have a low positive ELISA.
Determining whether someone has herpes or doesn't is far more complicated than just looking at test results, in some situations. Yours is a good example. If your regular girlfriend doesn't have herpes, then the only other contact you've had is 20 seconds of giving someone oral sex, right? This is in your whole life, right?
The 20 seconds of giving someone oral sex (and the accompanying activities) is so low risk, I don't really consider it a risk.
The confusing lab tests appear to me to be reflecting some other protein that is artificially tripping the test for herpes. That's why you must combine the sexual history, the specific sexual behaviors that you are concerned about and your lack of any sores with this indeterminate test. I know it is difficult to move on from this, confusing test results can really throw people a curve ball. But I hope you will take all of this in context, which is very limited sexual experiences and almost nothing that puts you at specific risk for HSV 2.
I don't think flying out to Portland or Seattle would be helpful, honestly. Do let me know how the next test comes out, OK?
Terri
Determining whether someone has herpes or doesn't is far more complicated than just looking at test results, in some situations. Yours is a good example. If your regular girlfriend doesn't have herpes, then the only other contact you've had is 20 seconds of giving someone oral sex, right? This is in your whole life, right?
The 20 seconds of giving someone oral sex (and the accompanying activities) is so low risk, I don't really consider it a risk.
The confusing lab tests appear to me to be reflecting some other protein that is artificially tripping the test for herpes. That's why you must combine the sexual history, the specific sexual behaviors that you are concerned about and your lack of any sores with this indeterminate test. I know it is difficult to move on from this, confusing test results can really throw people a curve ball. But I hope you will take all of this in context, which is very limited sexual experiences and almost nothing that puts you at specific risk for HSV 2.
I don't think flying out to Portland or Seattle would be helpful, honestly. Do let me know how the next test comes out, OK?
Terri
MEDICAL PROFESSIONAL
I'm not sure where you are leaving messages for me - please talk directly to the front desk people to set up a phone consult and we'll be sure to connect.
Terri
Terri
Hi Terri,
I've called your office a couple of times and haven't heard back from you. What's the best way to get into contact with you? Thanks!
I've called your office a couple of times and haven't heard back from you. What's the best way to get into contact with you? Thanks!
MEDICAL PROFESSIONAL
OK, we will talk soon then
Yes, we can definitely do that. I called your office yesterday, so hopefully we can connect soon. The lab did say they need an order. Thanks!
MEDICAL PROFESSIONAL
Quest labs can draw blood for you and ship to somewhere else. Please contact your local Quest lab and ask them about this. I may need to write an order and you will need to pay a fee but they have done it for others of my patients.
Let's continue this on the phone as clinic patients, OK?
Terri
Let's continue this on the phone as clinic patients, OK?
Terri
I didn't reply correctly to the last post. Will you look at my previous post and let me know what you think? Thanks!
Terri,
I finally saw the second test results, and they also included the first test results on there and they do look identical. It would be interesting to find out what the lab has to say about why they are indeterminate.
Additionally, I noticed that it says no change in antibody about halfway down the page. Do you know what this means? I never got notice of antibody status in the first place, so does no change mean I have some and the levels stayed the same or I have none and I still have none? I didn't realize they tested antibody levels with the WB as well. This would be really interesting since based on the ELISA tests I've taken I went from testing low positive to antibodies to testing negative for antibodies.
Finally, I've been trying to get blood drawn so I can send serum to you. However, I can't seem to find a doctors office or lab that will do it without either doctor's orders or a testing kit. Currently, no one will just give me my serum to mail, apparently it's a bio hazard or something according to the lab. Can you help me solve this? Is there a kit you can send out? Or write an order?
Thanks!
I finally saw the second test results, and they also included the first test results on there and they do look identical. It would be interesting to find out what the lab has to say about why they are indeterminate.
Additionally, I noticed that it says no change in antibody about halfway down the page. Do you know what this means? I never got notice of antibody status in the first place, so does no change mean I have some and the levels stayed the same or I have none and I still have none? I didn't realize they tested antibody levels with the WB as well. This would be really interesting since based on the ELISA tests I've taken I went from testing low positive to antibodies to testing negative for antibodies.
Finally, I've been trying to get blood drawn so I can send serum to you. However, I can't seem to find a doctors office or lab that will do it without either doctor's orders or a testing kit. Currently, no one will just give me my serum to mail, apparently it's a bio hazard or something according to the lab. Can you help me solve this? Is there a kit you can send out? Or write an order?
Thanks!
Thanks Terri,
I look forward to hearing from you when you return. That's fascinating information, I haven't seen the second test, so I'm going to get a copy tomorrow. I am also going to get blood drawn for the other test tomorrow and I will have the lab send it to you.
I look forward to hearing from you when you return. That's fascinating information, I haven't seen the second test, so I'm going to get a copy tomorrow. I am also going to get blood drawn for the other test tomorrow and I will have the lab send it to you.
MEDICAL PROFESSIONAL
I'm out of the country now for a week, will address this when I return. But I did see these before I left, and they interpreted them as being exactly the same as each other.
Terri
Terri
Hi Terri,
You hopefully received the test copies by fax at your office yesterday. If not, then they should be there early next week. Let me know what you find out! Thanks for your help.
