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Negative Herpes Test

Answered by
H. Hunter Handsfield, M.D. -
University of Washington Seattle - WA
Welcome to the STD Forum, which is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.
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MedHelp Member's Question
Negative Herpes Test
by big hurt, Oct 10, 2004 12:00AM
I am a married male, who has herpes.  I contracted it about 18 years ago, had 2-3 early occuurrence and have been outbreak free since.

Recently, my wife has developed a few small bumps in her genital area.  She was tested for HSV 1& 2 with a "Serum IGM" and "Serum IgG" tests, and they both came back negative.  She as also tested negative about four years ago before the birth of our child, but I  am not sure which test it was.

Her OB/GYN is sayng that it may be Shingles, since she was positive for Zoster, but the bumps have come back about 2-3 times in the past 6 months,  and she thinks may have happened some other times before as well.  Note that until recently,  she did not see any sort of  bumps, and at the time suspected a yeast infection.  

My wife went to her Gen Prac for a second opinion, and was told that she suspects HSV-2 even though the tests are negative.  

Based on my experience with HSV-2, I believe that my wife  has something other than HSV-2.  I saw this because there are only a few bups, and they are not blistering, bursting, scabbing, etc.

I should also mention, that the bumps have never been cultured, because the docs keeping saying it is "too late" to get a good culture.

I also want to mention that my wife has PCOS (Polycistic Ovarian Syndrome) and is taking heavy doses of Glucaphage.

My wife is convinced that she has herpes, understandly upset.  However, I cannot understand how she could test negative three times, and still have HSV-2.  

Any thoughts or opinions that you may have would be appreciated.

Thank You
Doctor's Answer
by H. Hunter Handsfield, M.D., Oct 11, 2004 12:00AM
From your description, I agree it is unlikely your wife has acquired herpes.  The symptoms sound atypical and the blood tests are negative.  She had the wrong tests (see next paragraph), but the negative results nevertheless are reassuring.

Your wife had outmoded, unreliable HSV blood tests.  How do I know?  The only blood tests that are accurate for diagnosis are not available in IgG and IgM versions.  She should tell her doctor she wants a test with the Focus (brand name) HSV-2 blood test, currently the only one on the market that is truly accurate.  If that’s negative, it will confirm virtually 100% she doesn’t have HSV-2.

Don't blame the doctor too much for using the wrong test.  Research has been progressing rapidly in recent years, and the Focus test only recently became widely available; your doctor and the lab s/he uses may be only a little behind the times.  Still, they should know they are using a lousy test that easily leads to misdiagnosis.

I think this is all going to turn out all right.  Best wishes--  HHH, MD
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