Am I Really Positive or Should I Do the Western Blot Test

[BeyondUpset]

I (F) found out last week that my ex (M), who I have known since I was child, and who I ended things with at the end of Nov 2021, but had a single sexual encounter with on 5/1/22, has been frequenting sex workers for years. This obviously came as a huge shock to me and has been extremely upsetting! We didn’t use protection since I had just been tested when we started dating and he claimed he had too and that he tested negative for everything. (But he also claimed that he was monogamous with me.)

I did the entire STD panel during my annual GYN appt on 9/22/21 and both the HSV1 & HSV2 IGG tests came back as negative. (My doctor uses Labcorp, which is in my doctor’s office.) I found that odd since I have had cold sores since I was in junior high school & my HSV1 IGG tests have always been positive. (I get tested with every partner.)

Luckily I had my annual GYN appt scheduled for 10/26/22 so I had the entire panel re-done. This time my HSV1 IGG result is 54 and my HSV2 is 1.58. The supplemental test is positive, but there is no number provided. My doctor’s note says “Out of range” positive”. He also wrote, “Care of this shows prior exposure to HSV 1 cold sore and prior exposure to HSV-2 no active infection currently”.

I have never had any genital outbreak or symptoms, but I also know that some people are asymptomatic and may never show symptoms and that the virus may allay dormant for years.

I’ve been a total basket case and in tears since receiving the test results. My doctor has not returned my phone call or email requests for him to call me. (He just sent the results via the portal.)

I know this isn’t a death sentence, but I feel like it’s one.

Do you think that since the supplemental test came back positive as well that I most likely did contract the virus or would you suggest getting the Western Blot test? There is an Any Lab Test Now near me.

I have no contact w/ my ex, and can’t since he was abusive, so I don’t know if he has tested positive.

[Terri Warren]

Unfortunately, your doctor does not seem to understand the meaning of a positive antibody test. If the test is correct (and we do see many false positives on these tests), that means you are infected and potentially infectious to others. the word “exposed” is misleading and terrifically unfortunate to use in this context.

I have 92 patients who have positive supplemental tests with labcorp who are negative by western blot. At this point, don’t believe anything until the blot is done. I think I have a cancellation tomorrow morning if you want to meet with me to arrange the blot or you can work with your own doctor, though I suspect they don’t know about the blot if they explained your positive as an “exposure”

Terri

[BeyondUpset]

Thank you so much for responding so quickly! I still haven’t heard back from my doctor despite leaving a voicemail and 2 emails.

I will try and book an online appointment with you this week, because I clearly can’t count on my doctor helping me determine whether or not I’m truly positive for HSV2.

How long does it usually take to obtain results after the blood is sent? I read that you deliver the test results via email. Is that correct? And then any subsequent communication would be via email. Would I then be able to discuss with you (via email) how to best move forward if I do test positive?

Is 54 considered especially high for HSV1? (I don’t currently have a cold sore nor have I recently had one.) I have read that sometimes a positive HSV1 result can lead to a false positive for HSV2. Is that true?

Also – do you find it odd that this same lab provided me with a negative HSV1 test result last year despite the fact that it’s always been positive due to having cold sores since I was a child?

And if I am truly positive, do I only have to worry about spreading the virus via towels or things of that nature (i.e., non-sexual activity) when I have a break-out? I know that I can spread it sexually at any point and that I don’t necessarily have to have a break-out to transmit it sexually (i.e., via vaginal or oral sex). My concern is spreading it during non-sexual activity, because I don’t want to accidentally give it to family members. In essence, how is HSV2 able to be transmitted if I am not sexually active and don’t have a breakout? Can it be spread via saliva (i.e., could my niece catch HSV2 if they drank from my cup)? And can HSV1 also be spread without having a break-out/cold sore?

Sorry for asking so many questions, but my doctor is clearly if no help and this is something that is very upsetting and scary to navigate through alone.

[Terri Warren]

Yes, I would send results via email and we can do further questions via email as well. I get results from western blots in 1-3 weeks, usually a couple of weeks. You have a very sound HSV 1 result – no need to think about confirming that but your HSV 2 is very low. IgG tests miss about 30% of HSV 1 infections so that could be what happened with the lab.

If you do have HSV 2, which I doubt, we recommend having your own towel rather than sharing though I am not aware of any cases of HSV being transmitted via towels. HSV 2 is not spread via saliva. HSV 1 can be transmitted when no symptoms are present, correct.

Terri

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