just to make sure

Ok, I have posted with Dr. hook and I do value his input greatly!  I know this is my anxiety acting up, like Dr. Hook has stated.  But for some reason I need more confirmation about my results.  I do absolutely trust Dr. Hook because he is an expert in the field.  But I ask that you do give your opinion!  My first test was as follows  HSV1: IgM 1.19 HSV2:IgM 1.94 HSV1: IgG 1.52 and HSV2: IgG 0.19.  This test was done 5-6months after my last vaginal intercourse. I had a second test done 7 months after the first and the results were as follows.  HSV1 IgG: .1 negative  and HSV2 IgG: .06 negative. I did have unprotected oral sex in between tests but never had any symptoms congruent with genital herpes besides constant itching (I am a runner and assume that the itching is due chaffing)  In your opinion do I have HSV1 or 2 at all? I know that IgM testing is useless but I figured I would give my complete results just to be sure.  Your input is greatly appreciated!  

[Terri Warren, RN, Adult Nurse Practitioner]

The test that you are having done is less sensitive for HSV 1 than HSV 2 but still a good test.  You've had a low positive HSV 1 IgG but that was followed by a negative HSV 1 IgG, right?  That suggests to me that you are not infected with HSV 1.  However, I'm guessing that the slightly positive HSV 1 IgG test, that once, is throwing you off and making you concerned.  I understand that.  My professional opinion is the same as Dr. Hook, that probably your anxiety is acting up, but since you did have that one positive HSV 1 test, I can appreciate that you have some confusion.  If you were my patient, I would suggest that you get a herpes western blot to resolve any confusion between the positive and negative HSV 1 tests.  I think you would feel better and more relaxed.  Clearly, enough time has gone by for the test to be accurate now.  Do you think that would be helpful for you?  The test code, through Quest laboratories, is 34534.  Quest is a large lab and available in most cities in the US.

Terri

[MCfan1]

Terri, thank you for your input!  Yes you are correct, I had a low posiive HSV-1 followed by a a negative result.  That has caused some confusion on my part but ironically it's the HSV-2 results that actualy worry me the most, even though both IgG results were negative both times!  Is this worry unfounded and irrational? I am just worried that I will pass genital herpes onto someone, although my results are negative.  I guess it's the stigma of HSV-2 that has my mind racing. I know deep down there is no reason to get a western blot for HSV-2 because two negative IgG tests should evidence enough that I don't have it.  As far as HSV-1, I will consider the western blot but never having cold sores or anything I wonder if it will really be worth it? Or if I should accept the results and expert advice from both you and Dr. Hook and move on.  So just to reiterate you suggest a western blot for HSV-1 if I think it will help, but no need for retesting for HSV-2 right? Thanks for your time and help Terri !I'm really trying to put these fears behind me but it's been tough ever since I started seeing someone.  Hopefully closure will come soon!

[MCfan1]

Terri,  I looked up the western blot and the nearest testing center is roughly 6 hrs away from me.  I just have a few questions.  1. In your opinion do you think a western blot for HSV-1 or HSV-2 is really necessary beyond putting my mind at ease?  I'm startig so see the somewhat irrational thinking, especially if I drive 6 hrs to get a test done that I might not even need.  2. Given my two lab results, with how much certainty would you say that I don't have HSV-1 or 2?  Once again thanks for your time.  I am hoping this will be my last post on this subject.

[Terri Warren, RN, Adult Nurse Practitioner]

Are you saying that the closest Quest lab is 6 hours from you?  Its hard to imagine that, but maybe if you live in a small town.  Are you closer to a Lab Corp testing center?  I think you should get the HSV 1 situation resolved for your future information.
Terri

[MCfan1]

Terri, I looked up Lab Corp as well and the closest one of those is roughly 2/12 hours away.  I do live a remote part of my state.  I asked my doctor if they would order it and they said no stating that there is no reason to test any further and as you know that was also the stance of Dr. Hook.  That's why I asked what you thought the chances of me having either HSV-1 or 2 were.  I figure if I had my doctor, an STD expert, and a herpes expert tell me that there was nothing to worry about that would be good enough for closure.  I'm not sure if you are willing do that but your input would be greatly appreciated.

