Your doctor's nurse is wrong. She doesn't understand that many low-level HSV-2 results are false positive, perhaps especially when someone has positive HSV--1 results. You can either have a Western blot test (expensive) or ask your doctor to repeat your test using the BiokitUSA test kit, which research has proved to be a good back-up sort out whether a low HSV-2 result is false or true. Statistically, only around 20-30 % of persons with HSV-2 HerpeSelect results around 1.6, like yours, actually have HSV-2.
As to what repeat test is in the works now, I cannot say. My guess is they are just repeating the HerpeSelect test. If it is definitely negative for HSV-2 (ELISA ratio under 0.9), you don't need further testing. If it's in the same range as before, have the Biokit or Western blot test. WB is only done by the University of Washington lab in Seattle, where the test was developed. Quest and/or your doctor's local lab will know how to refer a specimen to UW. But the BiokitUSA test is just as good in this situation, much cheaper, and probably covered by your medical insurance, which WB may not be (because it is not a commercial, FDA-approved test).
Having said all that, any guy who would forego a potentially promising, committed relationship because of fear of herpes most likely is someone who shouldn't be in a long term relationship anyway. Of course that's a judgment for you to make, not me -- but think about it. Herpes is an impersonal virus that usually causes trivial or no symptoms, definitely not something that should be permitted to have such an impact. Only immature persons would allow it to do so. (Of course you should present this issue to him diplomatically, if in fact this is a relationship you believe otherwise has promise.)
In terms of bringing your doctor and/or his nurse up to speed, you might refer them to this research report: http://www.ncbi.nlm.nih.gov/pubmed/16225691.
Bottom lines: Like half of all adults in the US, you are infected with HSV-1, probably an asymptomatic oral infection from childhood. Most likely you don't have HSV-2, but repeat testing -- either BiokitUSA or Western blot -- will sort it out.
I hope this helps. Best wishes-- HHH, MD
So, I have never been more frustrated! I just got off the phone about an hour ago with my doctor's nurse again. My results came back again as a 1.6 on the HerpeSelect test. When I asked what test they used, she didn't even know what I was talking about. I had to tell her to read the paper, was it the Herpeselect... to which she said it was. Then, I said that I wanted to retest again using a different test, either the BioKit USA test or the Western Blot. She had never heard of the BioKit and said the Western Blot was only for HIV. I told her that wasn't true and tried to explain to her how may research found that many of the low positive HerpeSelect tests were false positives. She only talked down to me and told me that I was in denial and that I needed to accept it. And that they just got back from some convention... but I interrupted her and told that I just wanted to retest. She only continued to talk down to me and said that it wasn't that bad and that I should be more concerned about my abnormal pap smear from this year. Also, she didn't know how to get such a test done, so I told her you just have to request it through the lab. She pretty much refused saying that nothing was going to change. So, I finally said that I'll find someone else that can give me the test, and she said that is what I needed to do.
So, then I looked up a gynecologist and spoke with someone there. Explained the situation. She said they only test a culture. I said I never had an outbreak and that I wanted a blood test. She asked isn't that what I just did? I said yes, but I wanted a different brand. She said they didn't have anything to do with that that it is the lab and gave me the lab number.
Finally, I spoke with someone who knew what I was talking about. She automatically knew about false positives. Told me I needed to find another doctor. Said she knew about the HSV-WB, but not the BioKit. She gave me the number for Quest to talk to someone there about the tests specifically.
So, I called Quest, and he gave me the test code for the HSV-WB and price. I am willing to pay $155 to just get this over with. He said all I need to do is find another doctor and get them to write a prerequisition for the test and take it to a Quest lab to get it done.
Since, people over the phone and doctor's nurses do not seem to know what I am talking about, how do I go about finding someone willing to do this? I do not want to go to my regular doctor anymore and need someone who can handle my care with my dysplasia history. Should I just make an appointment with a doctor for my 3 month pap smear and give them all this other information and request the testing during that appointment or should I continue to inquire when I am calling to find a new doctor?
You have been so helpful. Thank you!
Thanks for the thanks; happy to be of help. But with apology, I cannot solve the problem -- which is very common -- of medical professionals who don't understand HSV testing. It's not all their fault; the research knowledge is moving rapidly.
It seems to me the best approach is to see whichever provider seemed to know the most about the topic (I haven't tried to decipher the details of your long comment to figure out myself who that is). Or find someone entirely new, such as an infectious diseases specialist in your community.
Hey! Just wanted to share some great news! I got the results back today for the Western Blot- Negative for Type 2!! Thanks again for your input.