Indeterminate result – no index value given by lab – Immunoblot IgG – Had Covid

[Ottawa Male 35]

Hi Terri, I’ve only had 1 partner in life (virgin until now), 1 time I performed oral on her, 1 time I had unprotected sex with her (same 24 hours). Kissed 2-3 times a few weeks earlier but nothing popped up until the former encounter. She’s untested but has had many partners. No visible lesions. I tested negative for standard panel but had 3 individual blisters (left, right, middle) accross bottom lip within days (painless, scabless as they arose where the “dry” part meets the “wet” part). Got them swabbed, lab lost the sample after waiting 7 weeks. Was prescribed antivirals “just in case” at time of culture swab and took them. Blisters gone within 10 days (at time of exposure, I had spent the weekend in direct sun, drinking, max sun exposure but I always do and have never had a blister on my lips before, my Dr. thinks maybe “sunblisters” but admits he knows nothing about HSV). When I learned my sample was lost without result (at 7 weeks), I drew blood for Immunoblot IgG (1&2). Both Indeterminate, the lab (Dynacare) “has no index number value for this kind of test”. Results suggest retest in 4-6 weeks. I hope to convince partner to test too.
Question: Is 7 weeks typically enough time for detectable antibodies? Would taking anti-virals affect that (I took the 10 day prescription – acyclovir or famcyclovir, can’t recall). I also developed extreme pain from what I later learned was an abcessed molar 2 days after encounter (day or two before blisters arrived). Can HSV trigger a molar abcess/attack a dying tooth nerve that’s exposed? The abcess caused ear & tooth route infection so 3 rounds of Amoxicillan and 7 weeks later I drew blood for this IgG…can that mess with results at all? I also had brutal Covid-19 that whole time from days after encounter for 3-4 weeks – you can’t make this up.

Does “Indeterminate” without index value from lab mean anything concrete for Immunoblot IgG? That is, is there a solid index range for that result or is it lab-specific?
Thanks

[Ottawa Male 35]

Hi again Terri, I just wanted to attempt to sumarise my above questions, I’m thinking I may not have been clear enough to ellicit a response.

Symptoms: three individual blisters of varied sizes on the left,right & middle of bottom lip where wet meets dry (right on the line), brutal tooth pain (an abcessed molar daignosed days later, became badly infected within 1 day of exposure, a full 2 days before any blisters showed up. Swollen lymphnode in jaw on left side only (abcessed molar side), ear infection (same side).

Timing: Blisters arrived 3 days after “exposure” (performed oral for <1 min., , kissing)….same day extreme direct sun exposure, alcohol, lack of sleep that night….I am very tan but my lips don’t usually see that much sun so Dr. says sun blisters or herpes. To note, we also had unprotected sex in shower same day.

Full STD panel, all negative.
Dr. swabbed lip blisters and sent sample, waited 7 weeks for results but the lab “lost” them, at time of swab I was prescribed antivirals (acyclovir?) just in case. began them immidiately (was also taking ammoxicillan and naproxen for abcessed molar for most of those 7 weeks (3 rounds of anti-biotcs)

During that same 7 weeks, no known penis symptoms, terrible Covid-19 symptoms and diagnosis. Immune system critical until about week 5 or 6 (covid hit me 4 days after exposure)

So at 7 weeks, next step was Immunoblot IgG, came back “Indeterminate hsv 1 & 2” without any number index range value given. The kicker? very mild looking, tiny reddish bumps, micro-sores? I don’t know, something I don’t recall seeing, on my glans around week 6…

Q: Is 7 weeks enough time? Indeterminate at 2 months seems right on time for a true positive at 3 or 6, right?

Do Indeterminates at 2 months normally go positive at a 3-6 month retest? Experts tend to claim this is often so.

What is the index range I’m looking for for an Indeterminate? I’m following up with the lab who did not provide any numbers with my result.

Thank you!

[Terri Warren]

seven weeks is not quite enough time, no, and the IgG test misses 30% of HSV 1 infections, compared to the gold standard western blot
If you get the lip lesions again, go right in to be tested.

Has your partner had an antibody test?