[Terri Warren, RN, Adult Nurse Practitioner]

I can only state what I would do if you were my patient.  If you were my patient, and first had a positive HSV 1 IgG and then a negative HSV 1 IgG, given the issues with this test and HSV 1 sensitivity, I would order the western blot just to be certain which is correct - a tie breaker, if you will.  This could be skipped, of course.  But remember that we order testing based on the needs of our patients.  If you need more clarity, then you could get this test ordered.  

Terri

[MCfan1]

I see your point Terri and I really do appreciate your advice.  In the end I know this is my decision and I can only go with the info I have.  In the end I think I need to bring closure to
this issue and am willing to accept the low positive and negative results.  I mean I have never had a cold sore and I know that about 60%of the population have HSV-1 and most acquire it in childhood.  In the end HSV-2 was always my biggest concern and two negative IgG results for that assures me I don't have it.  If I do decide to have the western blot I will be sure to
let know what the results are.  Once again thank you for time an advice, you truly are an invaluable resource!

[Terri Warren, RN, Adult Nurse Practitioner]

Sounds like a plan!  

Terri

[MCfan1]

Hi Terri, I have a question for you and I can assure you it will be my last one.  This question does not have to do with my blood tests since I have decided to just accept the results.  Last night while masturbating I noticed that my skin became very irritated under my thumb and noticed a small, I guess I'll call it an ulcer, under my thumb. It was very small and the skin around it seemed to be darker.  I put antibiotic cream on it and went to bed.  When I woke up roughly 9 hours later it was completely scabbed over.  Does this sound anything like herpes or is this just my anxiety up?  I have had skin irritation on penis before from masturbating and my common sense tells me this is just a brush burn but I thought I would just check to help put my mind at ease.  Thanks for your time.

[Terri Warren, RN, Adult Nurse Practitioner]

Without a swab test, it is not possible to know what that is. If you have had broken skin from masturbating in the past, it could be just friction burn or it could be herpes.  Again, I recommend a western blot for clarification.  Every time this kind of thing happens, you will wonder.  but it is of course up to you.  This will be the last response to this thread.

Terri

[MCfan1]

Terri, I am only posting this because I am a bit confused.  I just want to clarify one thing.  You recommend a western blot for both HSV-1 & 2? The reason I am double checking is because both my IgG HSV-2 results have been negative.  I realize that I am being quite redundant but I thought the possible uncertainty was with the HSV-1 results, not the HSV- 2 results.  The reason I couldn't get a swab test was because the burn had scabbed over so fast (within 9 hrs).  I am asking because from what I read the western blot can be a bit expensive and since my docotor won't order my insurance won't cover it.  That why I want to be sure if I do it if I should only get it for HSV-1 for clarification purposes.  I do promise that this will be my last post on this thread. Thanks for your time and effort!

[MCfan1]

Terri, I want to apologize for taking up your time...I don't why I didn't say this in the first place but in the end I don't think I can afford the 2 1/2 hr drive or the western blot to get clarificaion.  That why in the based on my IgG results the amount of confidence I can have that I don't have HSV-1 or 2.  Everyone I talked to, including my doctor, therapist, and Dr. Hook advise against any retestig based on my results and for some reason I guess my rationale was that if I had a herpes expert say the same thing that would be good enough for closure.  Once again I apologize for the time I have taken up and if you could respond I would be extremely grateful but would also understand if you didn't....this is my last post and I will be a man of my word.

[Terri Warren, RN, Adult Nurse Practitioner]

The western blot automatically tests for both - its just the test, you can't separate them.  It is possible for experts to disagree about this.  I would manage it one way, they might another.  If you can't afford it, you can't.  But I think your doctor should agree to order it since you have conflicting results, I'm not sure why they wouldn't, but if that's the way it is, then it is.  At least you know your HSV 2 status for certain, and that's good for you.

Terri

[MCfan1]

Thank you Terri!  I will talk to my doctor again and see if they will order it...if not then like you said that's just the way it will be.  Maybe if I have more money soon I'll take the drive and do it myself.  Just want to thank you one more time for your advice and patience.  I hope you enjoy the rest of your summer!

[Terri Warren, RN, Adult Nurse Practitioner]

Thanks, you too.

Terri