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Indeterminate HSV2 Western Blot
Hello Doctor,
I'm having trouble interpreting the results of a Western Blot test, and I could use some expert advice.
My background: I'm a 31 year old gay man who practices safe sex. In early July I noticed a red lesion, not unlike an infected hair follicle (which I am prone to) on my abdomen, just at my belt line. I had no itching or pain, just an unsightly lesion which developed a whitehead around a hair follicle after approx. a week. After about ten days, I noticed that another nearby follicle started to exhibit similar symptoms--redness, whitehead, but again no pain, itching, pus or oozing. I also noticed that a lymph node in my groin on the opposite side of my body from the rash was tender, and I had a soreness in my ribcage. I applied Neosporin to the area, and within a few days the rash had spread to include about 7 lesions, all small and centered on hair follicles.
I went to a STD clinic where the physician thought the symptoms were consistent with an acute staph infection, particularly because the symptoms were aggravated by the Neosporin. She ran a blood test for STDs as a precaution and prescribed Bactroban ointment, and immediately the whiteheads peeled off and the swelling reduced.
A week later the blood work came back with a 2.6 IgM index and 2.4 IgG index for HSV2. I immediately sought care with my primary care physician, who examined the area and the test results and thought HSV infection unlikely given my sexual history and symptoms. At my insistence, he performed a Western Blot and prescribed Valtrex for confirmatory results. Important to note: it had been approx. one month since the "infection window" as determined by my doctor when the blood draw for the WB test took place. In the meantime I contacted all my sexual partners in the weeks before and after symptoms began (5 in total) and explained the situation. All took IgG blood tests, and all had negative results. None ever showed any overt symptoms.
Two weeks passed before we received the WB results: negative for HSV1, and indeterminate/atypical for HSV2. My doctor advised me that, though I still had redness where my lesions had appeared, HSV2 infection was unlikely since my partners all tested negative and my infection cleared with the Bactroban but the Valtrex had no measurable affect on my healing. After about 6-8 weeks, the redness had finally dissipated.
A month passed, and I noticed another red lesion in the same area, approx 3cm across. I watched it very closely, and again, had no itching, burning or pain or any sign of blistering. The skin felt rough, and the hair follicles in the affected area were raised like goosebumps. I also had glandular swelling again. I applied Bactroban and kept the area bandaged again, and after 3-4 days the swelling shrank to about 3/4cm across and noticed broken skin on the remaining lesion. It didn't bleed or scab, though I noticed if I did a lot of walking a orangish stain on the bandaids. Again, no pain or pus. After 2 weeks I noticed slight bleeding in the area when I cleaned the wound. The bleeding only happened when I dried the area after getting out of the shower and lasted exactly 2 days before the wound closed and healed. I saw my doctor, who again thought I had no cause for alarm, that the sore was likely due to recurrent staph infection, and that it was unlikely I had been infected with HSV. Still, I had high anxiety over the possibility that I had somehow been infected.
I still have a red spot 3 weeks after the initial lesion appeared, but no other symptoms. I've had panic attacks in the matter--so much conflicting data and advice, atypical symptoms, indeterminate tests, opposing statistics. I realize at some point I should likely be retested, though whether or not my insurance will cover another test is uncertain. I know HSV2 Western Blot tests have cross reactivity with other antibodies, possibly including those of gonorrhea and HPV, though I've not found any definitive data on what might cause a false positive. It's also my understanding that HSV2 is quite rare in the gay community, and since I practice safe sex my chances of infection are supposedly lower.
So then, I'm looking for some kind of peace of mind. My doctor has already advised me that if I am somehow infected with HSV2, because of the area of infection I'll not be able to have body contact with another person ever again, as condoms and antivirals will not protect against exposure. Based on the history and data I've provided, what's your assessment and advice?
This discussion is related to HSV 2 Western Blot "atypical results".
I'm having trouble interpreting the results of a Western Blot test, and I could use some expert advice.
