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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?
Well your doctor is a little off. But let's figure out a few things. First if you have HSV symptoms you should be seen within 24-48hrs after they show to have a lesion culture done. This will quickly tell you if you have HSV or not. Though false negatives do happen with cultures but doing so early on in the symptoms helps reduce that risk. A PCR test would be easier.
HSV is localized to a set of nerves. But the infection does re-appear and the immune system attempts to fight it with the anitbodies and continues to make those antibodies even after symptoms have gone.
Given the amount of testing you have had I think it is safe to say you don't have herpes. The only change would be if you had a positive PCR test or culture with typing.
For the most part our HSV-1 testing isn't as sensetive as our HSV-2. But most people do have positive tests. But some times there isn't enough antibody in the system for our tests to see. It can and does happen. No test is 100%. But if you had one encounter then chances are low you even caught herpes.
HSV is localized to a set of nerves. But the infection does re-appear and the immune system attempts to fight it with the anitbodies and continues to make those antibodies even after symptoms have gone.
Given the amount of testing you have had I think it is safe to say you don't have herpes. The only change would be if you had a positive PCR test or culture with typing.
For the most part our HSV-1 testing isn't as sensetive as our HSV-2. But most people do have positive tests. But some times there isn't enough antibody in the system for our tests to see. It can and does happen. No test is 100%. But if you had one encounter then chances are low you even caught herpes.
HSV blood test not an accurate most of the time 80-98% accurate from the last CDC report.
This virus is a very tricky and still not a good test of that. No good research until now because as they said u can get a false positive and false negative so how come we can trust this blood test.
It's a game to make money from the fake blood test.
If you have symptoms so that mean u had the virus do not waste ur money for any test.
This virus is a very tricky and still not a good test of that. No good research until now because as they said u can get a false positive and false negative so how come we can trust this blood test.
It's a game to make money from the fake blood test.
If you have symptoms so that mean u had the virus do not waste ur money for any test.
I disagree with you william. The test for HSV-2 is rather accurate. HSV-1 it is not as good for and that is just because the way of our immune system. Just because someone has symptoms doesn't mean they are caused by herpes. The Western Blot is one of our most accurate tests out there and while it does miss infections so do other tests out there for various other things. It has nothing to do with the virus being tricky. It's the antibody.
I have an appointment for a PCR swab next time i present symptoms. What ever it is that i have, it acts like herpes. When it started, there was mild burning when urinating, rash on my penis and leg pains. The rash occurs to the same area to this day, and is accompanied by mild nerve pains from penis to groins, thighs and joints (mostly on the side of the rash). Rash looks like red pimples and is somewhat "scaly" in appearence. It is not painful in itself, but sometimes little itchy.
So it's not classsical blister-type of thing, and if it really is herpes, i think it is more likely to be genital HSV1 (due to the behaviour that led to my symptoms). But isn't GHSV1 supposed to recur somewhat rarely? I have it like every month now, which is weird.
But the main question here was the information i got about herpes antibody-production and detecting it with a blood test. If it were true, it would be a general issue in diagnosing herpes with antibody blood tests.
So, even if the infection is local, in genitals for example, it would most likely launch the antibody-production to a level that could be seen in a blood test after certain amount of time has passed? Not always, but likely?
So it's not classsical blister-type of thing, and if it really is herpes, i think it is more likely to be genital HSV1 (due to the behaviour that led to my symptoms). But isn't GHSV1 supposed to recur somewhat rarely? I have it like every month now, which is weird.
But the main question here was the information i got about herpes antibody-production and detecting it with a blood test. If it were true, it would be a general issue in diagnosing herpes with antibody blood tests.
So, even if the infection is local, in genitals for example, it would most likely launch the antibody-production to a level that could be seen in a blood test after certain amount of time has passed? Not always, but likely?
I have the same symptoms like u and never test postive for almost 2 years now. But its a herpes outbreak or may be its a new viral infection we don't know it.
You are way over thinking this. The tests are good when it comes to Herpes. But nothing is 100%. The theroy that because you have one or two blisters means you won't test positive on a blood test isn't true.
Granted at this point you are having symptoms monthly. While not typical of herpes it does happen to some people. But there are other things this could be from a fungal infection to contact dermatitis.
Getting the PCR swab done is going to give you the best answers. Be seen when you have symptoms within 24-48hrs. This way you will know pretty quickly you have it or not and what type.
Granted at this point you are having symptoms monthly. While not typical of herpes it does happen to some people. But there are other things this could be from a fungal infection to contact dermatitis.
Getting the PCR swab done is going to give you the best answers. Be seen when you have symptoms within 24-48hrs. This way you will know pretty quickly you have it or not and what type.
Okay, thanks. I don't see how i'm over-thinking this though, because isn't it understandable to be confused about getting information that conflicts with other information out there, from a person that is very specialized in infectious diseases? It wasn't my own theory, just something that i was told by an authority on the subject. So i needed some kind of clarification for that information being incorrect, and that i got. Thanks.
The nerve pain related to herpes from buttoaks down to legs and most of the time u can have nerve pain without any sores or blister but ur viurs is active on ur nerve. It won't kill u or even ur partner or even ur kids ..its a skin disease and u can get herpes by check hands with others too then u spread to ur anywhere in ur body the same like warts. Its not HIV to kill u but the problem u one would like to be sick even with a flu or cold. No one will live forever... its our life.
Thank you
Thank you
could this be herpes? yes it could be but it's more likely that it isn't. have you seen a dermatologist at all yet when you have the rash?
grace
grace
No i haven't seen a dermatologist with the rash on because it's difficult to have the right timing for an appointment. But now i got a "time-flexible" appointment to a dermatologist so i can negotiate about being seen with the rash.
