western blot -- too early to test

[aworriedguy]

hi doc -

had a very low risk exposure at a massage parlor 11 weeks ago --genital stimulation by her with her hand and a few cursory licks by her on my body (not penis).

about two weeks ago, i broke out with a yeast infection in the groin area as diagnosed by my dermatologist. a first for me.

decided to go to harborview to relieve my anxiety and get tested for herpes using the western blot as the clinician at harborview said this was the gold standard and if i could afford it, that was the way to go.

i just now read that western blot may not pick up the antibodies as quickly as herpes select test.

3 questions:

1. at 11 weeks, was it too early to take the western blot?
2. should i have taken the herpes select since it picks up the antibodies quicker than western blot?
3. should i go back in and get re-tested using herpes select?

[H. Hunter Handsfield, M.D.]

You made two mistake, I think.  (OK, three if you count the exposure itself.)

First, you didn't need herpes testing.

Second, I am suspicious that your provider didn't recommend the Western blot until/unless you raised that idea yourself.  (Apologies if I am wrong on this.)  If you had just requested a herpes blood test without specifying which one, you would have had the HerpeSelect test, which indeed becomes positive sooner than western blot.

But it makes no difference.  You COULD NOT have acquired herpes during the exposure you describe--period, full stop, no argument.  Therefore, the time since that exposure is meaningless in interpreting your test.  Your negative western blot shows you are not infected.  I recommend against further testing.  Just forget the whole thing and go on with your life.

Regards--  HHH, MD

[aworriedguy]

believe it or not, they explained to me that there were two tests and that one was considered the gold standard. hence, i opted for it.

last question -- so taking the western blot test after 11 weeks would most likely yield a negative result regardless whether positive or not -- essentially making the test worthless? (only ask as i just had the test done this morning)

[H. Hunter Handsfield, M.D.]

No, you misunderstood.  In your circumstance, if the WB is negative for HSV-2 it will mean you definitely are not infected.  

And even if you had been possibly exposed or infected (which is not possible for the exposure you describe), at 11-12 weeks a negative WB is 80-90% reliable.

HHH, MD