Aa
Please help me understand
Hi,
I can't stop thinking about this...
Back in March 13 my boyfriend performed oral sex on me. He had red pimples around the mouth but I didn't suspect anything since he never told me that he had HSV1. Few days later I started to feel that something was wrong and I went to see a doctor who said with no doubts that it was herpes and gave me valacyclovir. It was a terrible news for me and I felt alone ashamed and like the rest of my life would be different from that time. The doctor said that it was a serious issue and that I had to consult a gynecologist ASAP. I went to see a gynecologist a month after with my boyfriend. She said that from the clinical signs and my story that she was pretty sure it was HSV1 but told me to do a blood test to confirm. In september 13 my boyfriend broke up with me and left me alone with this. In november, I finally decided to do the blood test ( 8 months after the primo infection). What a shock I had when I looked at the results! I have HSV2 too
Here are the test results: HSV 1 : >8 Positive , HSV 2 : 1.6 Positive
I was depressed. I decided to start reading about HSV.This forum gave me some hope. Considering that I have a a high positive result for HSV1 and a low positive result for HSV2 there could be a chance that I am negative for hsv2.
Also, I cross my fingers but I never had outbreaks after this first episode and it's been one year now.
I decided to go see my gynecologist to discuss this. She said that I tested positive and that she had nothing to add. I mentionned the fact that some studies suggest that Igg testing could give false positive results for HSV2 and asked her about the Western Blot testing. She wasn't aware. Can you please help me interpret my results and if there is a chance that I could have a false positive result for HSV2?
Also, I live in Montreal and I 'm almost sure that the Western Blot test is not available. Can you please tell me where can I have one?
Thank you in advance for your help.
I can't stop thinking about this...
Back in March 13 my boyfriend performed oral sex on me. He had red pimples around the mouth but I didn't suspect anything since he never told me that he had HSV1. Few days later I started to feel that something was wrong and I went to see a doctor who said with no doubts that it was herpes and gave me valacyclovir. It was a terrible news for me and I felt alone ashamed and like the rest of my life would be different from that time. The doctor said that it was a serious issue and that I had to consult a gynecologist ASAP. I went to see a gynecologist a month after with my boyfriend. She said that from the clinical signs and my story that she was pretty sure it was HSV1 but told me to do a blood test to confirm. In september 13 my boyfriend broke up with me and left me alone with this. In november, I finally decided to do the blood test ( 8 months after the primo infection). What a shock I had when I looked at the results! I have HSV2 too
Here are the test results: HSV 1 : >8 Positive , HSV 2 : 1.6 Positive
I was depressed. I decided to start reading about HSV.This forum gave me some hope. Considering that I have a a high positive result for HSV1 and a low positive result for HSV2 there could be a chance that I am negative for hsv2.
Also, I cross my fingers but I never had outbreaks after this first episode and it's been one year now.
I decided to go see my gynecologist to discuss this. She said that I tested positive and that she had nothing to add. I mentionned the fact that some studies suggest that Igg testing could give false positive results for HSV2 and asked her about the Western Blot testing. She wasn't aware. Can you please help me interpret my results and if there is a chance that I could have a false positive result for HSV2?
Also, I live in Montreal and I 'm almost sure that the Western Blot test is not available. Can you please tell me where can I have one?
Thank you in advance for your help.
MEDICAL PROFESSIONAL
Welcome to the forum. And thanks for your question. I can help!
It's too bad your initial infection wasn't swab tested for HSV culture or PCR; that's the best way to determine virus type. The blood test is often helpful, but it's not perfect -- which is the problem here. The bottom line is that it remains most likely you are infected only with HSV-1, not HSV-2.
Although the usual HSV blood tests (e.g., HerpeSelect or Captia) are technically positive with ELISA ratio values of 1.1 or higher, in fact they are not reliably positive unless 3.5 or higher. And the lower the value, the more likely it is false. In addition, false positive results are most common in people with positive HSV-1 results. With your HSV-2 value of only 1.6 and your very high HSV-1 result (>8 is off the charts!), there's the odds are 80-90% your HSV-2 result is false and you are not infected with that virus.
You already seem to know a lot about the HSV blood tests, including the fact that the HSV Western blot is the way to sort it out. You even seem to know more than your gynecologist. That's not critcial of her: the HSV blood tests are done infrequently in Canada (more about which below) and I imagine she doesn't have loads of experience wih them.
