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Shocked by my Diagnosis
Hi Dr.,
I got a routine check up at my OB and ....I was just diagnosed with HSV 2, but I am shocked! I had sexual contact with someone about four months ago and he was negative for everything. I have not had sexual intercourse for over a year (we used condoms), before that I did not have sexual contact at ALL for five years (and that guy was a virgin!). I have never EVER had symptoms. I was so shocked I had my doc test me twice. The results were the same as follows:
Herpes Select IGG Type 2: 1.09
Inhibition Interpretation: Positive (I don't know if this is reliable or not - I can't find enough info and my doc said there is no numerical results, just pos or neg).
I talked to my primary care doc and she said that I could have been infected as a child, even though Type 2 is usually below the waist. She said that it doesn't mean I am contagious either and this is not a big deal..people have hsv in their system and it does nothing in some people..that she doesn't even test unless there are symptoms b/c people get so freaked out. She and my OB/GYN said this is not always contracted sexually and not necc in the gential area. I called my OB that I had for those five years that I was not active at all and she said she did not routinely check for herpes!! Here all along I thought I was being test!! Partially my fault for not asking enough questions...anyway...
Questions:
1- Should I get the BioKit or Western blot test done even though I tested twice with HerpesSelect and Inhibition and it came out positive? I read your posts that the 1.09 is uncertain with Herpes Select. If I get retested, how long should I wait?
2- If I am positive, am I contagious? Is it in the gential area?
3- With such a low score of 1.09 what are the chances I will have an outbreak? I am terrified!!
4- Is this something I could have had for years and not even know it? Will an outbreak occur in the future?
I am just hoping those tests were wrong..pls advise.
I got a routine check up at my OB and ....I was just diagnosed with HSV 2, but I am shocked! I had sexual contact with someone about four months ago and he was negative for everything. I have not had sexual intercourse for over a year (we used condoms), before that I did not have sexual contact at ALL for five years (and that guy was a virgin!). I have never EVER had symptoms. I was so shocked I had my doc test me twice. The results were the same as follows:
Herpes Select IGG Type 2: 1.09
Inhibition Interpretation: Positive (I don't know if this is reliable or not - I can't find enough info and my doc said there is no numerical results, just pos or neg).
I talked to my primary care doc and she said that I could have been infected as a child, even though Type 2 is usually below the waist. She said that it doesn't mean I am contagious either and this is not a big deal..people have hsv in their system and it does nothing in some people..that she doesn't even test unless there are symptoms b/c people get so freaked out. She and my OB/GYN said this is not always contracted sexually and not necc in the gential area. I called my OB that I had for those five years that I was not active at all and she said she did not routinely check for herpes!! Here all along I thought I was being test!! Partially my fault for not asking enough questions...anyway...
Questions:
1- Should I get the BioKit or Western blot test done even though I tested twice with HerpesSelect and Inhibition and it came out positive? I read your posts that the 1.09 is uncertain with Herpes Select. If I get retested, how long should I wait?
2- If I am positive, am I contagious? Is it in the gential area?
3- With such a low score of 1.09 what are the chances I will have an outbreak? I am terrified!!
4- Is this something I could have had for years and not even know it? Will an outbreak occur in the future?
I am just hoping those tests were wrong..pls advise.
MEDICAL PROFESSIONAL
Although the opening comments don't suggest it, question 1 implies you have reviewed other threads and realize that an ELISA ratio of 1.09 really is not a positive indication of HSV-2. The official recommendation of the test manufacturer is to consider a test positive if the HSV-2 OD ratio is over 1.1 (yours actually isn't quite there), but the test is not reliably positive unless the value is 3.5 or higher. At 1.09, there's probably about a 10-20% chance you have HSV-2.
It's also pretty clear from your description that your ObG is not up to speed on this issue, or on herpes in general. Even if your test were truly positive, the explanation of a childhood infection is exceedingly unlikely. And she is also wrong about how HSV-2 is acquired; the exceptions to sexual transmission are extremely rare. That said, please do not fault her for not routinely testing for HSV-2 before this. Routine HSV-2 testing is quite controversial, partly because many people have exactly the same sort of borderline results that you do. Although HSV-2 testing in fact makes sense in many situations, it is not done on a regular basis by most doctors, and most STD experts don't recommend it. (If you want to diplomatically educate your doctor about these issues, refer her to the following research paper http://www.ncbi.nlm.nih.gov/pubmed/16225691. She also can look up other research by Dr. Rhoda Morrow of the University of Washington.)
To the specific questions:
1) You could have a BiokitUSA or Western blot test to sort this out. Or you could just have a repeat routine blood test. Your test probably was the HerpeSelect, so have another one. If that result shows an ELISA ratio under 0.9, you can be sure you don't have HSV-2. If you get another result over 0.9, then go ahead with Biokit or WB. Either way, most likely repeat testing will show you don't have it.
2) If you have HSV-2, you need to assume it is a genital area infection and that you can transmit it (even without symptoms) through genital sexual exposure.
3) Very low; see above. No cause for being "terrified"!
4) Conceivably yes, you have had HSV-2 for years. But most liklely not.
Your hopes likely will come true. I hope so.
