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Desperately need help understanding HSV results!!
Hi Dr.,
I will try to make my story as short as possible but here is a brief history about me. I have performed unprotected sex on four men, 2 of which never engaged in vagina-penile intercourse, and two did and I do not really know of their sexual history. The last guy performed unprotected oral sex on me and also fingered me and twice that he did, I got a yeast and bacterial vaginosis infection and got both a lot for the next few months. This was back in 2004. I went to get tested twice at my gynecologist and was negative for two years. I do not have the first test result but as of may 2007 my HSV I and II were <.91
I have been in a monogamous relationship for 3 and a half years now and trust my partner very much. He has tested negative for both HSV I and II in June of 2008 and was a virgin prior.
Confusing part begins:
5/23/2008: I went to the same gynecologist that I tested negative for and had a result of
HSV 1 - <.91 and HSV II- 1.13 specific IgG
Under Miscellaneous test: IgM for HSV1 and 2 combo was <0.91 I've read enough to know that IgM should be disregarded but I thought I would put it on anyway.
I went back and got a retest at the same lab on 6/6/2008 for HSV II and the result was under miscellaneous:
0.96 specific Ab IgG ( what does Ab mean?)
The third test was performed at LabCorp on 6/18/2008 results are:
HSV I -specific Ab, IgG - <0.91
HSV II -specific Ab, IgG- < 0.91
Fourth test: Labcorp on 8/7/08
HSV I- specific Ab, IgG- <0.91
HSV II- specific Ab, IgG- <0.91
And finally on my fifth test was done at Quest laboratory on I believe 9/2/08 and only a HSV II was done:
results were HSV II- specific IgG = 0.08
I've never experienced outbreaks but I did have frequent yeast and bv infections after the last encounter with that random guy twice or maybe three times back in 2004. The only thing I've done differently is I went to a new person for brazilian wax. She touches the phone while she waxes.
Thank you!
I will try to make my story as short as possible but here is a brief history about me. I have performed unprotected sex on four men, 2 of which never engaged in vagina-penile intercourse, and two did and I do not really know of their sexual history. The last guy performed unprotected oral sex on me and also fingered me and twice that he did, I got a yeast and bacterial vaginosis infection and got both a lot for the next few months. This was back in 2004. I went to get tested twice at my gynecologist and was negative for two years. I do not have the first test result but as of may 2007 my HSV I and II were <.91
I have been in a monogamous relationship for 3 and a half years now and trust my partner very much. He has tested negative for both HSV I and II in June of 2008 and was a virgin prior.
Confusing part begins:
5/23/2008: I went to the same gynecologist that I tested negative for and had a result of
HSV 1 - <.91 and HSV II- 1.13 specific IgG
Under Miscellaneous test: IgM for HSV1 and 2 combo was <0.91 I've read enough to know that IgM should be disregarded but I thought I would put it on anyway.
I went back and got a retest at the same lab on 6/6/2008 for HSV II and the result was under miscellaneous:
0.96 specific Ab IgG ( what does Ab mean?)
The third test was performed at LabCorp on 6/18/2008 results are:
HSV I -specific Ab, IgG - <0.91
HSV II -specific Ab, IgG- < 0.91
Fourth test: Labcorp on 8/7/08
HSV I- specific Ab, IgG- <0.91
HSV II- specific Ab, IgG- <0.91
And finally on my fifth test was done at Quest laboratory on I believe 9/2/08 and only a HSV II was done:
results were HSV II- specific IgG = 0.08
I've never experienced outbreaks but I did have frequent yeast and bv infections after the last encounter with that random guy twice or maybe three times back in 2004. The only thing I've done differently is I went to a new person for brazilian wax. She touches the phone while she waxes.
Thank you!
MEDICAL PROFESSIONAL
Also, I suggest you never be tested for HSV again, except if 1) you have sex with a partner known for sure to have HSV-2 (and even then testing probably isn't necessary unless/until you have a regular, ongoing relationship with such a person); or 2) if you develop symptoms that suggest genital herpes. The HSV antibody tests are not designed for people at low risk for herpes, which is one reason you got into trouble with that low false positive initial result. (In other words, your first test should not even have been done -- and look where it got you!)
MEDICAL PROFESSIONAL
Your first HSV-2 result was technically in the borderline positve range, which includes ELISA values of 1.1 and higher. The one value of 0.96 was in the "indeterminate" zone. All the rest of your results were completely negative. You can be 100% confident you are not infected with HSV-1 or HSV-2 and don't need any further testing.
Ab is just an abbreviation for antibody, which is what the test measures (antibody to HSV).
I hope this helps. Best wishes-- HHH, MD
Ab is just an abbreviation for antibody, which is what the test measures (antibody to HSV).
