scaredwife73

[scaredwife73]

Iam in desprite need of answers please okay it all stated with a red itchy rash and a vaginal ulcer for which i went to the dr. (ob-gyn) and had a culture and it came back neg iwas told this could be a false neg. so i request some blood work results are as follows:

1st test not sure the type
hsv1/2 igg 1.5h pos
hsv1 igg type spec. <0.91 neg.
hsv2 igg type spec. <0.91 neg.

2nd Test (not sure of test type)
hsv-1 pos.
hsv-2 pos.

3rd test (not sure of type)
hsv-2 igg type spec. 1.5h pos.
hsv-2 igm neg.

4th and 5th Test (same results these are herpeselect)

hsv1/2 igg 1.1 h pos.
hsv 1 igg type spec. <0.91 neg.
hsv 2 igg type spec. <0.91 neg.

he then referred me to an infectous diease dr.  and he said that with a vaginal ulcer (that last a month)and a hsv-2 igg type spec.1.5h pos. and all of the hsv1/2 igg pos. that i definitely had hsv-2. is this accurate? by the way i have had 4 sexual partners 2 were virgins and were 1 time only unprotected oral sex that i performed and protected vaginal intercourse.  what are my risk?

[H. Hunter Handsfield, M.D.]

The opinions of an ObG and an infectious diseases specialist who has directly evaluated a patient need to be respected.  However, I am skeptical that you have genital herpes.  Some aspects of your blood test results support the diagnosis, but others do not.

You can pretty much ignore the screening tests, i.e. the HSV 1/2 IgG tests.  I also am inclined to disregard the second group of tests you report.  The important results are the type-specific ones done in test groups 1, 3, 4, and 5.  The rise in the HSV-2 result from <0.91 to 1.5 certainly suggested you had recently experience a new HSV-2 infection.  However, that result hten returned to negative (once again <0.91) for two more tests.  Therefore, my conclusion is that test no. 3's result of 1.5 was a false positive -- and this is supported by the fact that 1.5 is a very low level; most true positive are 3.5 and higher.

Also, your sexual lifestyle -- as you imply yourself -- is low risk for any STD, including genital herpes.  Of course, I don't have the advantage of having examined your genital ulcer, although I will say that a "red itchy rash" doesn't sound typical for herpes.

All in all, I doubt you have HSV-2 and suspect your genital ulcer was due to something else.  Maybe it was just a severe yeast infection, something to discuss with your gynecologist.  As far as the ID specialist is concerned, you might print this out and show it to him or her.  Perhaps s/he will give consideration to a Western blot confirmatory test to sort it out once and for all.

I hope this helps.  Best wishes---  HHH, MD

[scaredwife73]

iam sorry i got in a big hurry when typing out my results my 1st test (the unknown type of test the results are:
hsv1&2 igg abs routine
hsv1/2 igg  1.5h  
hsv 1/2 igg intrep     pos a
hsv2 igg type spec. neg

does this change anything also my drs. have never heard of the wb or biokit.

[H. Hunter Handsfield, M.D.]

This makes no difference in my opinion or advice.  You don't have HSV-2.

Use the search link to find lots of discussions of HSV Western blot and BiokitUSA tests, then show the information to your doctor.  An ID specialist should know about them -- but your comments above suggested the ID doc wasn't really up to speed on herpes blood test interpretation, so I guess I'm not surprised.  You may need to make some phone calls to find a consultant in your area who understands herpes.  Try calling your local health deparment STD clinic; even if you don't go there for an opinion, they probably will know which private docs in your area are most knowledgeable about STDs.

I'll be happy to comment on a WB or Biokit test result if/when you have it.  But until then, that's all for this thread.

[scaredwife73]

sorry last question since these were all heterosexual relationship would you yourseldf do any further testing if you were in my shoes?

[H. Hunter Handsfield, M.D.]

Your lifestyle is virtually zero risk for all STDs.  But it can't hurt to have tests for gonorrhea, chlamydia, and syphilis -- and perhaps for HIV.  The risks are nil and you can expect all results to be negative.

No more comments or questions except confirmatory HSV testing.

[scaredwife73]

i have had of those test  done all were neg. thanks for all of your help

[scaredwife73]

okay i don't know what to do now to confirm that i don't have herpes because i can't find a dr in my area that will do the wb or the biokit. also all other std test have come back neg. but the herpes thing is still haunting me.

[H. Hunter Handsfield, M.D.]

You do not need further testing for HSV.  The tests you have had are rock solid:  you don't have it.  If you can't accept that, there is nothing more I can do.  But if you insist on further testing, it's your money -- so feel free.  Any doctor can do an HSV Western blot.  They only need to draw the blood and send it to almost any laboratory, with a request that that lab in turn send it on to the University of Washington lab in Seattle.  All labs know how to arrange such things.

That will have to be the end of this thread.