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Negative HSV test due to a "local" infection?
I've had Herpes-like symptoms recurring in my genital area for over 1,5 years after an sexual encounter. So i have had 3 blood tests done during this time: first after 8 weeks from possible exposure, second after 11 months from possible exposure, and last of them was done last month, 1,5 years ater possible exposure. The type on the test performed to my understading was ELISA that didn't differentiate between HSV1 and HSV2. And that didn't really matter because the result was negative everytime, meaning - due to the general guidance, that i am HSV-negative altogether. Right?
But: the infectious disease specialist i saw, said that if the infection is local, the body doesn't produce antibodies to be detected in a blood test. That is somewhat confusing, because i thought that most of the herpes infections are "local" and not systemic? If my doctor is right, that would mean that all the general info about herpes blood tests and their accuracy in diagnosing herpes, oral or genital, was wrong or at least very misleading.
So, is it really so? Of course i asked my doctor this : Isn't herpes almost always local and not systemic, meaning it presents itself as a sore or a blister on lips or genitals? And why are antibody tests then used and recommended fo diagnosing that type of HSV-infections if the body isn't really likely to produce antibodies to be detected?
Answer was that the body produces antibodies to be detected in blood mostly if there is, for example, mouth full of blisters - but not if there is, for example, one blister on a lip?
This goes against pretty much everything i've read about diagnosing herpes via blood tests and the reliability of them in doing so.
I understand that false positives and false negatives do happen but do they really happen that way? And if they do, wouldn't that mean that most of the negative blood tests for HSV (when there is a reason to believe in a possibility of being infected) were actually false negatives, if it really is that Unusual for the antibodies to be produced in a way that could be detected in a blood test if the infection (like most of the HSV-infections?) is local?
But: the infectious disease specialist i saw, said that if the infection is local, the body doesn't produce antibodies to be detected in a blood test. That is somewhat confusing, because i thought that most of the herpes infections are "local" and not systemic? If my doctor is right, that would mean that all the general info about herpes blood tests and their accuracy in diagnosing herpes, oral or genital, was wrong or at least very misleading.
So, is it really so? Of course i asked my doctor this : Isn't herpes almost always local and not systemic, meaning it presents itself as a sore or a blister on lips or genitals? And why are antibody tests then used and recommended fo diagnosing that type of HSV-infections if the body isn't really likely to produce antibodies to be detected?
Answer was that the body produces antibodies to be detected in blood mostly if there is, for example, mouth full of blisters - but not if there is, for example, one blister on a lip?
This goes against pretty much everything i've read about diagnosing herpes via blood tests and the reliability of them in doing so.
I understand that false positives and false negatives do happen but do they really happen that way? And if they do, wouldn't that mean that most of the negative blood tests for HSV (when there is a reason to believe in a possibility of being infected) were actually false negatives, if it really is that Unusual for the antibodies to be produced in a way that could be detected in a blood test if the infection (like most of the HSV-infections?) is local?
No need for me to look into another dermatologist since the doctor i consulted wasn't one. I've been referred to a dermatologist sometime soon.
The test that was taken (or was meant to be taken) was an immunofluorescent antigen test where they search for HSV-specific proteins byt detecting how the antibodies for those proteins react to the cells from the swab. And since they look for proteins, i think the amount of living viruses doesn't matter as long as there is a rash. And i had it at it's "peak" presentation. But as i mentioned, the statement i got was that there weren't enough cells in the swab for the test to give a reliable result.
I don't know if there will ever be enough cells in a swab from the rash when there weren't even know when my rash was at it's worst. I guess these methods are more useful if there is a blister from which the lot-of-cells containing fluid could be taken. But i, thankfully, don't have ever had blisters.
When i say i had the rash at it's peak presentation, i mean that it had been there under 48 hours but that's one more tricky thing: my symptoms start usually with a little milder rash or with a bump or two and then progress to a worse presentation. So the first, milder rash symptoms could have been there for a few days until it progressed to it's peak - I don't even know if that's typical for herpes but i think that if some test was performed on a rash at it's worst, it would be reliable? Well the reliability doesn't matter since the cell-deficiency of that sample made it unreliable in the first place.
