Initial 1.06 equivocal result and now 1.09 equivocal result.. help! :(

[worrywart25]

Hi Terri,

I am very worried (as everyone else here, haha). I recently got tested with a regular check up visit with my PCP, on April 18. I wasn’t thinking much of it because I know I’ve had generally safe sex recently.

Here’s the background:

I was with the same person for 5 years until last September. Both of us were STD/STI free. I admittedly had a promiscuous streak in recent passing months. I had a new partner after the breakup, back in October/November. It was unprotected but we shared test results upon our first meeting. So that was fine. I received 2 more STI/STD screenings during that blip of time, one in November and once in January, both panels coming up 100% negative. I proceeded to have a total of 3 new partners: one in January (one time only + protected with male condom), one in February (1st encounter protected, 2nd encounter unprotected). I naively was under the impression that he had a fresh results, but he didn’t show me, yet I showed him mine from January. I have to also mention, after that encounter, I do remember getting a yeast infection kind of situation. But the irritation went away with 3-day Monistat so I figured I was good. The 3rd partner was a one-night stand while on an extended international vacation (protected, but I think we still kinda rubbed crotches). And I have since rekindled with my ex—boyfriend, about a week after coming home from the trip. All sex with him has been unprotected but I have confidence that he has not been with anyone else.

Fast forward to my current HSV-2 results. I got a 1.06 equivocal result for a test taken on April 18 & out of panic, I visited urgent care this past Monday. I woke up to the equivocal result of 1.09 (it went UP!).

It’s closer to positive and it’s making me nervous because I am worried not only am I infected, but I’m worried if my ex-boyfriend is infected.

When you’re able, please let me know what my next steps should be. (Also note, I’m asking my PCP for an inhibition test.)

[worrywart25]

I also want to mention:

My ex-boyfriend has HSV-1 but doesn’t do anything orally when a break out is occurring, not even regular kisses. Also, I haven’t had any symptoms of anything. I recognize that I had a period of itchiness after the January partner and February partners but I figured it was due to irritation from the condom used because I never used that type before. I felt validated in that opinion because I didn’t have irritation from the international partner, who provided a different branded condom.

My ex-boyfriend and I, however, recently suffered friction burn from sex and now I’m concerned that it wasn’t friction burn because never in our 5 years together have we had that type of irritation happen. I was quite dry and it stopped after introducing lube so I figured it was fine. But now I worry it was an initial outbreak for both of us. I’ve never ever had a reading on an HSV-2 test and I’m just so scared.

Please let me know what my next steps should be, if you’re able. Should I be worried since I have 2 results that equivocal? Or should I keep an eye on it since my equivocal result increased?

I also want to mention I had unusual CBC readings, too. Very low WBC (2.5), low neutrophils (1028) & high hemoglobin and hematocrit. Do you think this effected the test or just further supports the presence of HSV-2? Please let me know.

I’m sorry for such long questions!

[Terri Warren]

Most equivocal test results stay equivocal or move into the very low positive range. you could try testing again in about 3 weeks, but since you are close to 12 weeks out from any of the encounters with people other than your ex boyfriend, I doubt things will change much. They can’t do an inhibition assay on a test with an equivocal result.

Terri

[worrywart25]

Thank you so much for responding!

But okay, I understand. So I would be stuck with having a Western Blot as my only option to ensure there’s zero actual infection? I’m still worried that there’s the slight chance of this being early infection & I just want to ensure the IGG tests were wrong (plus I’m terrified that I might have infected my ex). Also, I visited my PCP today & she said she’s sure I’m negative since I had 2 equivocal results but she also noticed that I have remaining tonsillitis from my last visit 2-3 weeks ago (but there’s no pain or sore throat or anything this time) & my lymph nodes are still a little swollen. Is non-painful, prolonged tonsillitis typically a symptom of hsv2? Everything new thing in my body is worrying me.

I also would like to know: Are there no other tests to use, if I can’t presently afford the Western Blot? Since an inhibition test might be rendered useless? I tried to look through the forum but I think I might have missed the answer.

Thank you again for all your help & expertise. You’re an amazing woman for helping everyone who comes to this forum panicking, haha

[Terri Warren]

If LabCorp still had the Biokit available as a supplemental test, I would trust that, but only if negative.
I would agree with your doctor that HSV 2 infection is very unlikely here. I’ve only had a couple people with an equivocal result on the IgG test, test positive on the western blot. If you think this could be a new infection, then redo the IgG test in a month or so and see where it goes, if anywhere. That will help guide you as to what to do next.

Terri

[worrywart25]

Okay, I got it. Thank you so much! I genuinely appreciate your help and professional advice. I’ll just keep note of these tests & try again in about a month. I have a follow up appointment in 2 weeks & I’ll just go from there. Thanks again!

[Terri Warren]

You’re welcome

Terri

[worrywart25]

Hi Terri, I realized I had one more question to ask (and maybe it’s unnecessary to ask but I just was wondering if it would make a difference?). So based off of how things are going: I presume I’ve been infected from regular male-condom protected sex on March 19, due to the foreplay involved a bit of dry humping and our crotches touched during intercourse (I apologize for the TMI). I got tested on April 18, it was an IGG test with equivocal results (1.06). Took another at urgent care on May 1st, it was 1.09. But I didn’t update you and tell you that I had my doctor do an inhibition test anyway on May 4. That result was STILL equivocal, at the value of 1.02.

I just wanted to provide that quick background. I still don’t have symptoms. I suspect that previous case of friction burn (once on like, April 7 and the other incidence on April 16). But there’s been nothing else. Just some swollen painless tonsils. I had a sore throat w/ some mucus & mild coughing for a bit around the week I first got tested, but it went away within like a week & some change. I’ve been getting tons of colds the past few months so it’s hard to know if it’s nothing tooooo unusual, but I’m assuming it isn’t.

Anyway, I will be seeing my doctor on Tuesday, May 30, for an additional follow up test (it’ll be 10 weeks post potential exposure at that point). But I was just wondering if you think an equivocal inhibition IGG assay result (at 6-ish weeks post potential exposure) means anything? I’ve been thinking I’m fine but recently I’ve been admittedly feeling anxious again. I understand you get tons of questions a day so just when you can, will you let me know?

Thanks!

[Terri Warren]

well, I think that IA test with an equivocal result SUGGESTS that you are negative. I’ve not seen one equivocal before, honestly. I would guess that you are negative, but I still think the western blot could help you though it could be indeterminate as well.

Terri

[worrywart25]

Okay, gotcha. Thank you! And yeah, I keep trying to google Equivocal Inhibition Results & it doesn’t seem to be common, I guess. But it’s a good sign, too, I hope.

I’m thinking I’m fine, but I will just find out after next week’s appointment for sure. Plus, after many, many headaches, the partner who may have infected me is finally cooperating. He is hellbent on telling me that he was not ever infected, so maybe he’s being honest.

Nonetheless, I appreciate your expertise & your input! I’m on a path to believe I’m negative, so we’ll see. Fingers crossed!

[Terri Warren]

So the inhibition assay gives a percentage as a result. It probably wouldn’t be equivocal. I hope you can either move on from this equivocal result OR work with your own health care provider or me to get the western blot if you are still worried.

Terri

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