How to time a WB test?

[angrynfrustrated]

Hi, 2 and a half months ago, I had oral sex.For a few weeks I had had some itching and a week after the sex, I took fluconazole thinking I had a yeast infection (common for me). However, about two weeks after the encounter I had a single bump/blister on my left inner labia minora and bad flu-like symptoms. Within a day of the blister and 18 days after the encounter (no other sexual encounters otherwise), I saw an OBGYN who suspected HSV, did a blood test and swab culture of the blister, and put me on 10 days of valtrex. All tests came back negative (no specific index #s to report).3 days after the 2nd 10 day dose ended, I started having itching, pins and needle feelings or other odd feelings (sometimes feeling like I was sitting on a rock) near my left labia as well as neuralgia-like pain/weakness down my left leg. I immediately went back on 1g 2x/day valtrex doses for 10 days and saw an infectious disease specialist 2 days after symptoms returned (33 days post-sex). He swabbed (no visible blisters but some localized pain on my left vulva vestibule), did blood and urine tests which still came back negative. They suspected I was still having a primary outbreak and it was just long. This week, I had a blood and swab test at an annual OBGYN appt (48 days post-sex) and the results are still negative. Because of how bad my neuralgia-like and itching symptoms were, I have stayed on the valtrex at 500g/day to avoid any symptoms and for my distressed mental health.Doctors say I should come off valtrex when I’m ready and wait to see if my symptoms return. My partner had no history of HSV and is waiting for his test results. I want to do a WB.

Does being on valtrex affect WB results? If yes, how long should I be off it before I have my blood drawn for the WB test? Should I wait a certain time period from suspected exposure to have the WB test? What are transmission rates for HSV positive women to HSV negative men for both HSV 1 and 2 (w/ and w/o suppressive therapy)? Thanks

[Terri Warren]

Absolutely the Valtrex can impact your western blot results. It’s too bad that you took them for so long as it will postpone you ability to get an accurate antibody test OR to have an outbreak that can be swab tested. I would wait at least two months to get a western blot – three off medicine would be better.
Without suppression on condoms, the transmission rates for HSV 2 infected females to uninfected males is about 4% – antivirals reduce the risk by half – condoms take the risk down to around 1-2%. We don’t have transmission numbers for HSV 1.

Terri

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