The dermatologist i saw without the rash though said also that it's not herpes and that i can pretty much rely on my blood test results (there were two taken at the time). But he didn't say what else it could be. Of course i understand it's hard to say without seeing the rash.
Still, the nerve pains and the rash being recurrent - coming and going - doesn't bring anything else to mind than herpes.
The dermatologist i saw without the rash though said also that it's not herpes and that i can pretty much rely on my blood test results (there were two taken at the time). But he didn't say what else it could be. Of course i understand it's hard to say without seeing the rash.
Still, the nerve pains and the rash being recurrent - coming and going - doesn't bring anything else to mind than herpes.
all sorts of skin issues that can occur that will also cause tingling and such. you saying it looks scaly sounds more like a fungal infection or even eczema or something going on. hopefully your rash reoccurs on a weekday and you can be seen promptly for a better work up!
Yes, let's hope so.
Talking of it reoccuring, i think it would be good to mention that there's not That clear line between the rash being on or off. Because i can see almost all the time very little to moderate traces of it on the area it usually appears - so that area looks at least little scaly all the time, and when the rash "recurs", the area becomes more noticeably scaly and the "scales" become red. I think that is somewhat non-herpes-like trait unless the area has been little scarred (due to herpes) so that i can see the change in it although it's not on?
Something like psoriasis has came to my mind too (that can cause joint sensations too) but i don't know how likely it would present itself only as a sexual reaction on genitals and not anywhere else.
Talking of it reoccuring, i think it would be good to mention that there's not That clear line between the rash being on or off. Because i can see almost all the time very little to moderate traces of it on the area it usually appears - so that area looks at least little scaly all the time, and when the rash "recurs", the area becomes more noticeably scaly and the "scales" become red. I think that is somewhat non-herpes-like trait unless the area has been little scarred (due to herpes) so that i can see the change in it although it's not on?
Something like psoriasis has came to my mind too (that can cause joint sensations too) but i don't know how likely it would present itself only as a sexual reaction on genitals and not anywhere else.
We didn't really discuss about the nerve pain itself, but i think something like this was implied:
Since the herpes virus resides in a nerve cell, that would cause some nerve sensations - but it would still be a "local" infection due to it appearing only on one area in the skin.
I haven't really discussed about other local infections and their possible relations to nerve pains with any doctor.
It's hard to think about any purely dermatological penis issues that would be also accompanied by nerve sensations down the legs. But there are different autoimmune conditions for example that can cause something like that - reactive arthritis for example could be broadly defined as a condition of which symptoms can be "rash on penis, leg pains and urinary issues" (though eye involment usually occurs also) and i think it wouldn't be impossible to misdiagnose that as genital herpes. For me it has been pretty much ruled out with HLA-B27 gene test, CPR, SED and WBC though.
And, in the end, maybe some dermatological conditions could also cause such nerve sensations, because the nerve-endings in the genital area could be sensitive enough to somehow remotely reflect primarily dermatological sensations to other places too. Nerves are interconnected after all, aren't they?
Since the herpes virus resides in a nerve cell, that would cause some nerve sensations - but it would still be a "local" infection due to it appearing only on one area in the skin.
I haven't really discussed about other local infections and their possible relations to nerve pains with any doctor.
It's hard to think about any purely dermatological penis issues that would be also accompanied by nerve sensations down the legs. But there are different autoimmune conditions for example that can cause something like that - reactive arthritis for example could be broadly defined as a condition of which symptoms can be "rash on penis, leg pains and urinary issues" (though eye involment usually occurs also) and i think it wouldn't be impossible to misdiagnose that as genital herpes. For me it has been pretty much ruled out with HLA-B27 gene test, CPR, SED and WBC though.
And, in the end, maybe some dermatological conditions could also cause such nerve sensations, because the nerve-endings in the genital area could be sensitive enough to somehow remotely reflect primarily dermatological sensations to other places too. Nerves are interconnected after all, aren't they?
I don't understand what you mean by "nerve test"? In case that was just a freudian slip and you in fact meant "nerve pain", then yes - i think that herpes isn't the only thing that can cause nerve sensations. But herpes is one of those conditions.
Yes sorry the nerve pain. The problem is the blood test not accurate to let us move away from herpes problem.
Well i think it is possible to keep multiple possibilities open at the same time? No reason to settle down to herpes speculation only. Of course herpes is one of the possibilities. But what can be done? If the blood tests are not accurate enough to rule out herpes, then a PCR swab should be taken from a suspected herpes lesion. And if it turns out to be negative, then it can be repeated - and at some point, if everything has continuously turned out to be negative for herpes, it must be accepted that it isn't likely to be herpes. And then, if not earlier, it would be reasonable to concentrate on other alternatives and consult different doctors from the fields of dermatology, urology and neurology - and, although i'm not a flag-bearer for psychosomatic explanations at all, some kind of psychological consultation could be beneficial for some people at least in trying to tolerate those symptoms without a known cause.
What has your own doctor said about your set of symptoms - does he think it is likely you have herpes? (I assume you have discussed this with your doctor since you've had blood tests done)
What has your own doctor said about your set of symptoms - does he think it is likely you have herpes? (I assume you have discussed this with your doctor since you've had blood tests done)
Well it's very infrequent really. When i had my first symptoms, the pain in both of my legs was there for some days. And nowadays i can feel only little "clues" of it every now and then, and when the rash is on.
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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.
