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What do negative swab test results really mean?

Hi,

I'm confused by my recent negative swab test results. I got a pimple or lesion swabbed for hsv and it came back negative. My urethra and cervix were also swabbed, and also came back negative.

How accurate are these tests? I've heard there are a lot of false negatives. I have read that the virus usually sheds in the cervix, even if there are no lesions, is this true?

I got my IgM and IgG test already, and the IgM came back positive. I recently got the IgG test again, and am waiting on those results.
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Avatar universal
I just found out 6 months ago I tested herpes simplex detected . I found out today but other then that one cold sore I've had no symptoms since my doc says not to worry since nothing has happened since but I'm worried I got a smear test again today but I don't know what to think
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101028 tn?1419603004
I'd be going to be seen every single time you have symptoms for further exam. no reason to continue with herpes blood testing over and over again.
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Avatar universal
Hi,

So i didn't know if i should create another post. But basically i've waited 3 months already since posting this thread and i still don't know if i have herpes. I got an IgM test done abut 6 months ago. It came back borderline (1.10). although my stupid doctor told me it was positive. The igG came back negative. Then I waited 3 more months, and tested again. I got the same results, the problem was that i had been taking antivirals and didn't know that could affect the accuracy of the tests. Then I waited 3 more months, and got negative IgG results AGAIN. The problem is that my symptoms continue. Pain and discomfort, burning and itching in my vagina and butt area.

So at this point i'm not 100% convinced it's not herpes. Terri said that I could retest in another month (that would make it 4 months without antivirals) with the Western Blot. But I was wondering if it would make more sense to wait an additional 3 months (that would make it 6 months without being on the medication) and then retest with the ELISA. I read that by that time most people seroconvert. Am I correct? I'm just worried that getting the Western Blot might be hard because not all doctors carry it, and also because it's more expensive...

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101028 tn?1419603004
not non-stop pain like this.

you have an escalation of symptoms and are off antivirals so another swab might give you better answers.  

there are medications for neuralgia you can try - no reason to just suffer through things. they should provide pain relief without affecting your future testing.

also feel free to pay to post to Terri Warren, our herpes expert here on medhelp too for her opinion.
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Avatar universal
I already got the PCR swab testing done in my cervix, and that was negative. But I was taking the valtrex back then too, so the results could have been compromised.

It seems the only solution is just to deal with the escalating pain for 3 months and get retestes if i want to know 100%

Have you heard of pain occuring how i described as a result of herpes (groin but also lower leg and foot?) I've read others describe this pain before as as symptom of herpes. I just wonder how common it is, especially without a noticeable outbreak. I am really starting to hate this virus.
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101028 tn?1419603004
you can go to the clinic and ask for a pcr swab of your cervix. if herpes is active, you would be shedding from there.  

you need some sort of positive testing at this point.  ask your provider about trying something else for pain in the meantime.
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Avatar universal
Hi,

I have another set of questions. As you can see above, i've recently tested negative on my second set of IgG tests. I decided to go off of the valtrex for the next 3 months and then retake the test to make sure it's accurate, since I've heard the valtrex can impact the accuracy of the results...

So basically now it's been about 5 days since I've been off of the Valtrex completely. While I was on the Valtrex, the pain was there but basically numbed or gone at times. No, i'm always in pain and the pain has travelled to my thighs and lower legs. Does't this basically prove I have herpes?! This is how it was too when i first started suspecting herpes about 3 months ago, before I went on anything, and those are the symptoms that brought me into the gyno.

I am so desperate, and i don't know what to do anymore. I don't know if I should just accept I have herpes. I just feel like I need to see a positive IgG test result, but I also feel like the change in pain makes me feel like  I should just accept it, and move on. I don't know if i can wait 3 months like this, especially knowing that if i take the valtrex the pain does seem to calm.

What should I do? I feel so stuck.
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Avatar universal
thanks so much
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101028 tn?1419603004
the CDC's current recommendations are that herpes igm testing not be used on adults for the purpose of diagnosing herpes.  If the CDC says no, then it's not something providers should be routinely doing.

you shouldn't be taking any valtrex at this point as I already suggested.   You've had consistently negative testing and being on valtrex supprsesively can affect your final testing as well as sometimes valtrex can cause neuralgia in some folks.

reread my post from 6/19 as to what to do next :)

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Avatar universal
Ok. Thanks for all your answers. I have another question, and I hope you can answer it. I'm sorry I keep asking, it's just that most doctors I go to don't seem to have any answers, and what I read online doesn't match what they tell me....

So I recently got my IgM and IgG test done after 3 months after the suspected exposure. I had gotten another IgM and IgG test about 2 weeks after the suspected exposure and those tests came back negative, but positive for IgM.

My current results after 3 months all came back negative for IgG but still positive for IgM. So i'm still basically very confused about my status. Here are some of my questions regarding my results:

1) I know you and others including some experts say that the IgM is worthless, but i can't help but feel that there's some truth to the test,especially because i tested positive for it twice. I didn't see any numerical values, it just said "detected". Is it possible that I just haven't seroconverted to the IgG?

2) I've ben taking a pretty high dosage of Valtrex for about 2 months now, 2 Grams a day. I read somewhere that that could also be interfering with a positive IgG test, and that that maybe be why the blood test isn't picking up the herpes. Is this true?

3) What should I do next? Should I wait 3 more months, not take Valtrex and get the IgG test? or should i consider getting the Western Blot?

I'm still worried it is herpes because as I mentioned earlier, I'm in constant pain. The valtrex seems to help a bit, but the pain is still a bit there...

Thanks so much


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101028 tn?1419603004
it's not a common cause of vulvodynia. herpes has clear periods of absolutely no symptoms at all, it won't cause constant pain like this.
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Avatar universal
Thanks!

But have you heard of a lot of cases in which herpes causes the vulvodynia? i guess i'm just trying to figure out how common it is. Sounds like there aren't any studies on this yet...
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101028 tn?1419603004
yes your post from april is what I was referring to. at this point, just follow up in this one from this point forward - thanks!

I'd stop the valtrex and this point. if you get any obvious symptoms or your pain worsens, be seen within 48 hours for a repeat lesion culture and typing. otherwise follow up with your type specific herpes igg blood testing in another month or two and go from there.

vulvodynia is a fancy word for pain in the genitals. Many things can cause it, not just herpes. most folks who contract genital herpes, do not get ongoing chronic pain from it. in the few studies we do have on folks who do, the pain goes away while on daily suppressive therapy.
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Avatar universal
Which original post? I posted something about 2 months ago, is that what you mean?

I actually have another question then:

Since i've been in pain for 2 months, and on a pretty high dosage of valtrex, my doctor said that this may not be herpes. She actually said that i might have Vulvodynia, which is chronic pain of the vulva. She claims that it can be caused by herpes.

what do you think? have you heard of this link?

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101028 tn?1419603004
it's most helpful when you just keep adding to your original post instead of making new ones - thanks!

there are false negative issues with lesion cultures which is why we always recommend follow up igg blood testing at the appropriate times.

grace
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