HSV2 Equivocal, HSV1 Mixed results

[rsecond33]

Dear Terri,

Here is my history

Earliest known test: March 2014: Tested Negative for HSV1&2-IGG and IGM
didnt remember why i was tested for those

Throughout 2014 i was very risky: un-/protected oral/vaginal sex with worker/non-worker

Around end of 2014:
I received oral sex from my partner and few days later a blister above pubic area appear but healed very quickly (Herpes?)

Early 2015 i broke a condom with a worker and that was the last of it, been abstained since

(1 Month After last possible exposure)
HSV1 IGG: Positive
HSV2 IGM: Negative
i didnt know why the doctor ordered this combination of test
(This lab doesnt provide numbers, they said, to get the numbers, we need special permission)

(5 Weeks After Last Possible Exposure)
HSV2 IGG: 0.86 <0.80 Negative;0.8-1.09 Equivocal;>1.09 Positive
HSV2 IGM: 0.51
HSV1 IGG: 1.80
HSV1 IGM: 0.32

(2 Months)
Did another test because i was so worried reading about STI and HSV
HSV2 IGG: 1.09 (Equivocal)
HSV2 IGM: 0.75
HSV1 IGG: 0.75
HSV1 IGM: Not tested (I read IGM is useless)

Sometime after that test i develop a symptom
2 blisters above my pubic hairline again, not painful, not itchy, i strongly believed it was herpes based on what i read and saw on internet
i took valtrex daily of 500mg for 30 days

(3 Months)
Same lab as the March Test (Supposedly the better one, still not sure why they dont give out numbers though)

HSV2 IGG: Equivocal
HSV1 IGG: Positive

(6 Months)
HSV2 IGG: 0.97 (Another equivocal)
HSV2 IGM: 0.42
HSV1 IGG: 0.28
HSV1 IGM: 0.43

Now, my questions are:

1. Do you think i have HSV2?

2. I read that if enough time passed, equivocal eaquals to negative, but does it really apply to me knowing that i probably have
that one symptom, and that my HSV1 IGG are all over the place, also the fact that back in the beginning of 2014 it was all negative?

3. If anything i rather have a genital HSV1 than HSV2, i read that in certain place genital HSV1 can be very common,
in your professional experience, how common is it really? and is it really that easy to get hsv1 genitally knowing that their preference is orofacial?

4. I have a history of autoimmune, does this affect Antobody Test for HSV1/2?

5. Does taking valtrex (2months after) affect my result?

Note: i live outside of the US and have to access to Western Blot, after looking around there is HSV PCR but they said its not type specific

Thank You

[Terri Warren]

Even if the PCR is not type specific, I think you should have the blisters swabbed for sure. when you say blisters, can you describe what the looks like to you? Are they water blisters? Because herpes causes water blisters.

I don’t think the Valtrex for 30 days will have a huge impact, but it likely will have some. Are you still taking it?
HSV 1 is the cause of at least half of new genital herpes in the US and in Japan, cause the majority of genital herpes so yes, it is certainly infectious genitally.

I don’t know about your immune disorder and it’s impact on antibody development specifically but I can tell you that if you severely immunocompromised, you will not make antibody as effectively as someone who is not.

Terri

[rsecond33]

Well. I only found out after it was healed. Let me try to describe it, forgive my limited english. It appeared overnight above my pubic hairline, there was a red base of about 1 cm diameter. And 2 obvious blisters. Both are watery. It healed around 3 weeks. During the healing, the skin around it sort of peeled and dried over (maybe this is scabbing, not sure. Did not seem like scabs i saw on internet). It then left a permanent slight discoloration.

I stopped taking the valtrex already, so my last test was 3 months after the last valtrex and 6 months after the last possible exposure

So. What do you think i can do for closure/confirmation. Should i repeat igg at different lab?

[Terri Warren]

You aren’t where you can get a western blot, I assume?
Your description of the lesions does worry me some, I must be honest. The timing is very good for the test, yes.
You might try getting an IgG at a different lab, yes.

Terri

[rsecond33]

Dear Terri,

Yes, it made me worried too. the moment i woke up noticing that blisters, something tells me it was herpes. Ironically, it happens just as i started discovering about these things.

Anyway, did another test on another lab , got even more confusing.

HSV1 IGG: 0.21 (Negative) Negative is below 0.9 ; it says methode: microelisa
HSV2 IGG: 16.6 (Negative) Negative:<20 Borderline: 20-25 Positive:>25 (Unit is U/mL, methode: ELISA)
HSV2 IGM: 6,0 (Negative)

So, here s the question, assuming i have herpes (based on my description), is it possible that it is HSV1 and that somehow some of my HSV1 IGG tests missed it?

Also, what is the accuracy of HSV1 IGG test in general? How can it change from positive to negative?

If i happens to go to the US, are you allowed to perform WB test on foreigners?
With all these confusion, i started to doubt my country’s standard on these tests

Thanks

[Terri Warren]

Hmmm. Your lab is using a completely different test than one I am accustomed to seeing. But given the reference ranges, it appears you are negative, though creeping up. I don’t know the sensitivity of that particular test for HSV 1 or HSV 2 so I can’t really answer your question about it missing HSV 1.

Yes, if you come to the US, we can order western blots for anyone.

Terri

[Author]

Posts