Herpes Expert Forum
Question for Dr Terri Warren
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Welcome to the Herpes forum. This forum is for questions and support pertaining to herpes simplex virus infections (HSV-1 and 2) and herpes zoster (shingles) and the virus that causes it, varicella zoster virus. Questions about genital herpes are welcome both here and on the STD Forum.

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Question for Dr Terri Warren

Hi, i recently posted to Dr hook about reliability of hsv testing. Basically i had hsv genital symptoms about six years ago after unprotected oral / protected sex. symptoms were raised lymph nodes in groin, small red like sores over foreskin,fever,aches and pains, ngu, however when examined about five days after the incident the doctor said he could see no sign of HSV. Only recently have i decided to follow through with a blood test and it was at a UK gum clinic and it came back negitive for HSV1 & HSV 2. I've never had a follow up outbreak after the initial incident however i'm concerned how reliable the test is. The gum clinic are stating it was a very strong negitive however i'm aware hsv1 sometimes does not show up on the elisa test and it requires a western blot / immunoblot test doing. Is this possible in the UK, or only America? Dr Hook believes it is unwarrented as i don't even know defintitly HSV however can i rely on the current blood test? Dr Hook states even if it was HSV 1 genital it is nothing to worry about regarding tranmission. Can i be certain i don't have HSV 2 and the Elisa is not picking it up? Feel really anxious and it is effecting my life severly. I'm unsure whether i'm being OCD and ridiculous or whether i should be genuinely worried. Please help. thankyou
55646_tn?1263664409
The ELISA test for HSV 2 picks up about 97% of cases.  The ELISA test for HSV 1 picks up about 91% of cases.  Those are the facts as the package insert states them to be.  

My feeling about this is that if you are still worrying and you just can't put it aside, then a western blot may have you to put this behind you.  I believe it is only done in the US at the University of Washington, for public use.  I'm not sure what the downside of testing would be except cost and inconvenience.  But if it would make you feel more reassured, then you could do it.

But here is one possible downside.  If the western blot is positive for HSV 1, you cannot know if the infection is genital or oral.  Even though you have had genital symptoms, if the test is positive for HSV 1, it doesn't mean those symptoms were herpes.  Is that clear?  

Terri
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Yes i understand thank you.

I've heard the Immunoblot is even more accurate than the Elisa? Or is that the same as Western blot?

I don't think i've ever had a mouth colsore so it would have to be genital.

My girlfriend thinks i'm being ridiculous however think i've got this subconcious guilt for sleeping with her unprotected knowing i'd had these symptoms and having researched hsv so much, i did not disclose at the time.

As HSV 2 is the main issue, can i be confident i'm no risk to my girlfriend and continue unprotected sex?

I've never had an additional outbreak that i'm aware of, what would just hate to put her at risk.

Dr Hook stated that other conditions can cause HSV similar symptoms however they matched HSV so much at the time i just can't get it out my head. I mean thrush and so on, would not cause raised lymph nodes, fever, sores etc?
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55646_tn?1263664409
I still don't think you can know these genital symptoms are herpes.
The Immunoblot is less accurate than the ELISA, in my opinion, because there is a subjective reading of a color change.  It is NOT the same as the western blot.  

Has your girlfriend been tested to see what she has in terms of herpes?

Terri
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My girlfriend is not bothered at all and does feel the need to get tested. I'm now thinking me getting the western blot would not really be beneficial. Hsv 1 really is no big deal, I'm just worried about the certainty of the elisa test against hsv 2. Does the western blot do better than 97%? Maybe I imagined or over obsessed the symptoms at the time as a lot of people are just saying maybe it was something else. I mean I say my inguinal glands were raised however I'm not sure if my legs just naturally ached from the sexual activity. I was actually monitoring the tops of my inner legs however google displays a different position of lymph nodes in the groin? I think the glands are actually abit higher up than the top of the inner legs?
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I've slept on it and do think it was my inguinal glands that were raised as i remember my jeans being very tight, however so long ago it is hard to recall. For a moment i thought it was just the inner leg groin however think it was def the actual inguinal glands.

if you could just clairify that the elisa test is adequate in confirming i do not have HSV 2?

Many thanks
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55646_tn?1263664409
I think it is adequate, yes.  
This is my final post on this thread.

Terri
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Westover Heights Clinic
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