Does Valtrex affect Herpeselect IGM test primary episode

[tinglered]

Hi Terry,

I believe I was exposed to genital HSV 1 or 2. I immediately began Valtrex taking 1 gram twice daily for 10 days (started within 12 hours of exposure). On the 10th day I had a Herpeselect IGM & IGG blood test done for HSV 1 & HSV 2.

The results showed ‘negative’ for both IGM tests with reference range ‘negative’ (there were no numerical results).
The results showed >5.0 for HSV 1 IGG
The results showed <.90 for HSV 2 IGG

I understand the results are telling me that I have previous HSV 1 and no previous HSV 2.

My question is if I was newly exposed to HSV 2 (or HSV 1 again) could the Valtrex have affected my body’s production of IGM antibodies thus skewing the test results Negative? My doctor said I was ok and not exposed to a new HSV 2 Genital herpes risk due to the IGM being ‘Negative’ but I am concerned if this has been affected by the immediate usage of Valtrex.

I have just taken the same blood test again at the 7 week post exposure mark and I am eagerly awaiting the results. Please reply fast if you can!!
Thank you!

[Terri Warren]

The IgM antibody test is completely unreliable What you want is only IgG. I would definitely NOT rely on an IgM test to determine that you are not newly infected with herpes. And if you want a reliable IgG test in the future, I would recommend that you stop the Valtrex. Taking Valtrex longer than about 10 days can cause a false negative on the herpes antibody IgG test. How long total have you taken the Valtrex?

Terri

[tinglered]

I mainly only took the Valtrex for those first 10 days.

I had the second blood test yesterday and I did take a single 1 gram Valtrex about 2 hours prior to the test but that was the first Valtrex since the initial episode.

Will 7 weeks since possible exposure be enough time to develop IGG antibodies for an accurate test?
And so you are saying put zero stock in the original IGM ‘Negative’ results? They were giving me hope but I guess I do not need false hope.
And even though you say ignore the IGM; I a curious does Valtrex effect the blood testing? I cannot find any info online regarding this.

Thanks for the quick response!

[Terri Warren]

You know, the IgM isn’t wrong every time, and it is particularly false positives that are the problem. But I still wouldn’t rely upon it.
You need 16 weeks for a reliable test result from the time of any concerning sexual exposure.
Valtrex can impact the testing if taken for a longer period of time than 10 days. I would just recommend that you not take any more until you’ve done your final test so you never have to wonder if your test result is correct or not.

Terri

[tinglered]

Great thank you.

Lastly, your opinion on this:

7 weeks ago I had genital contact with a very, very questionable person. Within 2 days I started having tingling/burning in scrotum and penis. For days I just did not feel normal. And days 3-5 I had night sweats. Also I felt a lump in my armpit and realized this was a swollen lymph node. I have not noticed any vesicles unless they were tiny and I missed them.
During the last 7 weeks I have had a recurrent dry patch of flaky skin on the same area underside of my shaft (this has occurred 5+ times and never happened prior). I also have on and off tingling/burning of penis/scrotum and during the burning the skin texture down there just does not seem normal and scrotum becomes red. The burning/tingling can be quite discomforting and sends alarms of worry of in my head. Would this be indicative of having acquired HSV 2?

[Terri Warren]

Night sweats would not be consistent with a new herpes infection. Nor would a lump in your armpit that was a swollen lymph node. Infections of the penis are not reflected in the arm pit lymph nodes. I am also not concerned about burning and tingling with any skin lesions. Genital herpes does not present just as a dry patch of flaky skin, either. The red scrotum sounds more like a fungal infection and this could also cause burning of the genital skin as well. Have you tried any anti fungal medicines at all?

If you have other question, you will need to renew your subscription. Thanks for visiting our site.

