› Forums › Herpes Questions › conflicting lab results and their meaning
- This topic has 5 replies, 2 voices, and was last updated 7 years, 7 months ago by Terri Warren.
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June 18, 2015 at 9:44 pm #7431blackbowlParticipant
I had a classic genital herpes outbreak and tested positive for hsv2 through viral culture (culture taken 6/1). I subsequently had a blood test (blood drawn 6/5) and it turned out negative for hsv1 and hsv2. The results indicated the IgG levels for each were <.9.
Based on my own research a negative hsv2 test result with a positive culture (and classic symptoms) would support the theory that this is a new infection. However, my partner has had no symptoms and he also just received a negative blood test result (blood drawn 6/5). We are newly intimate (<6 weeks) and I did have a possible exposure by another partner exactly 3 months prior to my blood being drawn for testing (3/5). I have not had any other possible exposures in the past year.
1. Is it possible that even after 3 months of exposure to hsv2 I have not developed immunity to the virus? How likely is that given that I am female and 36 years of age and otherwise healthy? This (person) seems like the most likely source of infection, but through my reading outbreaks generally occur within 2 weeks of infection if they are going to occur.
2. How likely is this to be an old infection? Is there any way to tell? At first the outbreak was so painful, I thought this had to be a new infection. But now that it has subsided, I do recognize quite clearly many of the milder symptoms. I have had these for a decade or more and always attributed them to irritation by soap. For the last two years I have been under a great deal of stress that spiked about a month before my outbreak. And it was a strange way it occurred. I had the same old irritation for about a month, and then on the heels of a beach trip and drinking more than I should on my birthday, it exploded. I should also mention that I have had menstrual irregularities (extremely light) and extremely sporadic for nearly two years after discontinuing birth control. One provider has suggested this is a sign of thyroid problems. She also thinks there could be a link between hormonal surges and this herpes attack (if it is an old infection).I know that most would advise it is too difficult to determine where an infection was obtained and not overly productive. It matters to me, though. On a more practical level, I fear if this is a new infection I will be in store for some many more outbreaks this year. I know they are supposed to become less severe, but even so, this outbreak was difficult to manage – into the third week and I am still very uncomfortable. I am taking acyclovir,but after 2.5 weeks doesn’t seem to be working very well. I have more hope that if this is an old infection my body will regain its ability to keep it in check.
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June 19, 2015 at 2:52 pm #7461Terri WarrenKeymaster
1. Is it possible that even after 3 months of exposure to hsv2 I have not developed immunity to the virus? How likely is that given that I am female and 36 years of age and otherwise healthy? This (person) seems like the most likely source of infection, but through my reading outbreaks generally occur within 2 weeks of infection if they are going to occur.
is is possible? Yes. Is it likely, no. It is possible that your newest partner could have had prior to you with someone who had herpes and has just not had time to make antibody yet but could transmit to you. Do you know the timing of their last sexual contact prior to you?
2. How likely is this to be an old infection? Is there any way to tell? At first the outbreak was so painful, I thought this had to be a new infection. But now that it has subsided, I do recognize quite clearly many of the milder symptoms. I have had these for a decade or more and always attributed them to irritation by soap. For the last two years I have been under a great deal of stress that spiked about a month before my outbreak. And it was a strange way it occurred. I had the same old irritation for about a month, and then on the heels of a beach trip and drinking more than I should on my birthday, it exploded. I should also mention that I have had menstrual irregularities (extremely light) and extremely sporadic for nearly two years after discontinuing birth control. One provider has suggested this is a sign of thyroid problems. She also thinks there could be a link between hormonal surges and this herpes attack (if it is an old infection).
The problem with this theory is the negative antibody test. If your last encounter was 12 (or more) weeks prior to the antibody test, there is a small chance it would be an old infection. The vast majority of people make antibody by 16 weeks and probably 90% make it by 12 weeks, if not more. There is a way to test this. If you do an antibody 6 weeks or 8 weeks from now, you will know this is new infection, right? That’s what I would suggest if you really want to know. If you don’t make antibody by 16 weeks from now, then you might think this is older infection and that you simple don’t make antibody detectable by this test. I don’t believe there is way other way to know the answer to your question.
Terri
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June 19, 2015 at 8:35 pm #7499blackbowlParticipant
Hi Terri,
Thank you for your reply!
It sounds like I am looking at one of three unlikely situations. 1) This is something I contracted from first partner (and still after three months had no detectable antibody), 2) this is a very old infection, or 3) I contracted it from my newest partner. Concerning the latter, if I understand the situation, and please let me know if you disagree… he would have to have been infected so recently that he would not have antibodies. We first met on March 19th. I know one can never know for sure, but I don’t believe he had any relationships with anyone other than me from that date until now (and his test was done on June 5). However, he is also older than me- 53- and I wonder if he might take longer to seroconvert? The other possibility, might concern his actual testing. I tried to get him to ask for information about his test results, but he was unable to provide any virus sub-type information or type of antibody test used. I am going to try to get him to ask for more information, but if it was an IgM test my understanding is that it is highly unreliable.
