Determining WB test date

[me123]

My ongoing sex partner and I recently sought HSV testing because his other ongoing partner reported she tested positive (she later learned her score was actually equivocal).

My scores:

8/28 IgG HSV-1 negative, HSV-2 1.38
10/16 HSV-2, 3.2

He tested negative HSV-2 IgG a week after my 1st test.

I don’t believe I’ve ever tested for HSV. Not aware of outbreaks, but lots of apparent UTIs and yeast infections this year.

Due to multiple partners, I’m not sure of the start date for my sixteen-week wait for WB. I contacted all from the last year (and I wasn’t active for some time before that) and narrowed things down based on confirmed history of HSV neg tests. These remain points of concern for me:

*HSV-pos sex partner 23 years ago (he revealed his status after sex), so maybe I carried this through my 20-year monogamous marriage.

*Unprotected sex, Nov 2014 (I got examined and had a std screening a month after this, but it didn’t include HSV. Treated for yeast infection and cervicitis. Told him of my situation, he denies pos. status, but no proof)

*Unprotected sex in July (he had negative IgG test in June, 12 weeks after his previous lover–plans retesting when 16 weeks have passed from our contact)

*Current partner: occasional sex throughout this year with me and with woman with equiv score, always with condoms. He will retest after 16 weeks have passed for he and I, all of us are behaving as if I am positive & avoiding intercourse as we wait for final confirmation.

Is there even a chance I acquired from him in Aug (so date from then) OR because he was neg should I date based on my other history? Do equiv scores ever mask high pos antibodies or is it generally either neg or low pos upon retesting? She doesn’t plan a retest, so it will remain a grey area.

Don’t want to damage the potential for clear answers, but am anxious to confirm my apparent positive status so I can stop the anxiety about the situation and start anti-viral meds. Thank you for all you do here!

[Terri Warren]

There are a couple of options here.
If he is truly negative, then you can test 16 weeks from your last encounter with someone else. However I think he should retest because he is having sex with someone else who has an unclear result.
You could also wait 16 weeks from the test date for greatest clarity.
And you could also test now and if it is positive then that’s that. If negative, you would likely need to test again.
Why does this woman not want to retest? All of the others of you know or will know your status and she will be the unknown right?

Terri

[me123]

He hasn’t had intercourse with either of us since testing began, though there has been other intimate contact such as oral sex.

Her decision is based upon consultation with her doctor about the potential insignificance of her results, thoughts that I suspect are similar to what I was told by the clinic and later my new Ob/Gyn after my first test results: that my low positive result indicated “possible exposure” and nothing more. I was actively discouraged from seeking the test, and I think that is the sort of advice that influenced her decision. It is hard to get clinicians to be supportive of seeking testing when not symptomatic and I think it feels like a can of worms to them. But maybe when I have higher score or WB confirmation, and certainly if our shared partner’s results change, she may change her mind.

[me123]

I should add, I have decided to seek all my testing on my own because of advice like this. Although I do like my new Ob/Gyn, her advice to me was that if I feel the need to retest she wanted it to be IgM, but I’m trusting what I’ve learned from your site instead.

[me123]

Do I still have remaining questions? If so, can you provide a link to good professional information resource that will explain the superiority of the WB, the inferiority of the IgM, something my doctor will accept and appreciate?

I’d like to check first to see if my insurance will cover it if my doctor orders it, but I definitely have decided I will seek WB sooner rather than later. If I have to pay completely out of pocket for the WB I still think it’s an excellent investment, but I want to make sure my doctor understands how this works and will be willing to work with me on the matter, such as in prescribing suppressive meds once we’ve confirmed.

Doctors generally don’t put much stock in what their patients learn about health on the internet, and I already tend to come off rather cheeky when I question or dispute things. I don’t want to make trouble with this new doctor, but maybe I will work to find someone more experienced with HSV treatment!

[Terri Warren]

I would recommend the Centers for Disease Control STD Treatment Guidelines for herpes. Here is the link:
http://www.cdc.gov/std/tg2015/herpes.htm
I don’t believe that your doctor can order this any longer. Our clinic can still order this to be drawn at a Quest lab near you and they will ship out or you can get a kit from the University of Washington and you need to arrange for a provider to draw your blood and arrange shipment from their office.

I think it is a good idea to bring some professional documentation regarding the western blot and IgM, yes.

Terri

[me123]

I have purchased another set of questions. I haven’t been able to save the money to pay for the Western Blot, but this weekend I’ve experienced itching, tingling and burning in the small of my back and can barely see some very inconspicuous spots there. Nothing earth shattering to look at, but it’s been three days of obvious tingling/burning sensation focused on that spot. I’ve had some other mostly mild symptoms, things that I could have dismissed as coincidental or possibly psychosomatic, but with this tingling spot I am feeling more certain that I am indeed HSV-2 positive — it just presents in relatively mild (and frustratingly difficult to spot) ways.

I continue to have some questions, I’ll start with one about confirmation testing:

Given how my test numbers have slowly risen, I wonder if you agree with my assumption that another IgG test now would probably result in a score moving beyond that 3.5 mark and therefore could serve as decent confirmation, given my newer symptoms.

If I were to order another IgG test, would it be best to go with the same lab I used the two previous times (LabCorp) or should I go through a different one (Quest).

I’ll save my other questions for a bit. Also, just a bit of follow up info: my current partner will be retesting to see if he is still negative soon (we’ve avoided intercourse and played it very safe for 16 weeks to be certain of clear results).

[Terri Warren]

If you order another test, I would stay with the same lab, yes, otherwise, there can be quite a bit of variability between labs, I have discovered – not huge but enough that I think staying with the same lab is best. But low positives still need confirmation.

Terri

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