herpeselect results

[scareduncertain]

Dear Doctor

I have posted up my story in the herpes forum, but at this point I need a physician opinion even though the correspondants have graet advice
.  I have had intercourse with only one person in the past.  At that time, we were both virgins and was a monogamous 3 yr relationship. my last time of having intercourse was 3.5 years ago with that guy.  i have had mutual masturbation from 2 other guys in between.  recently, I started a new relationship and i had suggested to get tested together before engaging in oral sex or intercourse in order to be safe.  we have engaged in mutual masturbation and kissing, but thats it.  2 weeks into the relationship, i saw a nurse practionner for OC and std testing.  

herpes select hsv 1 igg was <0.90 and hsv 2 igg was 1.09.  

i was shocked given my sexual history. and hoped it was sa false positive since I am low risk.  I asked to be retested which is 2 weeks after my first test.  I just got the results today.

hsv 1gg <0.90 and hsv 2 igg is 1.71.  

i realized with the same testing, there was the chance of receiving a slightly higher or equivocal test. but not realized this high.  i have been asymptomatic this whole time.  I am very aware of my body esp bc of my fear of stds and have always checked if an unusual sensation came up, so I dont think I would have confused a outbreak symptom w something else.  i called my ex and he reassured me that he had not cheated on me.

the NP seems more adament that i am hsv 2 positive and suggests taking valtrex for suppression.  I asked for western blot since they dont provide biokit assay at that office, but she seems more annoyed at my persistence that this is a false positive since the values were below 3.5 and i am asymptomatic.  but since the number has increased in 2 weeks i am no longer sure.  what would be the next best step?

what do you suggest?

[Edward W Hook, MD]

I have read your posts on the Herpes community and agree with the advice they have given you as this has evolved.  I can understand your concern with what appears to be a substantial rise in the HSV-2 value but it is still quite low.  If you had been developing antibodies, I would have expected the level to be even higher (once you start developing antibodies they tend to go up rather quickly).  I would say there is still a good chance that you are dealing with a false positive assay, particularly with the information you provide regarding your partners.  This is clearly bothering you as well hence I would suggest pushing for the Western Blot assay fro the University of Washington.  The alternative would be to repeat the HerpeSelect in another two weeks but I think there is a substantial chance that that test result would once again come back as a low positive.  While they HerpeSelect is, in general, a good test, I think it may have let you down.

Hope this helps. Please let us know what happens next.  EWH

[scaredofstds]

read your post and I have similar concerns about herpes testing.  I just scheduled an appointment at planned parenthood for a full check up and curious to what tests they use there. For now I wanted to say, congratulations on a neg western blot and wish you the best moving forward.

[scareduncertain]

my western blot results are negative!!!

I know that a positive wb takes many weeks from an encounter.  should i worry with a herpeselect hsv 1 negative x2 and positive hsv2 at 1.09 and 1.71 (2 and 4 weeks past last encounter)?? although that encounter was just mutual masturbation..no oral or sexual intercourse? i just dont want to be surprised later in life in that this is a false negatve. although im accepting this as a true negative :) esp given my low risk sexual history:)

[Edward W Hook, MD]

Th white bump could be a HSV recurrence but it is equally likly to be some other, probably normal process that you've noticed through  careful, anxiety induced self-examination.  As to what will the Western Blot show, I really don't know.  that is the reason I suggested it.  Please let me know what it shows and if positive I will be pleased to help address further questions.  Till then however, no further quesitons please.  EWH

[scareduncertain]

do you think that i should expect a positive from the wb?  after reading some articles and posts, it seems that since my hsv 1 is negative, that teh chances for a false positive are extremely low, below 5%. I am getting the wb today but I feel that i should expect a positive and accept it even though my sexual history and being asymptomatic point otherwise.  i did notice a couple of days a small white bump on the tip of my labia majora.  it doesnt hurt, about a 1 mm in diameter, so small that i prob wouldnt even noticed except im looking for something.  looks like a pimple.  but nothing else around there. and it hasnt changed either. could this be my symptom?

[Edward W Hook, MD]

To rephrase your question, you are asking if you could have gotten HSV from mutual masturbationa dn without having developed lesions.  The answer is most probably not.  His chances of having infected you are very, very low.  Within your relationship, there is always value to knowing if your partner has HSV but I doubt that it will impact the resolution of your question.  EWH

[scareduncertain]

if it is the hsv 2 igg increasing...could it be from the current relationship even though there has been no intercourse or oral....just mutual masturbation?  i found this article that says that 22 % of low pos index values are from long term hsv infection...but the other is recent?  he is concerned if he had infected me..and should be tested himself even though we are no longer intimate

[scareduncertain]

also, since this hsv 2 igg is increasing, could it be from my recent relationship even though there has been no intercourse or oral sex?