My background: I'm a 31 year old gay man who practices safe sex. In early July I noticed a red lesion, not unlike an infected hair follicle (which I am prone to) on my abdomen, just at my belt line. I had no itching or pain, just an unsightly lesion which developed a whitehead around a hair follicle after approx. a week. After about ten days, I noticed that another nearby follicle started to exhibit similar symptoms--redness, whitehead, but again no pain, itching, pus or oozing. I also noticed that a lymph node in my groin on the opposite side of my body from the rash was tender, and I had a soreness in my ribcage. I applied Neosporin to the area, and within a few days the rash had spread to include about 7 lesions, all small and centered on hair follicles.
I went to a STD clinic where the physician thought the symptoms were consistent with an acute staph infection, particularly because the symptoms were aggravated by the Neosporin. She ran a blood test for STDs as a precaution and prescribed Bactroban ointment, and immediately the whiteheads peeled off and the swelling reduced.
A week later the blood work came back with a 2.6 IgM index and 2.4 IgG index for HSV2. I immediately sought care with my primary care physician, who examined the area and the test results and thought HSV infection unlikely given my sexual history and symptoms. At my insistence, he performed a Western Blot and prescribed Valtrex for confirmatory results. Important to note: it had been approx. one month since the "infection window" as determined by my doctor when the blood draw for the WB test took place. In the meantime I contacted all my sexual partners in the weeks before and after symptoms began (5 in total) and explained the situation. All took IgG blood tests, and all had negative results. None ever showed any overt symptoms.
Two weeks passed before we received the WB results: negative for HSV1, and indeterminate/atypical for HSV2. My doctor advised me that, though I still had redness where my lesions had appeared, HSV2 infection was unlikely since my partners all tested negative and my infection cleared with the Bactroban but the Valtrex had no measurable affect on my healing. After about 6-8 weeks, the redness had finally dissipated.
A month passed, and I noticed another red lesion in the same area, approx 3cm across. I watched it very closely, and again, had no itching, burning or pain or any sign of blistering. The skin felt rough, and the hair follicles in the affected area were raised like goosebumps. I also had glandular swelling again. I applied Bactroban and kept the area bandaged again, and after 3-4 days the swelling shrank to about 3/4cm across and noticed broken skin on the remaining lesion. It didn't bleed or scab, though I noticed if I did a lot of walking a orangish stain on the bandaids. Again, no pain or pus. After 2 weeks I noticed slight bleeding in the area when I cleaned the wound. The bleeding only happened when I dried the area after getting out of the shower and lasted exactly 2 days before the wound closed and healed. I saw my doctor, who again thought I had no cause for alarm, that the sore was likely due to recurrent staph infection, and that it was unlikely I had been infected with HSV. Still, I had high anxiety over the possibility that I had somehow been infected.
I still have a red spot 3 weeks after the initial lesion appeared, but no other symptoms. I've had panic attacks in the matter--so much conflicting data and advice, atypical symptoms, indeterminate tests, opposing statistics. I realize at some point I should likely be retested, though whether or not my insurance will cover another test is uncertain. I know HSV2 Western Blot tests have cross reactivity with other antibodies, possibly including those of gonorrhea and HPV, though I've not found any definitive data on what might cause a false positive. It's also my understanding that HSV2 is quite rare in the gay community, and since I practice safe sex my chances of infection are supposedly lower.
So then, I'm looking for some kind of peace of mind. My doctor has already advised me that if I am somehow infected with HSV2, because of the area of infection I'll not be able to have body contact with another person ever again, as condoms and antivirals will not protect against exposure. Based on the history and data I've provided, what's your assessment and advice?
This discussion is related to HSV 2 Western Blot "atypical results".
I think they can do a pcr test on the lesion. I think it is very accurate and will determine whether it is hsv or not. I am not medical professional.
yout tried to add to a prior post on the experts forum so it was bumped over to here. you have to pay to post on the experts forum.
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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.
