Last Question Doc.

Thanks for all of your help that you have given me (and others).  I still don't know what's going on, but you have helped reduce my nerves a bit and for that I am thankful.  

Now on to my question.  I have heard numerous reports and comments on the various blood tests for herpes.  Many claim that they are not accurate at all, while some are.  I have no visible signs, so a culture test is out.  I do want to get tested for herpes but it has only been about a month.  Is that too soon to get checked with a reasonable amount of accuracy.  Also, what type of test would you suggest I get?  I know I have oral herpes (1) for many many years.  I want to know what is going on downstairs.  I will most likely have to pay for this test out of pocket so if I do, i want to get the best type of test available.  

Thanks again doc.

[H. Hunter Handsfield, M.D.]

The proper HSV tests are accurate.  Ask for the HerpeSelect HSV-2 test.

HHH, MD

[illuzionz]

i have very tiny blister looking things on my tongue.  they have been there for over a week and do not hurt at all.  they are not white but clear.  could this be herpes?

[mvisitor]

Thought I'd post a response here in regards to: "The proper HSV tests are accurate." I had a blister which was raised maybe 3mm wide near the base of the shaft - I popped it leading to mostly clear fluid and finally blood. It immediately scabbed (and resembled a scabbed herpes scab picture like those online) but it didn't turn into an ulcer healing in a week. Finally, when the scab fell off the underlying skin became flaky/scaly. My doctor who saw it when it was at the flaky stage announced that it was indeed herpes. So I took a blood test HSV CGC (I think) antibody and antigen for Type I and Type II (LabCorp insisted that there was no brand so I don't think it was HerpeSelect). These came back negative.

1. Does this sound like anything else - i.e. any other STD
2. Were these the right tests?
3. The doctor mentioned that the accuracy of the tests were 50/50 because the blister had healed and the disease was now 'dormant'. Is this accurate?

[DarkDryad]

Well I know that this is the third question in the same thread. I just want to know, what is culture and the culture test? I heard it before on this site, but don't know exactly what it is.

[H. Hunter Handsfield, M.D.]

To illuzionz:  A painless clear fluid-filled lesion in the mouth are called mucocele--usually inside the cheek or lips, but sometimes on the tongue.  The pore to a mucus-secreting gland plugs up and mucus accumulates.  You can ***** it with a needle and open it up, if you like.  Definitely not herpes.

To mvisitor:  1) It sounds most like herpes.  2) I believe LabCorp offers the HerpeSelect test, but they might do more than one type, depending on what the doctor orders; or the "default" test, if the doc doesn't specify, might be one or the other.  It is very unlikely that LabCorp makes its own unbranded herpes blood test; like virtually all labs, they actually purchase branded test kits from manufacturers.  You spoke to someone at LabCorp who either doesn't know the answer or blew you off.  (However, unlike blood tests, culture tests for the virus often are unbranded in-house tests.  So maybe the person you spoke with wasn't clear on culture vs blood test.)  3) Your doctor's statement is accurate for culture, but not for the blood test.  Once the blood test is positive, it stays that way forever.  But you might have been too soon; it takes a few weeks for the blood test to become positive.  I suggest you have another blood test in 1-2 months, and insist that your doc request LabCorp for HerpeSelect by name. (Or, if s/he wants to use generic test terminology, tell him to request a test that detects antibody to HSV-2 glycoprotein G.  HerpeSelect is the only test offered by most labs that does that.)

To DarkDryad:  For most infections, including herpes, blood tests detect antibody, that is the body's immune reaction to the virus or bacteria.  Culture tests detect the virus or bacteria itself, typically by taking a sample that is inoculated into nutrients that allow it to grow so it can be easily detected.  So a culture can only be positive when the infection is active, but a blood test typically remains positive a long time, often forever.

I hope that helps everyone--   HHH, MD

[mvisitor]

Regarding your answer to question 3:

1. What's your opinion on the test that was administered: HSV CGC IGG for Type I & Type II - antibody and antigen?

2. My last sexual encounter was two months prior to the date of the test and the blister appeared 3 weeks before the date of the test. Does this relate to the accuracy of the test state in (1)?