Even though your lab test results are somewhat confusing, the clinician's concern about herpes probably was valid. My experience is that trauma, whether from a fingernail or suspected injury during sex (e.g., poor lubrication), is an uncommon explanation for genital ulcers. Herpes is much more commonm, even in people who believe an injury is the cause. Also, I am skeptical that abrasion from running shorts or other irritation from exercise would make such a lesion worse. So had you come to my clinic, my staff also would have recommended testing for HSV.
But as you already realize, your test results are smack in the gray zone. Most people with a Focus (HerpeSelect) HSV-2 result of 2.2 are infected with HSV-2. However, some results under 3.5 are false positive, especially when the HSV-1 result is positive, as yours is. Now here is where it gets interesting (to me). Recent research, not yet published, suggests that the BioKit test is a good tie-breaker: positive confirms Focus as true positive, negative shows it is false-positive. Now you come in with a borderline reading on BioKit.
So what next? You can either repeat it all (Focus HSV-2 and BioKit), and see if either or both give definitive results one way or another. Or you can just ask your provider to send a specimen to the University of Washington or other reference lab for a Western blot. Your partner's test result may help sort things out, but perhaps not; whether she is positive or negative will only be a clue about your status, not definitive.
Of course, in the event a similar penile lesion reappears, get to your doc within a day or two for a culture test. If that happens and is positive for HSV-2, you won't need to worry about further blood testing.
Putting it all together, my guess is that you will ultimately be confirmed as having HSV-2. But do not take that as anything like a firm conclusion. Repeat testing, with or without Western blot, is what you need to sort it out.
Good luck-- HHH, MD
Thanks for the response and candor on the situation. I have talked to people at clinics and that were not very enlightening and you feel like a convict when you are done talking to them. To figure out many people are not up to date or just don
It can't hurt to wait another 2-3 weeks before retesting, but I don't think it is necessary. You can proceed any time.
Thanks for the citation. Dr. Morrow and I are close colleagues; I spoke with her about the data 2 days ago, and she didn't mention it had already been published.
My girlfriend went to see her doctor today. I will start off with; she is Canadian. The weirdest thing happened, she gave her doctor my results and the doctor asked my GF if she had any symptoms, she said:
I am aware of the philosophical and attitudinal differences between Canada and the US about HSV serological testing. Needless to say, I disagree with the Canadian position. The same attitude delayed regulatory approval of the truly type-specific HSV antibody tests for several years, but happily HerpeSelect is now approved in Canada and available in at least some laboratories. Reports on this forum indicate that other Canadians have been able to find private providers who have ordered the test. Alternatively, if your partner visits you in the US from time to time, or lives not far from the border, she can be tested in this country.
Got the restest as you perscribed herpeselect IgG hsv2:
3-26 blood drawn
3-28 results 3.9
3-28 Biokit, Positive; a light one but positive
The 3.9 on the Hselect i guess pretty much nailed before i got the biokit done, but the student did tell me it was lighter than others, but positively positive. I have to give the med student credit; she did do her homework and got with the manufacture of biokit and got some things understood on the test because some the visual aids, left thing open to user interpitation. I went ahead and had the blood work done, because I was scheduled for one of the unversity follow ups and wanted the results about the same time. I do have a couple of more questions with all the test I had done:
Could the first biokit been a false negative?
Am I a recent seroconverter or still could have had this a while? Does the increase in the numbers mean I am serconverting or the virus wants to show off for the lab tech?
What are the future physical problems associated with hsv2?
A related discussion, where to test