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Testing next steps
I'm struggling with HSV test results and knowing what to do next. I am middle aged woman, 1 partner for 25 years. Known to be HSV 1 and 2 negative. 1 new partner recently of unknown status with no condom. After this, I had a full STD panel done, negative for everything.
Igg HSV 1 and 2 (separately) < .9 at 7 weeks
Igg HSV 2 only <.9 at 13 weeks
Igg HSV 1 and 2 (separately) <.9 at 20 weeks
Igm positive at 20 weeks with 1:20 titer
I'm have some doubts about the results. I've had 2 separate sets of bumps on the interior of one butt cheek and now a 3rd on the other cheek. The 1st papule was a single spot that healed in 2 weeks. This was about 8 weeks post exposure. I had another set of 3 small spots almost 20 weeks, along with a bad cold, no fever. These were tiny, the size of a single pencil point and dry, until they itched a bit on day 3, got weepy looking in the center, but never looked like blisters or popped and were gone in 4 weeks. I went to PPH for an exam & test. The Dr was doubtful they were HSV 2. No "crater like appearance" and too late to culture. 3rd papule on the other butt cheek. Just a bump, never looked like a blister, but itched for an hour or so on day 2 or 3. It's shrinking and going away after a week.
So, I know my Igg tests say negative, but the Igm has me worried. And in conjunction with papules, I'm very worried. What's your opinion? I'm healthy, though quite stressed and anxious about this. There are a million possible explanations for the spots - from staph to irritation from sweat and panties to anxiety. Should I test again? Western Blot? PPH can't order that or do a PCR culture.
Does HSV 2 always appear in the same area unilaterally? I've now had spots on both sides at separate times.
If it was HSV 2, would the first spot have been sooner than a month after exposure? I'm trying to make sense of all of this and put my mind to rest. I'm thinking about another blood test, but not sure it'll tell me anything new.
Igg HSV 1 and 2 (separately) < .9 at 7 weeks
Igg HSV 2 only <.9 at 13 weeks
Igg HSV 1 and 2 (separately) <.9 at 20 weeks
Igm positive at 20 weeks with 1:20 titer
I'm have some doubts about the results. I've had 2 separate sets of bumps on the interior of one butt cheek and now a 3rd on the other cheek. The 1st papule was a single spot that healed in 2 weeks. This was about 8 weeks post exposure. I had another set of 3 small spots almost 20 weeks, along with a bad cold, no fever. These were tiny, the size of a single pencil point and dry, until they itched a bit on day 3, got weepy looking in the center, but never looked like blisters or popped and were gone in 4 weeks. I went to PPH for an exam & test. The Dr was doubtful they were HSV 2. No "crater like appearance" and too late to culture. 3rd papule on the other butt cheek. Just a bump, never looked like a blister, but itched for an hour or so on day 2 or 3. It's shrinking and going away after a week.
So, I know my Igg tests say negative, but the Igm has me worried. And in conjunction with papules, I'm very worried. What's your opinion? I'm healthy, though quite stressed and anxious about this. There are a million possible explanations for the spots - from staph to irritation from sweat and panties to anxiety. Should I test again? Western Blot? PPH can't order that or do a PCR culture.
Does HSV 2 always appear in the same area unilaterally? I've now had spots on both sides at separate times.
If it was HSV 2, would the first spot have been sooner than a month after exposure? I'm trying to make sense of all of this and put my mind to rest. I'm thinking about another blood test, but not sure it'll tell me anything new.
MEDICAL PROFESSIONAL
quest sends all their western blot tests to the University of washington.
I'm not aware of any way for you to order the test directly from the University of washington, but again, you can arrange this through my office if you wish.
terri
I'm not aware of any way for you to order the test directly from the University of washington, but again, you can arrange this through my office if you wish.
terri
I don't have a regular provider right now - no insurance currently, thus the visit to Planned Parenthood and the online testing sites.
I live in northern California. Any way for me to directly arrange the WB through Quest and pay cash? And is the Quest WB as good as the one ordered dirctly with the Univ of Washington?
I think the WB results would end this for me .... research on folliculitis and lots of other skin issues don't quite match, especially b/c the flat red spots keep popping up about ever 3-4 weeks and take about a week to go away on their own or with antibiotic ointment and/or antifungal creams. Ugg. I just need this to be over.
I live in northern California. Any way for me to directly arrange the WB through Quest and pay cash? And is the Quest WB as good as the one ordered dirctly with the Univ of Washington?
