Equivocal hsv2 test

[Mlisa]

Hi Terri,
I was separated from my husband & had unprotected sex with a man I recently met. The last sexual contact we had was on May 11, 2015. We used a condom once but did not the two other times we had sex on that day. Early June I went to my Gyno for my annual pap & mentioned to him that I had intermittent burning during urination. He suggested treatment for a yeast infection which I did take. I did reunite with my husband in the meantime & noticed every now & then after sex I would burn during urination. Then early July the burning started to be a constant problem. My dr prescribed Cipro & bactrim which neither helped. I decided to have a full STD panel done. My 1st I had July 6th (8 weeks past exposure) the test came back HSV1 5.5 & HSV2 1.03. Went to my Gyno who I found out knows nothing about herpes and he sent me for a second test on July 20th (10 weeks past exposure) HSV1 was still high >5 & HSV2 was .98 The man I was with supposedly got tested & is negative but I didn’t physically see his results. Although my husband says he wasn’t with anyone during the separation, he did get tested & is negative. Both tests were herpselect igg tests. I’m wondering if I should have another igg test done since it’s now 14 weeks past exposure or should I do the wester blot test? In the meantime I did see a urologist who did a cystoscope, didn’t notice anything unusual. He sent me for a Pelvic MRI and urinalysis with microscope & sensitivity. I have not received those results yet. I’m just concerned that I do have HSV2 & it’s possibly in my urethra? I have not noticed any outbreaks anywhere else on my body except a cold sore on my lip, probably because of stress ( which I knew I had HSV1 since childhood) Thank you in advance for your reply!

[Terri Warren]

Your HSV 2 antibody test index value is hovering around the positive cutoff, though is not positive. Almost enough time has passed since the sexual encounter for an accurate results – I love 16 weeks but without any antiviral medicine, now is very close and might be fine. Setting up the western blot takes about a week from the time we talk so at that point, I think you’ll be right at the appropriate time. If you want the most reassurance this is it.

You don’t mention your age – could you be premenopausal? Do you have any vaginal dryness that could be causing these symptoms?

Terri

[Mlisa]

Terri,
I had a hysterectomy about 10 years ago, I am now 44 so I would definitely say I’m premenopausal. I do get hot flashes now & then. I do not have vaginal dryness at all though. Would you suggest another igg test in the meantime? Did I do that test to early the first two times? I forgot to mention that it seems my irritation was mostly when we used a flavored warming lube. Although since my husband & I haven’t had sex in well over a month now the irritation is still there but not as intense. I did call this past Monday directly to the University of Washington to order a western blot kit. I was told by them my high HSV1 is what is probably making my HsV2 equivocal but I pressed the issue that I still wanted a western blot kit, which they were happy to send me.

[Terri Warren]

OK, sounds good. I would not suggest another IgG test in the meanwhile, no, I think you will likely get the same result.
We used to think that the HSV 1 result influenced the HSV 2 result, but recent research has not confirmed that relationship.

Terri

[Mlisa]

I went for another igg test last Friday waiting on the results. I live in pa so I guess you would have to order the western blot test for me in Jew jersey? I did get the western blot kit in the mail Saturday. If my igg comes back equivocal or negative this time I’m going to put this to rest. I spoke with my previous partner and he has reassured me that he is definitely negative! I’m read that a lot of western blot tests are coming back indeterminate as well which would be very frustrating after spending over $300 to get a solid answer. Please advise.

[Mlisa]

Oh & I made a mistake on my results from my original post
1st igg (8weeks) past exposure was hsv1 >5, HSV2 1.03. Second igg test (10 weeks) past exposure was hsv1>5, HSV2 .94
Not sure if those numbers make much of a difference but wanted to report them correctly. My MRI came in ruptured hemoragic cyst, bladder retention. Urinalysis came back urine clear, no white or red blood cells but did find blood in urine.

[Terri Warren]

In people who have low positive or equivocal results on their screening test do a western blot, it can be indeterminate, true. But we don’t see it happen that often – maybe one out of 10 times. Can UW bill your insurance for this test if you do it directly?

Terri

[Author]

Posts