You hopefully received the test copies by fax at your office yesterday. If not, then they should be there early next week. Let me know what you find out! Thanks for your help.
MEDICAL PROFESSIONAL
No problem. I look forward to talking with you.
Terri
Terri
hi Terri, I called the office and setup an appointment for next Tuesday. It will be helpful to talk to you over the phone. I should already be a patient at the clinic because I did a phone consult with a different nurse a few months back. Unsurprisingly, this is not my real name, so I won't have any records under James Brody. I look forward to talking with you soon.
MEDICAL PROFESSIONAL
Just set up an appointment. You need to become an official patient of ours for me to order any testing for you.
Terri
Terri
That sounds great. I will call your clinic tomorrow. Is there a better time to connect with you or should I call and set up an appointment?
MEDICAL PROFESSIONAL
If we talk and you give me your information, I can call the lab and speak with them about actually comparing the two blots. Perhaps that can get us a bit more information.
Terri
Terri
Update: I called the university of Washington Virology Clinic and they told me that since the convalescent tests went from completely indeterminate for hsv to negative for hsv-1 and indeterminate for hsv-2 that I should wait another 2 months and get tested AGAIN. They said if that test is also indeterminate then they will have me do a consult with their head doctor who does the test. Thoughts on that?
I'm still very interested in other testing options as well.
I'm still very interested in other testing options as well.
Let me clarify, the first test actually just said Indeterminate for HSV.
Terri,
I just received the results of my latest WB test. I haven't seen them, my doctor just read them to me over the phone. He said that it said negative for HSV-1 and Indeterminate for HSV-2. This is a bit confusing to me because my last test just said indeterminate for HSV-1 and HSV-2.
Can you help me interpret? I'm don't understand how now they know for sure on the HSV-1 but the HSV-2 is still indeterminate. I suppose the next course is to call your office and discuss further testing?
I just received the results of my latest WB test. I haven't seen them, my doctor just read them to me over the phone. He said that it said negative for HSV-1 and Indeterminate for HSV-2. This is a bit confusing to me because my last test just said indeterminate for HSV-1 and HSV-2.
Can you help me interpret? I'm don't understand how now they know for sure on the HSV-1 but the HSV-2 is still indeterminate. I suppose the next course is to call your office and discuss further testing?
MEDICAL PROFESSIONAL
Yes, if your next western blot is indeterminate, call my office and we will talk about further testing.
Terri
Terri
Thanks for your feedback. I got my first wb at almost 5 months post exposure, and my second one at 7 months post exposure (which I'm still waiting for the results on). I'll definitely let you know what they say. Based on your previous comment, if that comes back indeterminate, then I should retest again at 6 months post the first one... if that one comes back indeterminate too, then you'd consider me negative? I also read about a new test from Illinois that you do in your clinic. Is that an option if I get an indeterminate on this next test?
MEDICAL PROFESSIONAL
I really don't think you are at risk for HSV 2. It is not common to get an indeterminate western blot, but it does happen from time to time, particularly with people who have low positive ELISAs, we just don't know why it happens. In your case, given your low risk exposure, if you get an indeterminate and it stays that way for six months, I would consider you a negative. There is daily home swabbing for shedding, but in your case, that seems a little over the top, given the low risk
We've certainly had many patients over the years who have been in your situation - always hard to know exactly what's going on, but with you and your low risk exposure, I am less inclined to think there is a chance you are infected.
Terri
We've certainly had many patients over the years who have been in your situation - always hard to know exactly what's going on, but with you and your low risk exposure, I am less inclined to think there is a chance you are infected.
Terri
Any thoughts on my further questions? Thanks for your help!
Correct - the only person I've ever had intercourse with tested negative for HSV1 and 2.
The only worrisome experience was oral sex for 20 seconds, that's correct. But she was an exotic dancer and after that experience another dancer told me that I should be worried because the other girl may have STDs.
I have just a few questions that I've posted below:
- How common is it for artificial proteins to trip the test in your experience?
- If the next WB comes back indeterminate, do I have any further options? I guess I suggested coming out to Seattle/Portland because I do have some real symptoms that I feel like have to be something, and I didn't know if there additional tests like daily swab tests for asymptomatic shedding.
- I can live with my symptoms, that's fine. I'm most concerned with infecting future partners, and correctly communicating any potential risk. At this point, I'm not having sexual contact with current dates. What is your opinion on this?'
- Finally, have you ever treated anyone with symptoms similar to mine? What was their course of treatment and/or result?
Thanks for your help!
The only worrisome experience was oral sex for 20 seconds, that's correct. But she was an exotic dancer and after that experience another dancer told me that I should be worried because the other girl may have STDs.
I have just a few questions that I've posted below:
- How common is it for artificial proteins to trip the test in your experience?
- If the next WB comes back indeterminate, do I have any further options? I guess I suggested coming out to Seattle/Portland because I do have some real symptoms that I feel like have to be something, and I didn't know if there additional tests like daily swab tests for asymptomatic shedding.
- I can live with my symptoms, that's fine. I'm most concerned with infecting future partners, and correctly communicating any potential risk. At this point, I'm not having sexual contact with current dates. What is your opinion on this?'
- Finally, have you ever treated anyone with symptoms similar to mine? What was their course of treatment and/or result?
Thanks for your help!
You are reading content posted in the Herpes Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