I think the WB results would end this for me .... research on folliculitis and lots of other skin issues don't quite match, especially b/c the flat red spots keep popping up about ever 3-4 weeks and take about a week to go away on their own or with antibiotic ointment and/or antifungal creams. Ugg. I just need this to be over.
MEDICAL PROFESSIONAL
Its difficult to get sometimes. You could also ask your regular health care provider, if you have one. what state do you live in?
terri
terri
That would be great. PPH is Planned Parenthood. I asked them about the ordering through Quest with 34534 and they said they can't. Also called to 2 online test services I've seen on this board, and they also do not. I'll call your office.
MEDICAL PROFESSIONAL
If you want to call our office, we can arrange a phone consult and a western blot. what is PPH again?
terri
terri
Any ideas about how to get a WB? PPH doesn't offer it, and I don't currently have insurance, so not seeing a regular provider. Do any of the online testing services offer the WB? PPH also doesn't offer a PCR swab, so the negative culture is also suspect.
Sigh. Darn IgM.
I suspect you're right - I just need to get there in my head.
Sigh. Darn IgM.
I suspect you're right - I just need to get there in my head.
MEDICAL PROFESSIONAL
and thats why we ask that providers NEVER do this test, because it gets into people's heads and make them nuts.
I do think that the Igg test would have picked up infection by now, yes. If you still have worries, you can have a western blot test done or have one of these bumps swab tested with PCR when you get it for extra reassurance. Perhaps it will take a couple more negative tests before you can offset the damage done by the IgM test
terri
I do think that the Igg test would have picked up infection by now, yes. If you still have worries, you can have a western blot test done or have one of these bumps swab tested with PCR when you get it for extra reassurance. Perhaps it will take a couple more negative tests before you can offset the damage done by the IgM test
terri
Hi Terri. One last question/plea for reassurance. I am still getting these little red dry bumps appearing about every 3 weeks and I just can't seem to let it go ... I need to be sure it's not Herpes. The Dr doesn't know what it is. Your reassurance and experience really helps.
So, if I have in fact been having outbreaks, would the IGG test definitely be positive? Meaning, if the bumps in May and June were Herpes, wouldn't the 20 week IGG have been positive? Is it possible to have had an outbreak and not test positive on IGG a few weeks later? If I'm having regular outbreaks every 3 weeks, wouldn't an IGG test be positive now (exposure in January)
I'm trying to be rational - looking at the statistics and numbers of even catching it, and the chances of being the 1 in however many who never tests positive, and I know that statistically, I should in fact be negative. But I can't seem to let it go when I keep getting these little pinhead size red spots on the inside of my butt cheeks (and this time at the base of my spine) pretty regularly at 3 week intervals. I can't find another logical explanation for them, and I've never noticed anything like them before exposure - not that I was looking.
I did also do more research on the IGM titers, and 1:20 is at the low end of positive, or possibly equivocal. But it's that darn test that is nagging at me and keeping me in a constant state of doubt, and from being able to move on.
Thanks for your thoughts.
So, if I have in fact been having outbreaks, would the IGG test definitely be positive? Meaning, if the bumps in May and June were Herpes, wouldn't the 20 week IGG have been positive? Is it possible to have had an outbreak and not test positive on IGG a few weeks later? If I'm having regular outbreaks every 3 weeks, wouldn't an IGG test be positive now (exposure in January)
I'm trying to be rational - looking at the statistics and numbers of even catching it, and the chances of being the 1 in however many who never tests positive, and I know that statistically, I should in fact be negative. But I can't seem to let it go when I keep getting these little pinhead size red spots on the inside of my butt cheeks (and this time at the base of my spine) pretty regularly at 3 week intervals. I can't find another logical explanation for them, and I've never noticed anything like them before exposure - not that I was looking.
I did also do more research on the IGM titers, and 1:20 is at the low end of positive, or possibly equivocal. But it's that darn test that is nagging at me and keeping me in a constant state of doubt, and from being able to move on.
Thanks for your thoughts.
MEDICAL PROFESSIONAL
because we never use IgM testing, I'm just not familiar with the titer system that is used, sorry. it is about dilutions, but that's all i know about it. can't tell you if that is high or not.
herpes can show up in various places in the genital area, doesn't always have to be the same area.
Most herpes lesions have fluid in them, but can I say every time? No.
