This topic contains 21 replies, has 2 voices, and was last updated by Terri Warren 1 month, 3 weeks ago.
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This is way too many questions. I feel overwhelmed with all of these questions. Please summarize in a list for me
Terri
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I think you misunderstand how this forum works. You can have three total posts for $2o. You have 11. I will answer some of these and if you wish more answered, you can renew your subscription.
1. The false negative rate for HSV 2 is 8%
2. We do not have statistics on the transmission of HSV 1 via oral sex. 70% of those infected with HSV 1 do not know it so it is possible to be asymptomatic for HSV 1.
3. The chances are low that you became infected at the encounter with another woman, given what you described.
4. The IgM is useless. You can test at 6 weeks out and the result will give you 70% certainty of accuracy
5.LOng standing HSV 1 can slightly delay antibody development – I think 12 weeks is plenty of time for greatest accuracy
6. It is possible to have HSV 1 both orally and genitally.
7. It is possible for Bartholin cyst to drain yes. Herpes blisters are normally not filled with pus
9. No
10. Yes
11. Maybe
12. Antibiotics would not help with a herpes infection no, but lesions eventually do go away on their own. This does not sound like herpetic cervicitis
13. It does sound bacterial, yes
14. yes
15. That is possible and condoms would greatly reduce transmission
16. I would see no need to disclose that have HSV 1 genital infection when you don’t know if you do.This is your final post on this subscription. If you have more questions, feel free to renew.
Terri
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#1. Does the accuracy of the hsv1 result reflect the accuracy of the negative hsv2? I understand the false negative rate for hsv2 is 8% but is it less likely to be a false negative because the test correctly caught the hsv2? I guess my question is, if it caught one that has a higher false negative rate, wouldn’t it have caught the one with the lower false negative rate?
No, the tests are separate. You cannot make that connection.
#2. As I do not have any genital symptoms and tested negative well after 3 months (More like 6) is it safe to assume I don’t have hsv2?
It is safe with 92% certainty.
#3. Have you ever seen someone who has a negative hsv2 at 6 months post exposure, no symptoms, and then tested positive on the Western Blot? Or is that mainly for people with positive swab results and negative Elisa?
Yes, I have seen this – that’s how we know the test misses 8% of HSV 2 infection.
#4. In your opinion, is it very likely I have both oral and genital hsv1?
I think is more likely that you only have HSV 1 orally but cannot be certain.
#5. I am also concerned about possibly asymptomsticslly infecting someone and that resulting in neonatal herpes in the future for their partners. Is this something I should dwell on?
No!
I think I answered all your question, but let me know what is left. I’m still only seeing $20 in payment but will look into it further.
Terri
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#1. I understand you said that many of those infected with HSV1 are asymptomatic and so do not get a primary outbreak but I have also read that it is more common that not that a new genital HSV1 infection results in a primary outbreak. What is your expert opinion on this information?
I would agree that more primaries with HSV 1 are symptomatic than first episode infections with HSV 2 in a person with prior HSV 1
#2. And, just to clarify, you’re saying it’s possible that I contracted HSV1 orally as a child (my parents both have it) and only get a recurrence as an adolescent/young adult? Do you see this often? Is it common to have an antibody count of 20plus and only been infected several years prior?
yes, that is possible and I certainly have seen it. and yes, that number could easily represent an old infection
#3. Is it common for someone to have contracted both HSV1 orally and genitally at the same time, or autoinnoculated, shown initial symptoms for only one location, and then had a HSv1 reoccurence later in a different location?
That is possible and pretty common.
#4. Is it more common to be a symptomatic HSV1 oral carrier than an asymptomatic one?
More common to be asymptomatic
#5. I have read that ELISA testing has a 97% sensitivity and a 98% specificity for HSV2. How does this relate to the 92% accuracy of the HSV2 negative result you mentioned? I think I am missing something.
Those number are comparing apples and oranges. In the sensitivity reported by lab kit makers, they are comparing the sensitivity of their test to people who are know to have positive swab tests for herpes. Our study, with the other numbers, is in a screening population – very different.
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#6. Does this 8% reflect both those who have and those who have not had recognizable herpes genital symptoms? Or do they account for only asymptomatic HSV2 carriers with false negatives?
Both
#7. Why exactly is it that false-negatives occur?
We don’t know – some sort of test issue as the western blot has picked up those infections
#8. Does it have to do with the specific individual’s immune response or is the fallibility of the test itself?
The test
#9. What would a herpetic case of cervicitis look like?
ulcerations on the cervix
#10. Does a prior, long-standing HSV1 infection affect the seropositivity and accurate and timely detection of HSV2 antibodies in an IGG blood test?
Prior HSV 1 can slightly slow the development of HSV 2 – perhaps by a few weeks.
You have posted 15 times and paid for 9. You owe $40.
Terri
- This reply was modified 1 month, 3 weeks ago by Terri Warren.
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#1. Is it more likely that this first recognized oral outbreak, given how mild and with the absence of flu like symptoms, was a reoccurrence rather than a primary outbreak? Could it possibly have had something to do with a weakening of the immune system? Do most children that get infected have primary outbreaks? Or do they usually present symptoms later in life? Is there anyway to know?
There is no way to know from an outbreak whether it is a primary outbreak or not unless that person has a positive swab test and a negative antibody test when first symptoms present. Many children with primary infections have no symptoms at all
#2. If someone was to get infected with HSV1 through direct contact with an active lesion, are they more likely to have a primary outbreak than someone who was infected via viral shedding during an asymptomatic episode? Does contact with a lesion ensure infection?
No, similar amounts of virus or should during symptomatic and asymptomatic episodes. Contact the lesion does not result in 100% transmission.
#3. And so anyone that has a known case of oral HSV1, unless they have not received oral sex, and even then, may also have a concurrent genital HSV1 as well?
If a person has not received oral sex than they are extremely unlikely to have genital type
#4. And if the false negatives for HSV2 are due to the fallibility of the test itself, and not the biology and immune response of the individual, why wouldn’t retesting with a new IGG provide a greater chance at picking up the antibody?
It is possible of the different brand of test might pick up an infection when the previous brand has not picked it up though I have seen people who have their HSV-2 infection missed by two different laboratories but positive by the Western blot
#5. Additionally, in your experience, does retesting with the IGG ELISA at a later date, perhaps giving the antibodies more time to develop, result in a decreased chance of false negative?
This would be true only was suspected new infection
#6. I guess I am just wondering why the test would consistently miss an infection in a specific person if it has nothing to do with the biological disposition of the specific individual. Are people with a positive HSV1 more likely to have a false negative for HSV2 even after more than 6 months post potential exposure?
We do not have that data
#7. How common is neonatal herpes? Why don’t doctors test both partners for HSV 1 and 2 if HSV is so common?
Neonatal herpes is not a reportable infection in the United States. It is difficult to know the prevalence but it is estimated between 1500 and 2500 cases per year
Terri
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