Opinon on Results

Thank you in advance.

Suffer oral cold sores since child.

All tests by Labcorp

Red spots referred below never hurt or had blisters. All same location and size. They peeled some, but didn't seem to scab.

26Apr08-protected sex with CSW in Brazil.
  
25May08-Red circular spot approx 4mm dia. appears on RIGHT side of penis, mid shaft.  

30 May 08 HerpeSelect test
HSV 1 - 5.33
HsV 2 - 1.54

18 Jun spot healed up

25 Jun 08 HerpeSelect test
HSV 1 - 4.15
HSV 2 - 1.35, result said test performed again to verify results.

27Jun08 new spot, heals 14 days.

20Jul08 new spot, heals in 10 days.

27Jul08- begin 500mg/day Valtrex

4Aug08 -area on LEFT side of corona down LEFT side of penis very sensitive (painful) to touch, lasts for a few hours. Then, red spot appears same location as previous (RIGHT side of penis). Begin outbreak dosage of Valtrex then 500mg bid for 14 days.  Just above area are 2 to 3 pin point scabs the size of periods on a page.
Red area persists until healed by 3 Sept.

From 26Aug08 to present I take acyclovir 500mg bid. No genital spots appear.

02Apr09, 5mm area on right edge of corona and just below looks as if injured in zipper (I didn't). Appears after very aggressive unprotected sex previous day.  Slight pain, scabs immediately, heals in 4 days. Not like previous spots in location or appearance.

8Apr09 - HerpeSelect. Lab took one vial (previous took two). HSV 1 processed in NC, HSV 2 in DFW.  
HSV 1 - 4.46
Hsv 2 - <0.91

Questions:

1. Why pos.HSV 2 May 08 and Jun 08, but <0.91 in Apr 09?  HSV 1 results varied but why would HSV 2 go neg?
2. would lab report higher or lower number when confirming Jun 08 HSV 2 test?
3. you state HsV 2 outbreaks don't cross midline of body.  Why do oral outbreaks appear everywhere on mouth?
5. do labs usually split one vial and send them to different labs?
6. other posters have actual numbers for their neg. tests. My result says <0.91.  Why?
7. do you think I have HSV 2?

Thank you.

[H. Hunter Handsfield, M.D.]

Welcome back to the forum.  I'll try to help.  The bottom line: Congratulations-- you don't have genital herpes.

As has been discussed many times on this forum, HSV-2 ELISA values over 1.1 are technically positive, but more recent research shows that numbers between 1.1 and 3.5 often are false.  This is especially common in people who have positive HSV-1 results.  in other words, your HSV-2 results of 1.54 and 1.35 always were suspect to be false -- and the more recent results, with HSV-2 ELISA under 0.91, confirms that you don't have it.  For a more detailed discussion of this issue, see http://www.medhelp.org/posts/STDs/IGG-Test-Result-Confusion/show/593272

Finally, your description of genital lesions does not sound like genital herpes -- and the blood test results confirm you don't have it.

To your specific questions:

1) See above.

2) I don't understand what you mean by this question, but I'm pretty sure I answered it above.

3) Oral herpes recurrences do not gnerally appear "all over the mouth".  In most people, each outbreak is in more or less the same spot each time, give or take an inch or so.

5) No, not usually.

6) Different labs have different reporting styles.  If you contact the lab, they might tell you the actual value.  But it doesn't matter:  any result under 0.91 is negative.

7) As I said above, I am quite certain you do not have HSV-2.  Sorry you went through the confusion of believing you did.  But congratulations on the good news.

Regards--  HHH, MD

[mt4p]

I forgot to ask:

What could have been causing the red spots if not HSV 2?

Why would they persist and keep coming back?

Thanks

[auntiejessi]

You've had very low positives for type 2, and with the negative results after, I'd say you are hsv2 negative.

I don't know what is causing your symptoms - could be fungal, dermatitis, etc., but a doctor needs to check it out.

[H. Hunter Handsfield, M.D.]

I don't know the cause of the red spots -- just not herpes or any other STD, and that's as far as advice on this forum goes.  I agree with auntiejessi:  see a provider if the spots persist or recur, or if you otherwise remain concerned.

[H. Hunter Handsfield, M.D.]

I don't know the cause of the red spots, but it isn't herpes or any other STD, and that's as far as advice on this forum goes.  I agree with auntiejessi:  see a provider if the spots persist or recur, or if you otherwise remain concerned.

[H. Hunter Handsfield, M.D.]

I don't know the cause of the red spots, but they aren't due to herpes or any other STD, and that's as far as advice on this forum goes.  I agree with auntiejessi:  see a provider if the spots persist or recur, or if you otherwise remain concerned.