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Inconsistent Western Blot Results - Update and Questions
I asked a question in Feb and doc Hook hope I can update my findings. I have some questions too.
Firstly my doc asked the lab on the inconsistent WB results. Reply: When the blood was collected from a std clinic such as Harborview, they used double the testing agent. And that's when my serum showed a pos result. It appears UW lab only do this for a handful of places, and not for standard screening.
Secondly I had more tests done in Apr:
Apr 14. Planned Parenthood
WB: HSV1 Pos, HSV2 Indeterminate
Apr 14. Public Health Clinic at Harbourview
WB: HSV1 Pos, HSV2 Indeterminate
Apr 16. Westover Heights
WB (convalescent): HSV1 Pos, HSV2 Indeterminate
HerpeSelect Immunoblot: HSV1 Pos, HSV2 Neg
Apr 17. Los Angeles
Biokit: HSV2 Neg
So in these tests all the WB are indeterminate for type 2, including in Harborview, where double testing agent ought to have been used.
Summary:
1 Pos WB (double testing agent)
4 Indeterminate WB (inc. one using double testing agent)
2 Neg ELISA
1 Neg Immunoblot
1 Neg Biokit
I haven't been taking any anti-viral or any other medicine.
I know I may be over tested but I'm trying to find an answer. Here're my questions:
1. Could you give me an estimate on the likelihood of me having hsv2?
2. For my WB tests in Harborview in Jan and Apr, that's exactly same test, same clinic. Why does the 2nd was indeterminate while the 1st pos? Is it normal? Could it be lab error? I know it's unlikely but isn't my situation equally unlikely too?
3. In your practice, how many ppl are like me, not on anti-viral, having inconsistent WB and neg other tests, but have hsv2?
4. Is there a better way to know my status?
5. I am seeing a wonderful girl and I wish I could start a meaningful life long relationship with her. However, I am really worried about the possibility I may have hsv2 and pass it to her. Unable to get an answer has made us very upset. Where can I proceed from here?
Firstly my doc asked the lab on the inconsistent WB results. Reply: When the blood was collected from a std clinic such as Harborview, they used double the testing agent. And that's when my serum showed a pos result. It appears UW lab only do this for a handful of places, and not for standard screening.
Secondly I had more tests done in Apr:
Apr 14. Planned Parenthood
WB: HSV1 Pos, HSV2 Indeterminate
Apr 14. Public Health Clinic at Harbourview
WB: HSV1 Pos, HSV2 Indeterminate
Apr 16. Westover Heights
WB (convalescent): HSV1 Pos, HSV2 Indeterminate
HerpeSelect Immunoblot: HSV1 Pos, HSV2 Neg
Apr 17. Los Angeles
Biokit: HSV2 Neg
So in these tests all the WB are indeterminate for type 2, including in Harborview, where double testing agent ought to have been used.
Summary:
1 Pos WB (double testing agent)
4 Indeterminate WB (inc. one using double testing agent)
2 Neg ELISA
1 Neg Immunoblot
1 Neg Biokit
I haven't been taking any anti-viral or any other medicine.
I know I may be over tested but I'm trying to find an answer. Here're my questions:
1. Could you give me an estimate on the likelihood of me having hsv2?
2. For my WB tests in Harborview in Jan and Apr, that's exactly same test, same clinic. Why does the 2nd was indeterminate while the 1st pos? Is it normal? Could it be lab error? I know it's unlikely but isn't my situation equally unlikely too?
3. In your practice, how many ppl are like me, not on anti-viral, having inconsistent WB and neg other tests, but have hsv2?
4. Is there a better way to know my status?
5. I am seeing a wonderful girl and I wish I could start a meaningful life long relationship with her. However, I am really worried about the possibility I may have hsv2 and pass it to her. Unable to get an answer has made us very upset. Where can I proceed from here?
MEDICAL PROFESSIONAL
No, I'm afraid not. As far as anyone knows, the infection is no less active, and there is no less potential for transmission, because of variable or uncertain antibody levels.
Thank you for your prompt answer, doctor. Assuming that I have HSV 2, the indeterminate WB and neg other test results must mean that I have an antibody level too low to be detected with significance, right? Does that have any implication on the chance that I shed the virus and transmit to my partner?
MEDICAL PROFESSIONAL
Welcome back to the forum.
As Dr. Hook commented in February, this is a very complicated situation. I would urge you to arrange for personal care by a herpes expert and not continue to try to sort this out by distant expert opinion. The Harborview STD clinic can refer you to any number of genuine, world-class herpes experts -- either in the Viral Research Clinic, or the general infectious disease clinics.
At this point I cannot say for sure whether or not you are infected with HSV-2. All your WB tests were done in the same UW laboratory. Not only does that lab serve both the Westover Heights and Harborview STD clinics; that lab does 95% of all HSV WBs done in the United States. Since it was the same lab, it should be easy for a UW-based expert to arrange to have all the blots re-examined simultaneously by the senior lab tech and/or the lab director, and perhaps come to a definitive conclusion.
To your specific questions:
1) As just said, I really don't know. Probably 50:50. Sorry I can't be more helpful.
2) I can't speculate on particular reasons for the varied test reports.
3) I have rarely if ever seen patients like this.
4) As suggested above, simultaneous inspection of all your WB results would make sense.
5) The fear and risk of genital herpes should never be permitted to interfere with love, romance, rewarding sex, and commitment. Until this is sorted out, consistent condom use plus anti-HSV suppressive treatment (e.g., valacyclovir) would be highly protective. However, this is an additional aspect of your care that would best be managed in person by an expert.
Sorry I can't give the clear answers you seek, but I hope this information is helpful in getting you into proper care.
Best wishes-- HHH, MD
As Dr. Hook commented in February, this is a very complicated situation. I would urge you to arrange for personal care by a herpes expert and not continue to try to sort this out by distant expert opinion. The Harborview STD clinic can refer you to any number of genuine, world-class herpes experts -- either in the Viral Research Clinic, or the general infectious disease clinics.
At this point I cannot say for sure whether or not you are infected with HSV-2. All your WB tests were done in the same UW laboratory. Not only does that lab serve both the Westover Heights and Harborview STD clinics; that lab does 95% of all HSV WBs done in the United States. Since it was the same lab, it should be easy for a UW-based expert to arrange to have all the blots re-examined simultaneously by the senior lab tech and/or the lab director, and perhaps come to a definitive conclusion.
To your specific questions:
1) As just said, I really don't know. Probably 50:50. Sorry I can't be more helpful.
2) I can't speculate on particular reasons for the varied test reports.
3) I have rarely if ever seen patients like this.
4) As suggested above, simultaneous inspection of all your WB results would make sense.
5) The fear and risk of genital herpes should never be permitted to interfere with love, romance, rewarding sex, and commitment. Until this is sorted out, consistent condom use plus anti-HSV suppressive treatment (e.g., valacyclovir) would be highly protective. However, this is an additional aspect of your care that would best be managed in person by an expert.
Sorry I can't give the clear answers you seek, but I hope this information is helpful in getting you into proper care.
Best wishes-- HHH, MD
You are reading content posted in the STDs 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.