Terri

[tinglered]

I just received 2nd Herpeselect blood test results that were drawn 7 weeks and 1 day post possible exposure. They are unchanged from test taken 1.5 weeks post exposure:

The results showed ‘negative’ for both IGM tests with reference range ‘negative’ (there were no numerical results).
The results showed >5.0 for HSV 1 IGG
The results showed <.90 for HSV 2 IGG

This week I am still experiencing intermittent cool, burning and tingling in my penis and scrotum and even an occasional coolness/tingle in my anus (embarrassed to say that). I am heterosexual so not sure why would be effecting that area. I was feeling good about the negative test result but the intense cool tingling down there all day (and most week), and my penis skin texture is just strangely wrinkled and scrotum red. And tonight, the area under side of shaft that had been having a recurrent patch of dry flaky skin 5+ times since possible exposure now had a very small white puss dot that I popped.

8 years ago I had a sexual encounter with a stripper and began experiencing similar tingling and red scrotum symptoms and I was diagnosed with Genital HSV 1 based on blood results and one time appearance of cluster of vesicles on my shaft. The first year I had redness and similar tingling but never had vesicles again. An for the last 8 years I have had no tingling and been symptom free.

So based on test results; and considering I took 1 gram of Valtrex twice daily during first 10 days, how likely am I in the clear of being HSV 2 free from my recent encounter? Could having Genital HSV1 effect antibody production for HSV2? Even though I already had Genital HSV1, could I have been exposed to Genital HSV1 again (different DNA strain) and be causing these symptoms? Or if this is a new primary would it have to be HSV2? I understand that once infected with HSV it has recurrence but I am quite sure based on the timing of this since my encounter and lack of any symptoms over last 8 years and now that I am having weekly issues for 7 weeks that this would be something new (not caused by original HSV1).

[Terri Warren]

Great that you continue to have negative HSV 2 results. Genital HSV 1 (which has never been confirmed, right?) would likely prevent you from getting HSV 1 genitally again, yes! And yes, those who have HSV 1 antibody already take slightly longer to make HSV 2 antibody. I think the few days of antiviral therapy that you took will not impact the time to antibody development, assuming you don’t take any more. Again, I seriously doubt that this is an HSV 2 infection! Nothing you have told me about your symptoms suggests to me that this is a new HSV 2 infection. And at 7 weeks past encounter, I think the odds are around 75-80% that you can believe the negative.

This is good news and I seriously hope that you can believe the good news and celebrate it instead of continuing to observe your genitals this closely for the next 9 weeks.

Terri

[tinglered]

I am doing my best to latch on to this good news latest blood test.

1) But, what about the very small white puss dot that I popped on my shaft just last night? This was located at the exact spot where I have been having a recurrent patch of dry skin since the encounter 7 weeks ago (which I have never had before). Where that tiny dot was the skin looks different; slightly pinker and maybe slightly raised (dot sized). My scrotum continues to be red (which is not normal) and the skin tighter looking, and the shaft skin all seems more wrinkled; it just is not my normal flesh colored relaxed group down there. I continue to have the burning and tingle through the whole genital region. The burning/tingling drives me crazy as I feel it at work; in the car, trying to relax at home and has been intermittent over last 7 weeks (not prior). It is a constant reminder that something is going on that was not happening before the encounter 7 weeks ago.

2) Also, I cannot wait another 9 weeks for the 16 week mark Herpeselect test. If I go in 3 weeks (at 10 weeks post exposure) would that get me towards 90% certainty of results?

Thank you again for your input

[Terri Warren]

I don’t have any specific research numbers about how certain a negative ELISA is at 10 weeks. But if it is also negative, that’s obviously a good thing – I just can’t give you a percentage.

The little white pimple is not how herpes looks. It looks more like a water blister. Men do get small pimples on their penis, I have seen it many many times, so it could just be that.

As for your unhappy group down there, I don’t have a great explanation but I think you are getting closer and closer to finding out that it is not caused by herpes.

Terri

[tinglered]

Many thanks again!

You said those who have HSV 1 antibody already take slightly longer to make HSV 2 antibody. Would there be any difference in the time of this HSV2 anitbody delay if it was previous HSV1 antibody from Genital HSV1 vs Oral HSV1?

