Question for Terri: Pursue further HSV2 testing?

[kisstherain]

Terri,
My partner was recently tested for a full battery of STDs which included HSV 1&2 after a condom broke.  We have only had sex a few times (protected other than that incident) and he was my first partner.  He got tested a few weeks after this happened and he was negative for all the other tests, his HSV1 came back negative, however the HSV2 came back positive at 2.6.  The test was done through Lab Corp.  The req. sheet says the test code is 164905 for both the HSV1&2 tests and it was an IgG.

After we both read about the test results, it looks as though he is in a gray area where it is possibly a false positive.  He does not want to go through further testing and unfortunately it looks as though he does not want to see me any further because he doesn't want to risk infecting me.  He thinks more testing will be inconclusive and that the Western Blot may also be inconclusive, although from what I've read, this will clear up any uncertainty.  His last partner was a year ago, and he has never had an outbreak.  I can tell he is very depressed over this which is why I think he does not want to know for sure either way.

Is he indeed in a gray area and how accurate is the Western Blot?  If he decides not to pursue any further testing, would it be worth me getting tested for HSV2?  (I know I have HSV1 b/c I've had cold sores since I was a kid).  I am afraid of ending up in a gray area also, but then again, I do want to know.  How soon would I be able to get tested and with what type of test?
Thanks Terri.

[Terri Warren, RN, Adult Nurse Practitioner]

He is indeed in the gray area and needs western blot confirmation.  However, he is correct that he may still be indeterminate on the western blot as well.  We run western blots on all low positives (1.1 to 3.5) but for those folks, the indeterminate result is more common than in others.  I would strongly encourage him to do it anyway.  He has a life to live fully, and this may provide an answer for him, either way.  

You could test four months after your last contact with him, though I think your risk of infection is very low.  You should start with a simple ELISA (herpeselect or captia) and go from there.

But he is the one that needs to pursue the western blot.  Quest labs has stopped offering it routinely as of July 1st, but so far, I am still able to order the test for my patients.

Terri

[Terri Warren, RN, Adult Nurse Practitioner]

YOu're welcome

[kisstherain]

Thank you Terri.

[Terri Warren, RN, Adult Nurse Practitioner]

I would say if his western blot is negative, then he is negative, with as much certainty as one can get about this infection.  And yes, he can become a phone patient of ours to get the western blot, yes.

Terri

[kisstherain]

Prior to me, his last partner was one year ago.  And if it shows negative, then he could be 100% sure he is negative?  Also, he could become a phone patient of you to get the test ordered?  Thanks again, I really appreciate your help.

[Terri Warren, RN, Adult Nurse Practitioner]

Yes, the test he had is mostly likely an ELISA.  You could test with that test as well.  You could do it if you feel you need reassurance.  Sometimes you can't put a price on reassurance.

When was the last time he had a different sex partner than you?  He should wait 16 weeks from that time to having the western blot done.  

If the western blot is positive, it is not a false positive.  

Terri

[kisstherain]

Thanks for your response Terri.  Is the test he had an ELISA?  I would just get that one if so.  Would you recommend it to a person in my shoes considering the low odds?

Then as far as the Western Blot goes, if it comes back negative, would that mean with 100% certainty that he is not infected?  And if it comes back positive, that could be another false positive?  I agree he should have the W.B., maybe with more information, I can convince him.