The test that was taken (or was meant to be taken) was an immunofluorescent antigen test where they search for HSV-specific proteins byt detecting how the antibodies for those proteins react to the cells from the swab. And since they look for proteins, i think the amount of living viruses doesn't matter as long as there is a rash. And i had it at it's "peak" presentation. But as i mentioned, the statement i got was that there weren't enough cells in the swab for the test to give a reliable result.
I don't know if there will ever be enough cells in a swab from the rash when there weren't even know when my rash was at it's worst. I guess these methods are more useful if there is a blister from which the lot-of-cells containing fluid could be taken. But i, thankfully, don't have ever had blisters.
When i say i had the rash at it's peak presentation, i mean that it had been there under 48 hours but that's one more tricky thing: my symptoms start usually with a little milder rash or with a bump or two and then progress to a worse presentation. So the first, milder rash symptoms could have been there for a few days until it progressed to it's peak - I don't even know if that's typical for herpes but i think that if some test was performed on a rash at it's worst, it would be reliable? Well the reliability doesn't matter since the cell-deficiency of that sample made it unreliable in the first place.
Rather interesting. Did they do the culture for HSV or bacterial? I haven't heard of that on a HSV test. Did you get the swab done within 48hrs of the rash showing up? (I believe you did just want to confirm).
I think you need to start looking at something other than herpes. I would ingore William as doctors know what to look for in zoster.
You may want to look into another dermatologist. I am not sure where you are but I bet there is more than one in your area and hopefully your insurance will be taken. Please keep following up with us. I am really curious as how this ends out.
I think you need to start looking at something other than herpes. I would ingore William as doctors know what to look for in zoster.
You may want to look into another dermatologist. I am not sure where you are but I bet there is more than one in your area and hopefully your insurance will be taken. Please keep following up with us. I am really curious as how this ends out.
Herpes zoster can tigger by stress any time and can effect belw weist area and cause nerve pain too and rash. U checked ur hsv 1 and 2 and came back negative . It could be any other types of herpes or other onfection or a new viral infections.
I don't think i'm going to have a fourth blood test done for HSV. It should have been positive by now, if it is ever going to be (assuming these symptoms were due to HSV)
Herpes Zoster is caused by Herpes Varicella-Zoster virus, which i have since, as most of the people, i have had chickenpox as a child. And i think that genital shingles isn't very common presentation of it. The clinical picture is usually different. It is also unlikely that sexual contact would somehow trigger it (since these symptoms started after sexual contact) and transmission i think isn't possible since i have the virus and the immunity to it of my own.
No, i haven't taken cipro but i'm on a roxithromycin now due to some borderline-positive blood tests for some bacteria that are not likely related to these issues. But that should also clear the other possible bacterial infections that could be causing these problems although nothing that would point to bacteria in my genital area (urinary tests, blood tests) have been found.
Herpes Zoster is caused by Herpes Varicella-Zoster virus, which i have since, as most of the people, i have had chickenpox as a child. And i think that genital shingles isn't very common presentation of it. The clinical picture is usually different. It is also unlikely that sexual contact would somehow trigger it (since these symptoms started after sexual contact) and transmission i think isn't possible since i have the virus and the immunity to it of my own.
No, i haven't taken cipro but i'm on a roxithromycin now due to some borderline-positive blood tests for some bacteria that are not likely related to these issues. But that should also clear the other possible bacterial infections that could be causing these problems although nothing that would point to bacteria in my genital area (urinary tests, blood tests) have been found.
Try to get another blood test to confirm..
And try to get herpes zoster test too.
Did you take cipro before?
Thank you.
And try to get herpes zoster test too.
Did you take cipro before?
Thank you.
Well, i got the "results" already: the statement was that there weren't enough cells in the swab for the test to give a reliable result. I don't know if there can ever be enough cells because when the swab was taken, the rash was almost as worst as it can get. Getting the diagnosis just seems to get harder and harder.
I haven't had the invitation to the dermatologist yet, so i don't know when the appointment is. It may take at least month.
I haven't had the invitation to the dermatologist yet, so i don't know when the appointment is. It may take at least month.
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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.
