Did Antivirals Affect Western Blot Results?

[Bumblebee6]

Hi Terri,

In May 2017 I tested positive via IgG for HSV-1 (1.19) and negative for HSV-2 after a 2 year monogamous sexual relationship. After a protected encounter (used condoms) with a different partner in October 2017, I later tested positive (at the end of December 2017) for both HSV-1 (1.29) and HSV-2 (1.99). The partner stated that he’d never tested positive for anything before (I’ve seen no results to confirm this though). I had no detectable symptoms or visible outbreaks and felt completely normal. I got tested as a precaution without much concern. Upon receiving the results, I did research about additional testing and read about the Western Blot test. My doctor agreed to order my labs. As a precaution, I asked her about taking antivirals and I was prescribed Acyclovir (400 mg 2x/day beginning around January 10th of 2018). I got my WB labs drawn exactly 12 days after I started taking the medicine. The results came back negative for both HSV-1 and HSV-2. I stopped taking the Acyclovir in late February of 2018. I’ve avoided sexual contact and am still worried about sexual activity. I considered getting intimate again with a previous partner (he knows about my positive IgG results, but not the negative WB). Over the last 2 days -yesterday and the day prior, I took 3 doses of Acyclovir (1200 mg total) on the off chance that we became intimate again; mainly so I could assure him that I was taking precautions against the virus to eliminate his worry of getting it. After my most recent dose (last night at 11 pm) I began to wonder if the antivirals may have skewed my WB results. It’s been exactly 6 months since the questionable encounter so I was considering getting tested again.

1. Do you think the Acyclovir affected my WB results?

2. How long should I wait before getting another IgG and WB test since taking the 3 doses of Acyclovir?

This has been affecting me mentally and emotionally and any help or support that you can provide would be appreciated. Thank you.

[lifeisshort74]

Following

[Terri Warren]

1. Do you think the Acyclovir affected my WB results?

I do not think that 12 days of antiviral therapy is going to influence your western blot results (and good for you for obtaining that test)

2. How long should I wait before getting another IgG and WB test since taking the 3 doses of Acyclovir?

If you want to do it again,you can certainly do it now. We are really concerned about dosing that lasts three weeks or more, and only with suspected first infection. If a person has not had antiviral medicine for at least a 4 month period after suspected acquisition, we feel you can trust the blot results.

Terri

[Bumblebee6]

Hi Terri,

This is a follow up to my first question on my subscription: Sexual encounter in October 2017, tested positive (IgG) for both HSV1 and HSV2 in December 2017 HSV1 value 1.29 and HSV2 value 1.99. I had a Western Blot done in January 2018 and got negative results for both types. I’ve never had any symptoms. I spoke with my primary care physician who said that he didn’t think I’d risk infecting my partner if I haven’t had symptoms and my Western Blot was negative.

I’ve recently re-engaged in sexual activity with my monogamous partner who is aware of my test results. We haven’t been using protection since my WB results were negative.

I got another IgG test again (11 months after initial positive IgG) as a part of a routine screening with postive values for both HSV1 (value 1.46) and HSV2 value (1.44). My new ob-gyn who authorized the IgG test does not seem to be convinced of my previous WB results even though the test said no infection was detected.

The test used by the doctor’s office was the HerpSelect ELISA test (the Quest Diagnostics website boasts that this test is more sensitive than the Western Blot test (paper by Ashley-Morrow cited)).

Should I get another WB test to confirm this? My fear is that the virus is indeed present in my body, but the WB isn’t sensitive enough to detect it.

If the HSVs are below the limit of detection for the WB tests and the virus is present, why didn’t my IgG index values change much?

I thought I left all of the stress and worry behind and now I’m right back to where I was last year. I’m afraid that I’ll infect my partner (if I haven’t already).

Any help that you can give would be appreciated.

Sincerely,

Bumblebee6

[Terri Warren]

NO. I’m so sorry that your physician is unaware of the Western blot and its role as a confirmatory test for those who have a low positive IgG results, such as you. It might be beneficial for you to go to the Center for disease control STD treatment guidelines and go to the section on herpes diagnosis. There you will find a recommendation for confirming these low positives with the tests such as the Western blot. You clearly have a protein in your blood that is tripping the IgG test artificially and you should ignore these results and believe the Western blot. Your physician is wrong.

Terri

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