My next steps are to 1) try to gain more information from him about his test results and if he did have an IgM test, convince him to retest ASAP with IgG. 2) Re-test myself on or around July 5. That would be a full four months since last exposure to the first partner and if I am still a strong negative this would likely eliminate him as a source.
What do you thin of this synopsis and plan moving forward, any flaws?
Also, in terms of the mild symptoms that I mentioned having in the past….. I lot of the feelings I am having now are very similar to previous experiences. For instance, I have had bouts of anal itching since my senior year of college. It comes along, gets worse, and worse at night, and then disappears in about 8 to 10 days. I have had exactly the same feeling during the last week. Also, prior to this outbreak, I had skin irritation around the labia for a month or more. It was very mild and I thought it was related to having a new sex partner. I figured introducing new bacteria, friction, etc could irritate the skin. I also remembered having the same experience about 10 years ago. It was mild and went away in about a month. It didn’t even occur to me to be concerned because I remembered having had this before. Finally, and this probably less consequential, most of the pain with the outbreak is gone but the nerves seem to be over- active. I constantly feel like I have to use the bathroom (number 1) and when I go there is very little urine. About 6 months ago I had the similar sensation. I thought a bladder infection was coming on, but the sensation went away on its own in a day.
In your experience, are these prior episodes consistent with mild hsv2 infection?
Finally, do you know anything about propolis and the treatment and prevention of an outbreak?
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June 19, 2015 at 11:24 pm #7504Terri WarrenKeymaster
I think it is less likely that this is an old infection because the HSV 2 IgG is pretty darn good at picking up infection and you are still negative, so I think less likely that.
I don’t know much about propolis, no, though I’ve heard of it in connection with herpes.
yes, try to have him get a copy of his test results. It does sound unlikely that he would still be negative if infected prior to March. This is confusing for sure.Terri
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June 24, 2015 at 5:06 pm #7618blackbowlParticipant
Hi Terri,
At this point (about 25 days from my symptoms taking off… I had mild irritation for a month before they did), I am still suffering pretty badly. The day I had my culture taken, was the day it got unbearably painful. Prior to that I had a fever, flu-like symptoms,a swollen groin, tingling in the buttocks, and abdominal pain. Initially, the pain was mediated by warm baths and advil. I started on acyclovir 400 mg/ 3x day. By the next week I was feeling better, but then I got what looked to be a yeast infection. I took a cure. It appeared to go away, but severe itching has set in after. It was so bad Monday of last week I couldn’t work and pain meds wouldn’t help. The warm bath did a little, but not great. I finally had a bunch of wine and it stopped the itching. I started to get better again and cut back on the acyclovir to 2x /day for suppressive. However my doctor also prescribed valcyclovir (1 gm /day) when I told her what was happening. I don’t have good insurance so the 335 dollar per month drug isn’t really an option for me right now. So I upped the acyclovir again. And, in a previous post I mentioned propolis. I use it topically for the outer areas that were itching so badly. I have been applying it for the last 4 days with great success! But, now I feel like i have another yeast infection and/or bladder infection. It is accompanied by painful bloating (and I have been having this for over a year now), The pain is internal and more intense. I took a yeast infection cure again, but it made no difference. I am frustrated. And, don’t know what to do. I had an appointment with my doctor but there was a issue with validating my insurance. I was told I might have to wait up to two hours for them to verify. I was tempted to pay cash… but part of this visit was for testing of my thyroid and I wasn’t sure if I could swing it financially. Normally I would have waited, but I was in so much pain I couldn’t bear sitting there.
From my reading, the appears to be a very extreme primary outbreak. I am starting to wonder, though, if the symptoms will ever subside. I have lost so very much money and time trying to treat this, and with the exception of the propolis, haven’t gotten any real relief. And, I do the other stuff like wearing loose clothing, keeping thing dry, and peeing in a tub of water during the first week.
1. Do you have any advice? Is this out of the norm?
2. Despite the high expense of the valcyclovir would it be worth filling my prescription for a month? I could use it as suppressive therapy, taking 1 grm for 5 days? Or, should I stop and let my immunity build?
3. I know your intuition is that this is a first infection. Maybe so, but I have been experiencing milder symptoms for many years, and for the last year painful bloating and watery discharge. I also have had a very light, irregular cycle. This is the reason for the thyroid testing. I guess I wonder if this is all herpes related or if something else is going on?
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June 25, 2015 at 4:04 pm #7637Terri WarrenKeymaster
I’m thinking there is something else going on here besides herpes. It definitely doesn’t fit with normal herpes at all.
Please – get your insurance settled and go back to see your doctor and be evaluated for other STDs as well. You may still have a yeast infection but the internal issues are the most concerning to me. Have you been evaluated for chlamydia and gonorrhea as well? Painful bloating should be evaluated and perhaps you need an ultrasound or other testing.Acyclovir when taken as directed (400 mg twice a day) is equally as effective as valacyclovir – multiple studies have shown this to be true so no need to take the more expensive medicine.
It might be truly an old infection had it not been for the negative antibody test.
This is your last post on this thread. Please feel free to renew if you have more questions.
Terri
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