Unsure of status, to late to get accurate results?

[Answers831]

Been married for 6 years. Two years ago I had a small red area near the top of my labia. Went to the dr he performed no tests because he said didn't look like herpes. Went back a week later because continued to hurt and took a swab and blood test. Test results: igg hsv 1 neg, igg hsv 2 neg,  igm hsv 1/2 positive. Dr didn't want to retest, still burning pain on left side only, for months.  Three different swabs all negative. Dr Insisted it was not herpes to just relax. Saw different dr when in pain and found lesions on my cervix. Swab and neg.  Had another blood test ran by my gp and wrong test, results were hsv igg 1/2 positive. Went back to the first gyn clinic with those results, but they were still unconvinced, since in a previous blood test I had years before was pos for hsv 1, but I have no idea what kind of test it was. Printout that said hsv1 pos, hsv 2 neg.  symptoms for a year sometimes constant pain. I have only seen two small bumps one that looked like a pimple and one that looked like an ingrown hair. The dr started me on lexapro and valtex upon my insistence. The pain eventually subsided. Stopped valtrex and continued lexapro until I got pregnant. Nine months no symptoms. Three weeks ago, burning in my bottom like an electrical shock and slight vag burning on left side, lasted two days.  Now 31 weeks preg, Had a retest at 30 weeks.Waiting for results. No one believes me that I am having these issues, because I haven't had a classic outbreak. They just keep sayng nerve pain.

1. If I do have genital herpes, did I get it from my husband?

2. At thirty weeks pregnant, is it too late in the pregnancy to get accurate results from igg test? Possible false neg
3. If this test comes back igg positive for 1 and negative for 2 is it safe to say I have hsv 1 in the genital region since I have never had a cold sore on my mouth?
4. Should i take the antivirals as a precaution, since i don't know where in my body I have hsv 1?
I am losing it!!!! Please help

[Answers831]

I would still like your thoughts about the pain problems. I mean does herpes even reactivate that much? I mean I have sciatic pain and then two days later I have the vaginal pain on the left side. I never see lesions when this happens. Just found a tiny bump after the resent episode and freaked cause it was so close to delivery. I mean almos every 4-6 days the pains cycle starts again. I just would like to know what the heck the problem is. I have seen three different drs before the delivery and none of them believed it could be herpes. It is just frustrating not knowing. I was so scared to have the baby. She is here now and there's nothing I can do to change the situation. From what I know the tests are pretty accurate for hsv2, but not so much for hsv1. Could hsv 1 cause this many reoccurances I'm the genital region or should I just believe my drs that it is a nerve issue and move on? I know tons of questions. I just hate that noone can give me an answer. So as much info as you can give me will be helpful. Thanks.

[Answers831]

I dont know why I keep trying to post and it is not working. Dr wasn't concerned over bump and stated it looked like normal skin changes but gave me the medicine to make me feel better emotionally. Well I had the baby 36 hours later. I wasnt having pain at the time and they checked for anything abnormal before the delivery. The baby is beautiful. I hope she is ok and it's just me being paranoid and over worrying everything. I will keep you updated.

[Terri Warren, RN, Adult Nurse Practitioner]

I would have urged you to go to an urgent care center to have the bump swabbed before monday, but it is now tuesday, so I will wait to here what was done and what your doctor thought.'

terri

[Answers831]

Well about eight days to go. I am having horrible pain and a bump. I plan to see the dr. First thing mon. They won't let me take the meds, cause I have never had a positive test except for hsv 1 10 years ago and now it's neg. I just want cry. I have been having symptoms about every five days, For the last five weeks. Havent had any bumps till now. I know the test misses hsv1 sometimes, does hsv 1 reactivate this much in the genital region? Or could I have hsv2 and the test Is missing it. I know Monday will probably be too late to swab. I am at my wits end I have seen to different doctors who just act like this is not really a big deal and both don't think my usual symptoms sound viral, but now the bump! This is supposed to be a happy time and all i can do is cry. Any thoughts about what's going on.

[Terri Warren, RN, Adult Nurse Practitioner]

You are most welcome.  Can you post for us when your baby is born so we know everything goes well?

Terri

[Answers831]

I agree with taking the meds, 1. To protect the baby 2. To ease the pain that comes and goes, if it is herpes. It makes this so much worse, because if there were no pain I probably wouldn't worry about it. The vaginal pain continues to show up every couple of weeks, but luckily it only last about 2 days. I makes my anxiety shoot through the roof and then I have a couple of days not sleeping and so upset. I hate that I don't know what this is. I wish someone could come up with an explanation. That's the worst part. Herpes doesn't really scare me because it's manageable. Its the fact that no one can give me a diagnosis. The couple of doctors I have seen just do not feel that is whats going on due to the absence of lesions and the newest negative blood tests, but still I have to suffer the pain. Frustrating! Thank you for your time. I really have enjoyed most of this pregnancy until the pain return. I just want to keep sane until she arrives. Thanks for your help!

[Terri Warren, RN, Adult Nurse Practitioner]

So how about if you just take the antivirals and stop worrying?  The antiviral medicines do not get activated unless there is herpes virus present.  If there is no virus, the medicines get excreted from your body, unchanged from when they went in.  I think it is a win win for you.  