I would recommend that you retest in about 5 weeks and see what you get. Maybe people who test indeterminate stay that way forever. it does not necessarily mean you are on the way to positive though you could be.

well, in the US, the equivocal range is 0.9 to 1.09

Terri

[Ottawa Male 35]

Thank you so much for your reply Terri. You are basically the sole expert on hsv and I’m grateful. Your opinion comes as much expected. Given the lip blisters and indeterminate result at 7 weeks, I imagine I’m almost certainly positive, question is 1 or 2 or both (mouth only or penis as well, despite the fact that no antibody test can discern).

My partner won’t get tested, she’s a terrible person, This is my burden alone.

As symptoms vary from nothing to awful for hsv (most people have nothing) I’m curious about the tiny red bumps on my glans (appeared 6 weeks after the lip blisters healed..I think?) which I THINK are new..never noticed before..do not “get better” or “get worse” or change at all over a month plus. They are noticable in some light, less pronounced in others (especially when erect, but even then almost non-existent, not raised, 1/16″ in size, 2 or 3 of them. They are identical to the ‘papules’ I’ve always had…I just don’t recall them being where they are but my mind is a disaster so who knows). If they are herpes, how long should they last? I expect they CAN remain permanently or for a year plus (literally anything’s possible, everyone’s different with hsv, nothing “isn’t herpes” based on looks and duration, I know).

Can I get a WB from Ottawa, Canada? I’m very interested in the exact process and willing & ready.

Have you often seen indeterminate IgG’s done within 3 months go positive at the 3-6 month mark? I know, difficult to predict, just seeking a sense, I’m basically sure I have it.

Ever heard of a primary HSV infection causing a tooth abscess infection in a vulnerable (already cracked) molar or tooth? Seems to me the virus would cause that bacterial infection that I had by attacking the exposed tooth route nerve, resulting in it’s decay, death and then bacterial infection…the pain began 2 days after exposure and about 3 days prior to lip blisters. It can’t possibly be a coincidence, even given the weekend of sun & booze.
Thank you.

[Terri Warren]

The things on your penis don’t sound herpetic to me.
I don’t recall seeing an equivocal going to any substantive positive but it likely has happened at some point. Most equivocal results stay equivocal or venture into the very low positive range.
Herpes does not cause a tooth infection. nope. That would likely be bacterial, not viral.

If you can find someone in Ottowa to draw your blood or you can fly to the states, we can get the blot done.

You are way more certain you have this than I am!

Terri

[Ottawa Male 35]

I see, thank you so much for your opinion. I can’t imagine what the three big blisters on my lower lip were if not herpes, and the little micro bumps/pimples on my glans..never had anything like that before in my life and now here they are, weeks after an encounter with an untested likely carrier. What is the “probability percentage” of a man contracting HSV 1 & 2 from a positive female showing no visible symptoms? The web says things like “8-10% chance within a year of sleeping with them” which, cannot possibly be right given that a chance encounter would then have a transmissibility likelihood in the 0.005- range or so…sounds like poor study in determining such results, which is of course easy to understand given the natire of HSV. How would they study something most people have/will contract in life that usually doesn’t even show itself in patients? The 8-10% thing just sounds insane really given that most people will have HSV by 40…it must be well more contageous than science really yet knows or has “proven”, just such low figures for what is by-far the most commonly transmitted sti, and the one most don’t know they have because symptoms are less likely than an asymptomatice HSV infection. Also the least widely tested sti on top of that, as it is not recommended to get tests by the CDC or WHO unless you have symptoms which science tells us, the vast majority do not ever experience. Herpes symptoms are so vague, most positive people apparently have none, or mild ones that don’t burst or scab..makes diagnosis almost not possible without the wb I guess. I’ll just have to wait and retake an IgG in a couple months then fly to the states for a wb I suppose. When you say moat equivicals stay that way or go low positive you do mean positive for herpes, correct? That is, is a ‘low positive’ more likely to be false than a high one?

Thank you so, so much Terri, it is hard to accept that HSV has so much misinformation and ingnorance from the medical world.

[Terri Warren]

I can’t address the HSV 1 part of your questions, but between regular partners (not new partners), the transmission rate of HSV 2 from a female to male is about 4%, given sex twice per week with no condoms, no antiviral meds.

If I were you, I would assume nothing in terms of infection at this point. Your labs are all too vague. If you were my patient, I would recommend that you wait 12 weeks from any exposure to this particular partner (or any partner) and do the western blot. It can be done for Canadians but easier to come to the US for the blot.

Terri

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