Negative HSV 1, then positive, now negative

Hi, I posted a while back on the Herpes Forum and GracefromHHP has been very helpful in answering my questions; however, I'm hoping a more detailed response may put my mind at ease.  

August 2012 I fooled around with a guy who later told me he had genital herpes.  He performed oral sex and there was some rubbing of genitals but no intercourse.  I went to my gyn for other reasons, and told her about the guy with genital herpes.  She offered to test for peace of mind.

12 wks: Labcorp <0.91 HSV 1 and 2

17 wks: Quest: HSV 1 positive 1.12;  HSV 2 negative .04

18 wks: Labcorp <0.91 HSV 1.  Didn't test for HSV 2 because of concern for false positive.

Prior test in August '11: Quest: HSV 1 negative .42; and HSV 2 negative .07

I've been dating someone for the past 2 months and I'm not sure of his HSV 1 status.  He performed oral sex on me twice so I'm worried this could be a newly acquired genital infection.  I do not know his HSV 1 status.

I have not had any real symptoms to see my doctor and get checked.  I feel very dry down there and sometimes there is a little irritation when I use tampons, this has been going on since August.  I have not seen any blisters orally or genitally. Occassionally I feel itchy but only for a few minutes and then that goes away, and it's not daily.  I think this is all probably normal but I just never gave it any attention before.  

My questions:

1)  Do you think this was probably a false positive on my HSV 1 test since I haven't had any blisters or sores orally or genitally?  (Last exposure was 7 weeks ago, and then very briefly (few seconds) on January 1 but I stopped him because I'm paranoid (so almost 2 weeks)).

2)  Can stress cause vaginal dryness?

3)  Does any of this sound concerning?

I want to get tested again but I don't think my provider will do a WB.  She still believes that IgM testing is accurate.  Thanks for your help, this site has been very informative.  

[Terri Warren, RN, Adult Nurse Practitioner]

I would guess that yes, this may be a false positive.  However, since the ELISA test that you had done is not great for HSV 1 antibody detection, it is difficult to know exactly what is going on here.  If I had to guess, I would say you are likely negative for HSV 1, but whatever it is, I don't think the testing situation is actually changing over time, I think it is the same.

Your provider is inaccurate about the IGM and also inaccurate about the western blot.  That's sad.

I don't think stress would cause general vaginal dryness, no.

No, none of this sounds concerning, but if the vaginal dryness is bothering you, there are solutions for that.

But in terms of the herpes, I think the western blot would help you sort this out more clearly.

Terri

[NeedMoreInfo80]

Thank you so much for your response.  I just wanted to clarify what you meant when you said "I don't think the testing situation is actually changing over time, I think it is the same."  

Do you mean that if I am in fact positive then it's most likely an old infection that I've had for some time?  (i.e. from childhood like most people.)  

Also, I have been unable to find someone in my area to order the WB.  If I call your clinic would they be able to refer me to someone locally?

Thank you again for your time.

[Terri Warren, RN, Adult Nurse Practitioner]

What I meant was that even though you had a low positive in there, there still is very little difference in the test results themselves.  

We can order a western blot for you if you become a clinic patient.

Terri

[NeedMoreInfo80]

Thanks Terri,

I haven't called the clinic yet because I assume I need to wait at least 4 months from the last exposure before I can get the Western Blot.  Is that correct?  

Thank you for your time.

[Terri Warren, RN, Adult Nurse Practitioner]

Yes, that's correct.  I would recommend waiting 4 months from any possible exposure.

Terri

[NeedMoreInfo80]

Hi Terri,

I'm not sure if I need to pay again or if I can ask another follow up question.  

I decided to test again using the ELISA through LabCorp 10 weeks after my positive of 1.12. I figured if it was positive I wouldn't need to wait for the WB. The test came back negative again.  This would have been 14 weeks after I last received oral sex, and almost 9 weeks since I last kissed someone.  

My test for the past five months are as follows:

11/8/12 - negative - less than .91
12/20/12 - positive - 1.12
12/26/12 - negative - less than .91
3/2/13 - negative - less than .91

Do you think I still need to get the WB or do you think it's safe to say that the positive was a false positive since I've tested negative twice since then and never before.

Thank you for your help.  

[Terri Warren, RN, Adult Nurse Practitioner]

I think you are quite safe to NOT get the western blot.  With 97% certainty, you don't have HSV 2.

Terri

[NeedMoreInfo80]

Thank you Terri, but the positive was for HSV-1 my HSV-2 was always negative.  Dose this change your opinion?

[Terri Warren, RN, Adult Nurse Practitioner]

Yes, I understand that.  What I am saying is that with 97% certainty (that's as good as this test gets as detecting HSV 2), you don't have HSV 2.  Am I missing something here?

Terri

[NeedMoreInfo80]

Yes, I'm sorry, I should have clarified. My test results were for HSV 1.