Best wishes-- HHH, MD
It's also pretty clear from your description that your ObG is not up to speed on this issue, or on herpes in general. Even if your test were truly positive, the explanation of a childhood infection is exceedingly unlikely. And she is also wrong about how HSV-2 is acquired; the exceptions to sexual transmission are extremely rare. That said, please do not fault her for not routinely testing for HSV-2 before this. Routine HSV-2 testing is quite controversial, partly because many people have exactly the same sort of borderline results that you do. Although HSV-2 testing in fact makes sense in many situations, it is not done on a regular basis by most doctors, and most STD experts don't recommend it. (If you want to diplomatically educate your doctor about these issues, refer her to the following research paper http://www.ncbi.nlm.nih.gov/pubmed/16225691. She also can look up other research by Dr. Rhoda Morrow of the University of Washington.)
To the specific questions:
1) You could have a BiokitUSA or Western blot test to sort this out. Or you could just have a repeat routine blood test. Your test probably was the HerpeSelect, so have another one. If that result shows an ELISA ratio under 0.9, you can be sure you don't have HSV-2. If you get another result over 0.9, then go ahead with Biokit or WB. Either way, most likely repeat testing will show you don't have it.
2) If you have HSV-2, you need to assume it is a genital area infection and that you can transmit it (even without symptoms) through genital sexual exposure.
3) Very low; see above. No cause for being "terrified"!
4) Conceivably yes, you have had HSV-2 for years. But most liklely not.
Your hopes likely will come true. I hope so.
Best wishes-- HHH, MD
A related discussion, Results of western blot was started.
MEDICAL PROFESSIONAL
The newer test with higher ELISA ratio raises the stakes somewhat, but not all that much. Although it is possible you have acquired HSV-2 within the last 2-3 months, the absence of symptoms makes it unlikely. The ELISA ratio can easily vary between 1.1 and 1.6 without meaning; the odds still are in your favor.
Most likely you misunderstood something about shipping blood to the UW laboratory. Certainly there is no legal requirement for any sort of "permit". More likely the concern is the cost of shipping; the NY State lab may not have payment or other procedures in place. Any commercial lab can ship a specimen whenever they want. Or you can still go the Biokit route as I indicated in my initial response.
Most likely you misunderstood something about shipping blood to the UW laboratory. Certainly there is no legal requirement for any sort of "permit". More likely the concern is the cost of shipping; the NY State lab may not have payment or other procedures in place. Any commercial lab can ship a specimen whenever they want. Or you can still go the Biokit route as I indicated in my initial response.
Dr,
Hi Dr...I am a bit more nervous now b/c I aquired by second test result and now all the results are as follows:
Jan 13ish:
HSV 2: 1.09
Inhibition interpretation: Positive
Two weeks later I was restested and it was:
HSV 2: 1.6
Inhibition interpretation: Positive
This rise isn't good, is it? Like I said the last time I had contact (not even intercourse) gentially was Oct 08 and he said he was negative.
I saw other rpeoples esults and even though there was a rise in results (like mine), they still with the WB ended up being negative for HSV 2.
Is there still a chance I can be negative? I still have no symptoms.
I haven't been feeling well since mid December and I always get sick real easily in the winter...could my body be fighting off something else and that explains the rise?
Is this possible?
I contact Uni of Washington and they informed me since I am in NY I have to get a permit from NYS dept of Health so they can test my blood. So, this could take a while to sort out..meanwhile...I can going to be so worried!
Please advise.
Hi Dr...I am a bit more nervous now b/c I aquired by second test result and now all the results are as follows:
Jan 13ish:
HSV 2: 1.09
Inhibition interpretation: Positive
Two weeks later I was restested and it was:
HSV 2: 1.6
Inhibition interpretation: Positive
This rise isn't good, is it? Like I said the last time I had contact (not even intercourse) gentially was Oct 08 and he said he was negative.
I saw other rpeoples esults and even though there was a rise in results (like mine), they still with the WB ended up being negative for HSV 2.
Is there still a chance I can be negative? I still have no symptoms.
I haven't been feeling well since mid December and I always get sick real easily in the winter...could my body be fighting off something else and that explains the rise?
Is this possible?
I contact Uni of Washington and they informed me since I am in NY I have to get a permit from NYS dept of Health so they can test my blood. So, this could take a while to sort out..meanwhile...I can going to be so worried!
Please advise.
MEDICAL PROFESSIONAL
First, most with low ELISA ratios like yours don't have HSV-2 at all; that's the main difference between those with low versus high. Second, among those who really have HSV-2, there is no relationship at all between the numerical result and the time since infection, symptoms, the amount of viral shedding, or the frequency or severity of outbreaks. The reasons some infected people have higher or lower ratios than other infected persons are simply unknown. It appears to be random.
One more question: Why is it that some people have really low scores pos for HSV 2 (like me) and some have the really high ones, which I have read are the people who most likely get the outbreaks? Does the viral shedding vs the highly contagious lesions have anything to do with this? Just wondering...
Thanks Dr.
I don't know what the first test results were...I am going to request my paperwork so I have it for my records.
I will get the WB and let you know what happens.
This had been really helpful!! Thanks!!
I don't know what the first test results were...I am going to request my paperwork so I have it for my records.
I will get the WB and let you know what happens.
This had been really helpful!! Thanks!!
MEDICAL PROFESSIONAL
I missed the fact that you apparently have had two routine antibody tests that were positive. But you describe only one of the two results. What did the other show? Also, the positive inhibition assay also suggest you may really have it -- although I still tend to doubt it. Disregard my comment above about a repeat HerpeSelect test. And in this situation I would not rely on Biokit. Talk to your ObG about having a confirmatory HSV Western blot at the University of Washington clinical laboratory. Your local lab will know how to arrange for it.
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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.