The main lab that offers HSV WB for clinical (non-research) purposes is the University of Washington Clinical Laboratory in Seattle, and I'm sure your local lab will know how to refer your blood to then for testing. (As far as I know, there are no cross-border issues in doing this.) However, another option is to seek a second opinion, and probably Western blot, from the experts available to you in Montreal. I can't give names on this public website, but do some research on Clinique A, Montreal, Canada Area | Health, Wellness and Fitness and ask your gyn either for a referral or to discuss access to HSV WB testing locally. (If you attend the clinic and happen to see its medical director, a first class herpes expert, give him my personal best wishes!)
The bottom line is that I'm quite certain that once WB testing is done, it will confirm you are infected only with HSV-1. As you may know, that's very important for your future: unlike HSV-2, you probably will have few recurrent outbreaks, maybe none at all, and will be quite unlikely to sexually transmit the virus to your partners.
Finally, I'll just add that I'm very pleased you even had an HSV blood test. As previously discussed on this forum, such testing is done infrequently in Canada, largely because of public health recommendations that most STD experts don't agree with. (The director of Clinique A is one of the folks trying to get the guidelines modified.)
Here are links to two other threads go into detail on differences between genital HSV-1 and 2 and on Canada's HSV testing policies.
http://www.medhelp.org/posts/STDs/Herpes-Confuses-Me/show/1414935
http://www.medhelp.org/posts/STDs/herpes-paranoia/show/1612258
I hope this has been helpful. If and when you have a WB result, or if you get an opinion at the other clinic, please return with a comment to report the outcomes.
Best wishes-- HHH, MD
It's too bad your initial infection wasn't swab tested for HSV culture or PCR; that's the best way to determine virus type. The blood test is often helpful, but it's not perfect -- which is the problem here. The bottom line is that it remains most likely you are infected only with HSV-1, not HSV-2.
Although the usual HSV blood tests (e.g., HerpeSelect or Captia) are technically positive with ELISA ratio values of 1.1 or higher, in fact they are not reliably positive unless 3.5 or higher. And the lower the value, the more likely it is false. In addition, false positive results are most common in people with positive HSV-1 results. With your HSV-2 value of only 1.6 and your very high HSV-1 result (>8 is off the charts!), there's the odds are 80-90% your HSV-2 result is false and you are not infected with that virus.
You already seem to know a lot about the HSV blood tests, including the fact that the HSV Western blot is the way to sort it out. You even seem to know more than your gynecologist. That's not critcial of her: the HSV blood tests are done infrequently in Canada (more about which below) and I imagine she doesn't have loads of experience wih them.
The main lab that offers HSV WB for clinical (non-research) purposes is the University of Washington Clinical Laboratory in Seattle, and I'm sure your local lab will know how to refer your blood to then for testing. (As far as I know, there are no cross-border issues in doing this.) However, another option is to seek a second opinion, and probably Western blot, from the experts available to you in Montreal. I can't give names on this public website, but do some research on Clinique A, Montreal, Canada Area | Health, Wellness and Fitness and ask your gyn either for a referral or to discuss access to HSV WB testing locally. (If you attend the clinic and happen to see its medical director, a first class herpes expert, give him my personal best wishes!)
The bottom line is that I'm quite certain that once WB testing is done, it will confirm you are infected only with HSV-1. As you may know, that's very important for your future: unlike HSV-2, you probably will have few recurrent outbreaks, maybe none at all, and will be quite unlikely to sexually transmit the virus to your partners.
Finally, I'll just add that I'm very pleased you even had an HSV blood test. As previously discussed on this forum, such testing is done infrequently in Canada, largely because of public health recommendations that most STD experts don't agree with. (The director of Clinique A is one of the folks trying to get the guidelines modified.)
Here are links to two other threads go into detail on differences between genital HSV-1 and 2 and on Canada's HSV testing policies.
http://www.medhelp.org/posts/STDs/Herpes-Confuses-Me/show/1414935
http://www.medhelp.org/posts/STDs/herpes-paranoia/show/1612258
I hope this has been helpful. If and when you have a WB result, or if you get an opinion at the other clinic, please return with a comment to report the outcomes.
Best wishes-- HHH, MD
MEDICAL PROFESSIONAL
The value of immunoblot depends a bit on which specific assay is done. If it was the HerpeSelect IB, it indeed is essentially the same test as the ELISA.. You'll have to sort this out with Dr. S. As for WB, I can't make this decision for you. I've already stated my confidence you have only HSV-1 and probably not HSV-2.. But if you feel you need certainty, WB is the way to go.