Lastly, I have been hitting Lysine daily at approx. 3000mg per day and avoiding high arginine foods. Would this have any impact on delaying HSV2 IGG seroconversion?

[Terri Warren]

No, it doesn’t matter if the infection is oral or genital, as far as I know, though I don’t know of any research on that topic.
Lysine is not an effective treatment for herpes and would not impact time to seroconversion.

I believe this is our last question on this subscription.

Terri

[tinglered]

The Herpeselect test that I have done thus far does not give a specific numerical value for IGG. It only gives <.90. I see many other people posting specific values such as 0.22 and so forth.

Is there a specific Herpeselect test that my Dr needs to request in order to see this specific numerical value? I would like to be able to compare if this HSV2 IGG number increases between my future blood tests. Current test results say “HSV 1/2 IGG, type specific AB Herpeselect” and then it gives “HSV 2 IGG Type Specific AB” result as < .90 but no specific figure.

Also, another symptom I did not mention which has been happening intermittently since the 7 week ago encounter (and not before), is if I run my finger across the top of my shaft I will get a dry white dandruff looking streak of dead skin cells. It is not like skin peeling off but rather a dry white dust line. Is this a possible symptom? I have excellent hygiene and again this symptom only started 7 weeks ago. So that is just one more new issue along with all the others (tingle, burning, red scrotum, shaft skin looking more tight and wrinkled, etc.)

[Terri Warren]

Dry skin is not a symptom of herpes and I am not concerned about the dry white dust line that you are describing.

Some labs report out actual values of the IgG herpeselect, others just report out the <.90 which is what your lab did. Since the numbers really don't matter because they will vary according to the control that they are run against, I don't think you should be focused on those numbers, and you probably aren't going to get them anyway. You will just have to wait! Terri

[tinglered]

I am waiting for the 10-12 week mark for another Herpeselect test but the tingling and burning just continues to cause me alarm.

Is there another test that can detect HSV2 sooner (Western Blot??) and how can I go about getting this test (my physician is clueless)?

Would it be blood or swab (if swab I have no lesions so would the skin area that is tingling show virus?)?

[Terri Warren]

No, western blot picks up infection later than the type specific IgG, not earlier. You could ask that a swab be done from the area that is tingling. If you do that, I would recommend a PCR vs a culture

Terri

[tinglered]

How do I go about getting the PCR done? Even without actual lesions, I would like to try to swab the skin on my shaft that is dry,red,tingling.

I just went to a Urologist (since my primary said that was the next step as he could do nothing more) and the urologist said that they do not do PCR tests and really do not service STDs. So this was a wasted 2.5 hours of my time and a day further away from having a better grasp on this.

[Terri Warren]

You can contact our clinic, do a phone consultation with one of our clinicians and we will send PCR swabs with instructions if you wish.

Are we once again out of questions? I think so.

Terri

[tinglered]

I just paid for 3 more questions today so taking away my last question I now have 2 left. thx

[Terri Warren]

oh great, I couldn’t see that.

Yes, we could send you swabs with instructions about how to gather them at home and return to us. Then we would send them to the lab. If you could get this done locally, that would be fine too. The point is to have swabs at home to gather right away when you have concerning symptoms so you can capture that exact moment.

Terri

[tinglered]

Terri,

I found a post of yours on MedHelp (link at bottom of my post) where the ‘patient’ tested roughly 6 different times on Herpeselect for HSV2 IGG and it was not until Week 15 that they finally tested in positive range. This person on previous tests had an HSV2 IGG that ranged from approx. 0.35-0.52. You stated that Normally, the index values that you see for negative tests are quite low, 0.01 maybe up to 0.20.

1) My question and concern is that my Herpeselect test only told me that I am less than 0.90. So doesn’t this mean that I could be at 0.88 and progressing to positive?

