Confusing test results and information

[ntmommy]

I was recently tested for hsv due to small lesions in my vagina.  The lesions were swabbed within 24 hours of noticing them and the culture test was negative.  I also had a negative hsv 1 IgG and hsv 2 IgG.  My husband was then tested and he received a negative hsv 1 IgG, hsv 2 IgG, and IgM (he actually took the IgM 2 different times to be sure the timing of the test was correct).  My doctor suggested I have an IgM test 4 weeks after my initial tests....and the resuts were positive 1.17.

My doctor feels that the IgM test is accurate and does not think that any new tests are needed.  She is putting me on Valtrex to reduce the possibility of transmitting to my husband.  She has told me the only way the virus is transmitted would be skin to skin.  Is there a possibility that I could have very recently contracted ora hsv 1 and then passed it to my genitals via masturbation/saliva?  I have not had any cold sores yet, so the first outbreak would have been in my vagina.  I have been completely faithful to my husband for over 10 years....and I trust he has been faithful to me too.  

My doctor says I need to stop beating myself up and just accept the results.  I understand I may never understand how this happened...but I just don't feel like any of our testing results line up with my diagnosis.   Do you agree that I should just move on or do you think additional testing is a good idea for my husband and I?  I am starting to see a therapist because this has totally turned my world upside down....thanks in advance for any help you can provide.

[Terri Warren, RN, Adult Nurse Practitioner]

The chance of infecting your genitals by touching your mouth or using saliva for masturbation is extremely low.  I just so disagree with your doctor about the very very low IgM test result.

If your husband is negative for everything, sure, go ahead and test with the western blot.  If you have any concerns that he had had another partner, then all bets are off here.  You are the one who knows in your heart of hearts if this is a concern.

Terri

[ntmommy]

I am not sure what that last post is about...it was not me.  Just to confirm
...because I have such anxiety right now.  Is the chance autoinoculation from asymptomatic oral hsv to my genitals low?  Have you seen cases of this in the past?  Would there be any benefit in doing the Western Blot now versus waiting the 16 weeks?  My current dr has complete faith in the IgM results....what causes the false positive results?   I am going to a new dr on Monday in hopes of finding someone who will help me.

Any advice would be appreciated.....

[ntmommy]

It has only been 7 weeks since my genital lesions showed up.  I am going to wait until closer to the 16 week mark and get retested.  I am really hoping the new tests are negative and the inital IgM results were not correct.  If I actually contracted oral hsv 1 (with no symptoms) and then gave myself genital hsv 1 with my own saliva....that is going to be VERY hard to deal with.

Thanks for your responses!

[Terri Warren, RN, Adult Nurse Practitioner]

If you've had a cold sore in your lifetime it would reduce the chances that you would infect the genital area by yourself.  Many people are asymptomatic with oral infection, probably most.

Have you heard anything from the lab results?

Terri

[ntmommy]

No, I have never had a cold sore.  Would that lessen the chance even more of autoinoculation?  I was not sure if I could be asymptomatic for oral hsv but have symptoms genitally.  I am just trying to figure out any possible scenario.  

Thanks again...any comments you have would be greatly appreciated!

[Terri Warren, RN, Adult Nurse Practitioner]

The HSV 1 scenario that you describe is possible but not likely.  Have you just recently had a major new outbreak of sores on your lips, is that why you ask?  

The test accuracy is best if someone waits 16 weeks from initial infection.  In your case, if your husband is not infected and neither are you and the chap thing scenario is the only risk, I guess you could wait 16 weeks and test.  Your health care provider can order the western blot from Quest labs.  The blood will be sent to UWashington.  The test code for ordering from Quest is 34534.

Terri

[ntmommy]

Thank you very much for your response.  This does not make sense to me either which is one reason I am having such a hard timing dealing with the diagnosis.

Could there be any possibility that I passed this to myself?  If I very recently contracted oral hsv 1 (sharing a cup/lipstick) and then passed it to myself via masturbation/saliva?  I have not had any cold sores or mouth sores.

In regards to the Western Blot test.  How soon can that be taken after showing symptoms?  Do you know how I can find a location in my area that will administer it?  Should my husband take it to confirm that his test results were accurate?  (Our tests have been taken at different places).

Again, thank you so much for your response and help.  

[Terri Warren, RN, Adult Nurse Practitioner]

I completely disagree with your doctor, could not disagree more.  If you had contracted HSV, if your history is correct and your feelings about your husband are correct, it would have been more than 10 years ago and your would have IGG antibody.  The only possibility that I can think of here is that your antibody test may have missed HSV 1 infection, as it misses 9 out of 100 cases.  To resolve this concern, I would suggest that you consider getting a herpes western blot antibody test, it is slightly more sensitive for HSV 1 than the ELISA you had done.

My guess, and I feel strongly about this, is that you don't have herpes and the IgM is a false positive, which we see all the time.  If your husband isn't infected, how could you have new infection if you've not had a new partner?  this just doesn't make sense to me.

Terri