I think this discussion has gone as far as it can. If and when you have a WB, feel free to let me know the outcome. Until then, I won't have any further advice. Best wishes.
I think this discussion has gone as far as it can. If and when you have a WB, feel free to let me know the outcome. Until then, I won't have any further advice. Best wishes.
Dear M. Handsfield,
Thank you for your time and answers.
I have a very last question for you.
After reading some stories similar to mine, I noticed that IB testing cannot be used as a confirmatory test for HSV 2 because it's very similar to ELISA.
In my case, the 2 elisa gig test I had were very low positives ( 1.6 and 1.00 for the last one ).
Since the WB is going to cost a lot because I'm in Canada, do you think in my specific case it would worth get it?
Thank you for your patience
Thank you for your time and answers.
I have a very last question for you.
After reading some stories similar to mine, I noticed that IB testing cannot be used as a confirmatory test for HSV 2 because it's very similar to ELISA.
In my case, the 2 elisa gig test I had were very low positives ( 1.6 and 1.00 for the last one ).
Since the WB is going to cost a lot because I'm in Canada, do you think in my specific case it would worth get it?
Thank you for your patience
MEDICAL PROFESSIONAL
I'm sure Dr. S has much more experience with the HSV IB test than I do, so this question is best asked of him. No lab test is perfect, so a false positive IB probably is possible, which is why I mentioned Western blot. But that's all I can say about it.
Ok, my ex-boyfriend is going to get tested but as I said Dr S. thinks that my clinical signs I have only HSV1.
With your experience, do you think that the Immunoblot could be falsly positive?
Thank you for your help.
With your experience, do you think that the Immunoblot could be falsly positive?
Thank you for your help.
MEDICAL PROFESSIONAL
My guess is that you have both viruses; as Dr. S said, the immunoblot is very accurate. But probably the HSV-1 infection is the only one causing symptoms. I agree it makes sense for your boyfriend to also be tested. You might also ask Dr. S whether it would be possible to have a Western blot at the University of Washington clinical lab. If not easily arranged in Montreal, you could easily find a doctor, clinic, or lab that could do it in the US if and when you next travel south of the border.
Beyond that, there's really nothing more I can say or do. You are in the hands of a genuine expert -- he knows as much about herpes as I do.
Beyond that, there's really nothing more I can say or do. You are in the hands of a genuine expert -- he knows as much about herpes as I do.
Dear M. Handsfield,
I just received my results and met Dr S. in Montreal and I'm still confused, even a little more.
ELISA Test:
HSV 1 IgG = 5 Positive
HSV 2 IgG= 1.0 Equivocal
Since Elisa was not conclusive, they performed a second test:
Immunoblot :
HSV 1 IgG Sérum Positive
HSV 2 IgG Sérum Positive
Does that mean that I have HSV2? Dr S. told me that my clinical signs make him think that I have genital HSV1 but at the same time he says that Immunoblot is very accurate...
What do you think? Please let me know. I also asked my ex-boyfriend ( the one that performed oral sex on me while having a cold sore in the mouth) to do the same tests. Dr S. said that it will help clarify the situation.
Thank you for your help.
I just received my results and met Dr S. in Montreal and I'm still confused, even a little more.
ELISA Test:
HSV 1 IgG = 5 Positive
HSV 2 IgG= 1.0 Equivocal
Since Elisa was not conclusive, they performed a second test:
Immunoblot :
HSV 1 IgG Sérum Positive
HSV 2 IgG Sérum Positive
Does that mean that I have HSV2? Dr S. told me that my clinical signs make him think that I have genital HSV1 but at the same time he says that Immunoblot is very accurate...
What do you think? Please let me know. I also asked my ex-boyfriend ( the one that performed oral sex on me while having a cold sore in the mouth) to do the same tests. Dr S. said that it will help clarify the situation.
Thank you for your help.
Thank you very much for your answer.
I'm going to look for the clinique that could do the WB test and be sure that if I see its medical director I'll give him your wishes.
Once I get a result, I'll get back to you.
Thanks again M. Handsfield for your advises and prompt answer.
I'm going to look for the clinique that could do the WB test and be sure that if I see its medical director I'll give him your wishes.
Once I get a result, I'll get back to you.
Thanks again M. Handsfield for your advises and prompt answer.
MEDICAL PROFESSIONAL
I meant to add that I constructed my reply above in part with the idea that you could print it out and show it to your gyn, as a framework for discussing the options.
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