Try not to get all wrapped up in whitlow now.  Try to focus on your little baby and how much joy you will have and how very unlikely it will be for you to infect them.  

This is in your control.  Take charge of your thoughts and let the medicine help you settle down about this so you can enjoy this last part of your pregnancy more.

Terri

[Answers831]

My main concern is if I could possibly have a false negative for hsv 1 and 2. I saw my doctor and she seems still very unconcerned. She Says she feels that if it were a viral infection of either type, I would have some symptoms besides just pain. She says she truly feels it is a nerve issue more than anything else, but could not explain why tests have been a little wired for hsv 1.  I have two more weeks before they will put me on the antivirals. She told me to think about it and decide if I want to take them as an extra precaution. She feels it unnecessary, but will prescribe if it eases my mind. I am so confused and the stress can't be helpful for the baby. I have also had some pain in my hands and have gotten a few small bumps that do not open and go away after couple of weeks, but my mind is freaking me out and I am now worrying about whitlow! Would like to eventually get the western blot, but really if it does show positive for hsv 1. That still doesn't really help because I wont know where the infection is. I have nothing to swab, except for the pin head bumps on my hands maybe. But no lesions or bumps in vaginal area. Any extra advice would be helpful. I am not sleeping do to the worry.

[Terri Warren, RN, Adult Nurse Practitioner]

So your concern is to make sure your husband doesn't have HSV 2, is that correct?

Terri

[Answers831]

I will get ask her about further testing, I have always just assumed I had hsv 1 since my very first test years ago, I just assumed it was orally. Since now i have had symptoms in my genital area its hard to say now. I don't think I have ever had a cold sore near my mouth, but my mother and sister get them so never really thought about it. This is my second child and I assume If I had hsv 1 genitallly I had it then. I delivered her naturally with no issues. I just want to lower my risk if possible. After a long and not so nice discussion with my husband he finally agrees to taking the meds to be on the safe side. Thanks for your help. This is a trying subject in my household!! I was glad I had something for my husband to read. Thanks again.

[Terri Warren, RN, Adult Nurse Practitioner]

I would try to get the western blot through Quest labs. It takes two weeks to come back.  You can ask your doctor to do that.  If your doctor says no, we can order it through the clinic for you.  But you must remember that if you are HSV 1 positive, and you've never had a cold sore on your lip (not in your mouth), that you can't know for certain where your infection is.  Only that you have it.  So it could be oral or genital, but without your worrisome symptoms, I can see why the possibility of genital herpes is difficult.

Terri

[Answers831]

Thank you for responding, I don't know if I can get the WB completed, as I only have about fifty days left. I see my doctor next week and will discuss it with her then. I want to take the meds to be on the safe side, but may have to beg. My husband is not concerned and he wants me to leave it alone. I have issues with anxiety and he thinks I am overreacting, but he doesn't understand that I have had weird symptoms. He thinks neg is neg and because he hasn't had symptoms ever that I do not have anything wrong. This has really affected my whole life and has for awhile. I wish it would come to an end and I could let it go.

[Terri Warren, RN, Adult Nurse Practitioner]

I can see why you are concerned, of course!  There is a lot at stake here.  You've had very mixed results with the testing, and your HSV 1, though negative, is a high negative.  You could get a herpes western blot, but that takes time, and I'm not sure you can get it done before delivery.  You could definitely try.  I know your doctor says to relax and not worry about it, but clearly, you are still worrying.  Do you feel that you could request western blot testing to clarify the HSV 1 situation and he/she would do it?  It can be sent through Quest labs or you can have UW send you a kit directly that your doctor would use to draw blood and send back to UW.  

You are having some symptoms, and you just want clarity, that is totally understandable, especially given the mixed test results you have had in the past.  This ELISA test misses 1 out 10 HSV 1 positives.

If you were my patient, this is what I would want:  a western blot for clarity.  I would also probably start you on suppression because of your mixed results in the past and because you are scared and because the HSV 1 ELISA test that you had done is not known for great sensitivity and because you are having symptoms that are concerning.  My feeling is that because the herpes drugs are safe and effective, it would  be better to err on the side of caution.  Having said that, this is a decision that you and your doctor must make together.  I just know a little more about this particular test than most providers, and so I see the results with a bit more caution.  

I don't know what your husband's HSV 1 status is so I don't know if you could have gotten this (if you have it) from him.

Continue to work your doctor to try to clear up this question.  I'm not very comfortable taking a position that might be different than your doctor's, and I'm not advising you to do something different that what they suggest, I'm just giving you my opinion, since you asked.

Terri

[Answers831]

Ms. Warren can you please respond. I am so worried that it's a false negative. I just need a different opinion. Pregnancy is hard enough, I just want to eliminate this worry. I want to move on, but my symptoms have me scared. I have dealt with the symptoms and the emotional aspects for myself, but don't want to harm our baby. Please respond, thank you so much for your time.

[sashaxasha]

Congrats your negative ...Now you can relax :-)

[Answers831]

Ok So the results came back igm neg
Igg hsv 1 neg .76
Igg hsv 2 neg .07
So do you think I can rest easy that I do not have genital herpes?
My doctor says leave it alone, but I am a little crazy when it comes to this situation because the pain was and is real!