1.13 HSV1 index with 4.98 HSV2 index on Herpeselect – want to WB confirm

[scared_hsv2]

Hi, Terri:
On 5/27/15, I went to Quest Diag. to have my blood drawn for a 10 test STD panel test I ordered online. I decided to have this test after my last unprotected sexual encounter (first time with this person. .not best idea) on 2/27/15. I also am looking to have a child in the not-to-distant future and wanted to check my status. All results came back negative except for HSV1 and HSV2. The news hit me like a ton of bricks. I was devasted. I still am since the news. My index value for HSV1 was 1.13 while for HSV2 it was 4.98. I know this is considered a definite positive for HSV2 especially since it is above the high positive cutoff of 3.5. I’ve spent alot of time reading information since this diagnosis. Based on the consultation from the company I ordered the STD test panel from, they stated there is no possibility of cross reactivity between HSV1 and HSV2 (Herpeselect IGg type specific test was used). Also, the level of antibody may go up or down but with an index of 4.98 it is going to remain positive with this test. At this level, is it even worth confirming with a Western blot from UW? I’m already experiencing the emotions of a positive diagnosis so this will only further confirm these results in my mind. I know a Person can be asymptomatic but I can not recall experiencing any symptoms from this. I appreciate your knowledgeable advice on this. r

[Terri Warren]

I think the chances are very high that you would confirm with a western blot. However, I had a patient with a 4.75 not confirm recently so I’m a little skeptical. If you can afford the test and are already viewing yourself as a person with HSV 2 infection, then I can’t see any downside to doing this test.

You can get this either by ordering a test kit from UW, having your provider draw the blood and spin it down and ship it for you or our clinic can order the test to be drawn and shipped from a Quest lab near where you live.

The western blot will also give you results for HSV 1 and you are at a low positive for this and it might be good to know if you actually have HSV 1 to consider future sexual activity.

Terri

[scared_hsv2]

Hi again, Terri:
Thank you for your prompt response. I have read that Herpeselect index values in the low positive range (under 3.5) may present as false positive. I have read of some instances of values of up 5.0 that have come up as negative on WB. I’m not sure the accuracy of that and I’m sure if it happens, it is rare. At an index level of 4.98 for HSV2, I feel that I will be more than likely be positive per WB. But, since you mentioned WB also looks at HSV1, it would be good to confirm my low positive for HSV1. I’m interested in having the WB done. I just don’t want to go through my provider for this test. I see that your clinic is able to do this, which appears more convenient by allowing me to go to a Quest Lab near me. I’m just curious on what I need to do and the cost though your clinic. Can you provide information on this.
In 06/2014, I was also diagnosed with HPV and I also have psoriasis since about April of 2007. It is heart-breaking to hear you are affected by something else that has no cure. I’m sure it is something you learn to adjust your life to but with the unfortunate stigma of having HSV2, I think this will take alot more time to do.
My question now is, at what point is it advisable to take anti-viral drugs if you have no symptoms and does index value (which provides information on IGg antibodies to HSV1 and HSV2) suggest anything about outbreaks?

Thank you!

[Terri Warren]

Index value suggests nothing whatsoever about outbreaks.
What type of HPV did you have, the external genital wart kind of the cervical pap kind?
We can certainly order the western blot for you at a location near you.
If you are truly positive, then beginning daily therapy is not really necessary until or if you have a sex partner who is HSV 2 negative and you want to reduce the risk of transmission.

Terri

[scared_hsv2]

Hi, Terri:
I have the cervical pap type. In February 2015, I had to have a colposcopy because my pap smear appeared abnormal. The results of that were that there was no dysplasia. I am due to see my gyn for my yearly exam of which I will have another pap smear.
As I mentioned in my previous post, I also have psoriasis of which I am taking a medication called Otezla. This medication supposedly does not affect the immune system as other biological medicines for psoriasis do but I wonder the impact of adding an antiviral drug as well.
Thank you for the information. I will contact the clinic to learn about ordering the WB and have the blook drawn at a lab near me.

[Terri Warren]

Good for you for continuing with regular pap smears to resolve any concerns about the high risk type of HPV.
I am not familiar with how Otezla interacts with herpes or herpes medicine, that would be a good question for your pharmacist.

We can likely order the western blot for you on Tuesday when I get back into the office. We’ll make time in the schedule. We’ll figure this out.

This is your final post on this subscription. We can talk about more questions when we have the telephone appointment to set up the testing.

Terri

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