I personally don't think another test is necessary, but if it gives you peace of mind, it is priceless.
terri
herpes can show up in various places in the genital area, doesn't always have to be the same area.
Most herpes lesions have fluid in them, but can I say every time? No.
I personally don't think another test is necessary, but if it gives you peace of mind, it is priceless.
terri
One other question:
Is the IGM 1:20 titer considered a low positive? I did not understand this result and PPH was not able to explain it to me. they said something about diluting the sample to get it to negative, but 1:20 seemed high to me. I just didn't understand it, and though I know I should ignore it, I'm curious about understanding it.
Is the IGM 1:20 titer considered a low positive? I did not understand this result and PPH was not able to explain it to me. they said something about diluting the sample to get it to negative, but 1:20 seemed high to me. I just didn't understand it, and though I know I should ignore it, I'm curious about understanding it.
Thank you Terri - that's exactly the feedback I got at PPH and from Grace on the Community Forum, even though PPH mistakenly ordered the IGM. But they did warn me that it could be showing something that might not show up on the IGG for up to a year and may never show. That really got me worked up. I'm thinking it's time to just let it go and move one, assuming I am negative. But I have a nagging suspicion when these bumps show up and I have a tremendous fear of passing this on to my long-term partner. I'd like to just chock it up to a bad mistake and be done. Can you just answer a few more questions about the lesions?
1. Do lesions always appear in the same area for a person? Meaning, if on the butt, always on the butt, or do subsequent outbreaks happen anywhere, such as moving to the vagina? I thought I read somewhere that they will always be in the same area and unilateral. So I'm thinking that the 3rd lesion appeared on the other butt cheek from the first 2, so maybe not herpes?
2. Are the herpes lesions always filled with fluid? Can I assume that a dry bump that looks like a bug bite and never bursts or doesn't show any fluid is not herpes? My concern comes from the day that the 2nd set and the 3rd one itched and maybe got little wet looking in the center, but was still just a bug bite-like bump. I was using antibiotic ointment on it in case it was staph or similar, at the recommendation of the PPH Dr.
3. I'm thinking of another blood test at 8 months, especially if there are any more lesions, just to put it all to rest. I can't seem to catch them in time for a culture and PPH doesn't do PCR, so I'm not confident I'd get a good result anyway. I just want to be sure, but I fear I may be the rare case that doesn't seroconvert for months. Likely or not? If there had been an outbreak at 6-8 weeks, wouldn't the 13 week and 20 week IGG test have been positive? Or is it possible to have an outbreak and not seroconvert for many more months.
Thanks Terri for answering these questions. Your feedback and thoughts will really help put my mind at ease and let me move on with my life.
1. Do lesions always appear in the same area for a person? Meaning, if on the butt, always on the butt, or do subsequent outbreaks happen anywhere, such as moving to the vagina? I thought I read somewhere that they will always be in the same area and unilateral. So I'm thinking that the 3rd lesion appeared on the other butt cheek from the first 2, so maybe not herpes?
2. Are the herpes lesions always filled with fluid? Can I assume that a dry bump that looks like a bug bite and never bursts or doesn't show any fluid is not herpes? My concern comes from the day that the 2nd set and the 3rd one itched and maybe got little wet looking in the center, but was still just a bug bite-like bump. I was using antibiotic ointment on it in case it was staph or similar, at the recommendation of the PPH Dr.
3. I'm thinking of another blood test at 8 months, especially if there are any more lesions, just to put it all to rest. I can't seem to catch them in time for a culture and PPH doesn't do PCR, so I'm not confident I'd get a good result anyway. I just want to be sure, but I fear I may be the rare case that doesn't seroconvert for months. Likely or not? If there had been an outbreak at 6-8 weeks, wouldn't the 13 week and 20 week IGG test have been positive? Or is it possible to have an outbreak and not seroconvert for many more months.
Thanks Terri for answering these questions. Your feedback and thoughts will really help put my mind at ease and let me move on with my life.
MEDICAL PROFESSIONAL
the IgM has a terrible reputation for false positives, especially in the low positive range. I would advise that you completely ignore this result, and shame on whoever ordered it. The IgM test is NEVER recommended for the diagnosis of herpes because of its high false positive rate. You lesions don't sound at all herpetic to me. Most everyone I examine has bumps on their bottom, they are just so common. I would not advise any further testing for you at all. Twenty weeks is plenty of time to wait before being tested, so you did it just right, good for you!
Terri
Terri
You are reading content posted in the Herpes Forum
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.