2) I would like to know my specific IGG so that I can see if it is progressing higher. How are people getting these specific IGG readings? I have gone to Quest Diagnostics twice now for Herpeselect IGG and they are only providing the <0.90 range. Is there a specific Herpeselect test code that my DR needs to order? Or do I need to go to Labcorp?

http://www.medhelp.org/posts/Herpes/Been-tested-5-timesmany-questions-remain/show/1680368

[Terri Warren]

Just because they tested positive at week 15, it doesn’t necessarily mean that that is a true positive. Also, they may have taken antiviral therapy that impacted their seroconversion time. It’s really impossible to tell the exact truth from posts to I have given up trying.

If you want to know the exact index value of your negative, you should ask the lab directly for those numbers. If they won’t give it to you, you’ll have to go through the ordering provider. The test code is the same, it’s just that not all labs report out the exact value.

Terri

[tinglered]

I have had some additional concerning symptoms set-in over the last 5-7 days (now at 9 weeks post exposure).

Over the course of a 5-7 days I started to feel intermittent lower back pain (both sides but at different times), intermittent tingling cool rush on my inner thighs, similar intermittent muscle soreness/pain in my butt (both sides but at different times) and even a bit in my calf. One night after several beers I felt a prickly feeling between by scrotum and anus. The next day I could see two small cuts there which could have been tiny ulcers. I have not shaved there or anything to cause that and have never had that or any of these symptoms. This is in addition to the burning genitals and previously stated symptoms.

My question is would you say that with these additional symptoms that I am starting to appear more likely to have the ‘H’?
Could Genital HSV1 present with these symptoms or are the more indicative of Genital HSV2?
I read that Tagamet (Cimetidine) can help boost the immune system to fight H. Do you have an opinion on this?

[Terri Warren]

I think any time that there are breaks in the genital skin, one should consider herpes as an option. Ulcers can be associated with herpes yes. I would recommend that you get these ulcers swab tested for herpes right away. The longer they are present, the less virus will be available for testing. When you go for testing of the lesions, be certain that you ask for PCR testing, not culture. You may wish to call ahead and see if PCR can be done before you settle on a location to go for testing.

The information about Tagamet is pretty old news, way old news. Unless there is something new that has been worked on, I’m not thinking that is a good thing to treat herpes, no.

And yes, the symptoms of genital HSV 1 are the same as the symptoms of genital HSV 2, they just happen less often.

Terri

[tinglered]

Aside from the skin break; do these other new symptoms that I am experiencing follow H symptoms?

[Terri Warren]

No, not really, but that’s like asking “other than that, Mrs. Lincoln, how did you like the play?” I mean, lesions are the main thing we are focusing on with herpes and if you have a skin ulcer, you really really need to have it swab tested. Did you do that?

Terri

[tinglered]

Ok, I am back with this final question. I am finally at 16 weeks post exposure and have my HerpeSelect IGG HSV 2 results back. Results are posted below as well as Valtrex consumption during the 16 weeks. Questions are below the results.

Valtrex consumption:
10 Days 2 Grams per day (started day 1 post exposure)
7 Days 1 Gram per day (at 10 weeks post exposure)
1 Day 4 Grams per day (1 day at week 16)
So Total of 18 days out of 16 weeks

HerpeSelect IGG HSV 2 Test Results:
1.5 Weeks <.90 Negative
7 Weeks <.90 Negative
12 Weeks <.90 Negative
14 Weeks <.90 Negative
16 Weeks <.90 Negative

-Do my test results indicate a certain negative at this point or could Valtrex usage be effecting?
-Seeing that antivirals are a first line and really the only defense that most doctors prescribe; wouldn’t there be a fair share of patients in the seroconversion studies that were on antivirals and thus the effect of antivirals on seroconversion are already ‘baked into the numbers’ on seroconversion rates?
-If I were to take Western Blot; do I order through Quest Diagnostics and should I do now at the 16 week mark or wait until 5 month or 6 month or longer?

Thank you again!

[Terri Warren]

Of course the studies all include reports about antiviral use that’s that information is included in these numbers.
I really feel that you can count on this negative result at 16 weeks.
If you are going to take the western blot, I think anytime now would be fine. However, if you still have concerns about the antiviral use then wait a month or so.

Terri

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