Confused on diagnosis /lab results need answers

[TerriblyConfused]

Hi Dr. Terri,
I am very new to this forum and just needed some insight and direction on diagnosis. I’ll begin, In October 2012 I had an itchy blister on my buttocks and went to my primary dr. And she took a swab test of the blister and it came back she said HSV2 positive. I have never had an std before in my life and attributed to my recently then boyfriend (ex now). That following year in February 2014 I found out I was pregnant with our daughter. I never saw the actual test results from my primary diagnosis although I did have symptoms. That year I kept getting a painful outbreak on my hand. I didn’t know it was here’s then until I went to the E.R. And the dr. There said it looked like herpes. I’ve never had any cold sores on or in my mouth and not many outbreaks other then my hand or buttock. Fast forward to this year I have a new dr and informed her I was diagnosed with HSV 2 in 2012 so she sent me to get blood work to be sure.
So I got my April 2015 results back and HSV1 and HSV2 came back negative. So I’m confused if I have it or not. She did say on the HSV 2 that antibodies were detected but from an old infection. I am no longer with my ex and have not slept with anyone since July 2013. But in 2014 I was still having some outbreaks and symptoms but have not had any this year.

My results were as follows: HSV1/2 igG ABS 0.06
>12.00 H index
HSV1/2 IgM Abs 0.58
I honestly don’t know how to interpret results and just want to know if i am positive or negative?
I am not dating at the moment but if I decide to date is this something I need to let my potential partner know? And can I transmit this to my daughter or family? I do breastfeed.
I was prescribed acyclovir if I ever experience an outbreak from previous dr. And she also told me she would put me on Valtrex after nursing. But I asked my new dr. If I needed to be on valtrex after nursing and she said no I didn’t need it and that it’s only if I had a rash. So I’m really confused and just need help. Thank you so much for your help and I hope this wasn’t to confusing to interpret.

[Terri Warren]

Your doctor is confused about how to interpret you lab results. There is no such thing with herpes as an “old infection”. Once you have herpes, you have it for life. Also, she used a combined HSV 1 and 2 antibody test which is very old school and I’m not really clear about the exact results because what you posted is a bit contrary. Could you look at that again? . What you needed was a type specific antibody test that separates HSV 1 and 2. However, if you had a positive swab test from a buttocks lesion that showed HSV2 then you have genital herpes. I’m not sure about your hand – it is possible that you have herpetic whitlow, a hand infection with herpes, but I don’t see if you had that diagnosed by swab test.

You will likely not transmit this to your daughter, but if you do have herpes on your hand, you should cover the lesions when they are present. In terms of medicine, you can treat outbreaks as they come up and should start just as soon as you notice anything starting at all on your hand and buttocks.

Buttocks is genital herpes. When you shed virus from the buttocks and have an outbreak there you may well also be shedding from the genital tract. Daily therapy would reduce the risk of transmitting the virus to a sexual partner. I think it would be good for you to read the herpes handbook for free on this website.

Many women take Valtrex while nursing, though the medicine is passed through breast milk in small quantities.

Please feel free to ask more questions as needed.

Terri

[TerriblyConfused]

My doctor wasn’t confused about the results,I meant to say that I was confused and didn’t really understand what my results actually meant as far as disclosure to future partners since my lab results came back negative but when initially diagnosed with a swab test in 2012 it was positive, or if I still had them. I’ve attached a picture of my lab results as I do not know how to interpret them correctly. If you could look at it to help me understand that would be a big help. I was not prescribed valtrex, I was prescribed acyclovir but was told to take it as needed.

[Terri Warren]

Your HSV 2 type specific antibody is strongly positive. You are both infected with HSV 2 and infectious to others as well. It is important that you disclose to others that you have genital herpes. Even though your outbreaks are on your buttocks, you will still shed virus intermittently from the genital tract. I think it is very important that you have the lesion on your hand swab tested when it comes again to know if this is also HSV 2 or not. The best test is PCR, rather than a culture, if you can arrange that. How often do you get lesions on your hand?

Terri

[TerriblyConfused]

What is the PCR test? And last year I had it come about 3-4 times, I have not had anything come up this year as of yet.i appreciate your time looking into all of this and answering your questions. Would you advise I not share anything with my daughter, such as food or drinks from the same cup? That has been something I’ve worried about as well.

[Terri Warren]

Polymerase Chain Reaction. It is a swab test that is far more sensitive than the culture, about 3-4 times more sensitive. Sharing things with your daughter is not an issue is you have no lesions on your hands. If you do, I think I would recommend covering the lesion but the first thing is to get it tested.

This is your final post on this subscription. If you have more questions, please feel free to renew.

Terri

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