I hope this helps. Best wishes-- HHH, MD
MEDICAL PROFESSIONAL
For that matter, you could replicate this entire thread for your doctor. I stand behind the scientific evidence of all I have said. If he still has questions, invite him to contact me by email (my address is pretty easy to find on the directory at www.washington.edu) and I can provide him with references to the medical literature on HSV antibody testing.
MEDICAL PROFESSIONAL
MedHelp asks its moderators to try to avoid overtly disagreeing with questioners' own doctors. But your doctor's statement about the "fairest interpretation" of the results is mistaken. Like many providers, he apparently does not understand the nuances of this test and seemingly does not understand some of the details of genital herpes. For example, there is no such thing as an HSV blood test showing "exposure" without infection. And infected people do not go back and forth between positive and negative results. However, he is correct about the possibility of minor variations from one lab to another in how a test comes out.
If you want to diplomatically correct your doctor, you might refer him to the thread I referred you to yesterday: http://www.medhelp.org/posts/show/593272. Or copy and print it out for him.
If you want to diplomatically correct your doctor, you might refer him to the thread I referred you to yesterday: http://www.medhelp.org/posts/show/593272. Or copy and print it out for him.
MEDICAL PROFESSIONAL
The biological reasons for low-level false positive HSV-2 results are not known. Some cases are related somehow to HSV-1; that is, false positive HSV-2 results seem to be more common in people whose HSV-1 test results also are positive. But this doesn't apply in your case.
The reason testing isn't recommended in persons at very low risk is to avoid exactly the sort of confusion/uncertainty you have been experiencing the past few months. The analytic concept is somewhat complex, but it relates to a calculation called "positive predictive value" of a test. The lower the likelihood a person has disease X (whether herpes or anything esle), the more likely a positive test result for X will be false. This is a minor problem for some diseases and their diagnostic tests, such as HIV and other STD tests. But it's a problem with many others, including HSV-2 testing.
The reasons beyond all this have been discussed in some detail in this forum. Scan some other threads. Here is a good one to start with: http://www.medhelp.org/posts/show/593272.
The reason testing isn't recommended in persons at very low risk is to avoid exactly the sort of confusion/uncertainty you have been experiencing the past few months. The analytic concept is somewhat complex, but it relates to a calculation called "positive predictive value" of a test. The lower the likelihood a person has disease X (whether herpes or anything esle), the more likely a positive test result for X will be false. This is a minor problem for some diseases and their diagnostic tests, such as HIV and other STD tests. But it's a problem with many others, including HSV-2 testing.
The reasons beyond all this have been discussed in some detail in this forum. Scan some other threads. Here is a good one to start with: http://www.medhelp.org/posts/show/593272.
Sorry for the constant need for reassurance. Thank you doctor. I will not ask anymore questions!
MEDICAL PROFESSIONAL
How many times and in how many ways can it be said?? YES!
That will have to end this thread.
That will have to end this thread.
thank you dr ! You have been so helpful . I can go on being positive that I am hsv1 &2 free?
Sorry one last thing. I emailed my doctor prior to asking my question to you about my lab results and his answer was
To address your labs and concerns over them, I think the fairest interpretation of those results is that variations will arise from lab to lab. Most of your results were negative with one being equivocal and one being positive. It is likely that you were exposed in the past, although you may not show anything currently, in which case no further treatment is needed. If you wish we can continue to check the titers, but I would recommend sticking with one lab only for a more reliable reference.
And to clarify he said that one of the lab said I'm positive so he thinks I am but is not showing symptoms right now? Or it possibly could be lab error. Should I just ignore him? Your explanation sounds most plausible to me but I wanted your opinion.
Thank you,
So sorry for bothering you again. I also have OCD so I can't help but obsess over this.
To address your labs and concerns over them, I think the fairest interpretation of those results is that variations will arise from lab to lab. Most of your results were negative with one being equivocal and one being positive. It is likely that you were exposed in the past, although you may not show anything currently, in which case no further treatment is needed. If you wish we can continue to check the titers, but I would recommend sticking with one lab only for a more reliable reference.
And to clarify he said that one of the lab said I'm positive so he thinks I am but is not showing symptoms right now? Or it possibly could be lab error. Should I just ignore him? Your explanation sounds most plausible to me but I wanted your opinion.
Thank you,
So sorry for bothering you again. I also have OCD so I can't help but obsess over this.
MEDICAL PROFESSIONAL
You're welcome. Take care and stay safe.
Thank you for all your help. I really appreciate it.
But in case you do I would also like to know why people with low risk for herpes are not suggested to get a blood test done? Thanks =X last post..promise!
Sorry! I'm not sure if I was allowed to ask more questions. Disregard that if I wasn't suppose to. Thanks again! I can have a peace of mind again.
Thank you so much Dr. Hunter Handsfield! It was just that my gyno was so quick to say hey you have HSV II! Good luck! Bye! and I was left being totally clueless! Why do borderline positive happen? and I gave it enough time for testing right? Sorry I'm super parinoid! Thanks!
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.
