Kinda confused and freaking out

[Mattinhere]

Hi Terri – hope you are feeling better.

Here’s my question: Given what I write below – in your opinion and experience – what are the chances this is false negative?

Situation:

49yo Male. 50/50 European and Ashkenazi.
HSV1 positive since childhood – never symptoms.
HSV2 always negative – but last checked about 10 years ago
I do take an immunosuppresent for skin issues (yes on genitals) – but no open sores
100% protected sex. Always (maybe not oral). With Females only. 2-3 year.

Results:

Potential exposure due to shaving nicks on scortum. at 5 weeks post exposure – test returned from labcorp as this:

HSV2 IGG: 4.08
HSV Supplemental: Negative
(all other STI negative)

I ve had a cold (but everyone around had a cold) which started about 2 weeks after exposure – and lingering tonsil pain for about 4 weeks since. CBC normal (few on fringe).

Zero Outbreaks. Random shooting tip of penis pains (but been going on for a few months)

Oh, and im losing weight because of the anxiety.

From all of my research to date:
* You say Labcorps supplemental is Biokit
* You say Biokit and has problems with false positive too. yet generally aligns with WB when Negative.
* and the kicker – Labcorps low positive range is <5 (which is very strange given everything everyone says that >3.5 index is positive an rarely negative…

Finally. – The HSV2 Test window 4-6 weeks – confirm at 12 which I will (hopefully blot) – I know I tested at 5. IGG showed antibodies, but again Biokit didnt. I know I should get a blot – but I live in NY and as you well know- its a huge challenge to do so. I will get it through travel to another state when that time comes.

Question again:

So what say you? in your experience. Negative supplemental and be confident with and move on – which is what I was told by STDCheck? or more than likely positive and prepare yourself emotionally when you get the blot.

Thanks for this valuable service.

[Terri Warren]

I would debate that it’s difficult to get the blot in NY – we do it all the time. But there really is good agreement between a negative supplemental test and a negative western blot, in my experience. If you want me to help, I’m ready to help you.

Terri

[Mattinhere]

Thank you. A quick follow up-

1) what is the likelihood that with a 4 hsv-2 igg with a negative supplement confirms negative on blot? You said 80% people with 2?

2) does the supplement have a different window period for detection. Could this be an early infection?

3) could a 4 be the results of prior HSV-1 or run down immunity or some other influence?

4) any idea why labcorps cut off at 5 when the rest of the world uses 3.5?

5) is shooting pain in tip with outbreak a symptom? Can intermittent sharp stabbing pain be a indication?

Thanks.

[Mattinhere]

Sorry typo:

5)is shooting pain WITHOUT outbreak an symptom. Intermittent stabbing.

[Terri Warren]

1) what is the likelihood that with a 4 hsv-2 igg with a negative supplement confirms negative on blot? You said 80% people with 2?
There is quite good agreement between a negative supplemental test and a negative western blot.

2) does the supplement have a different window period for detection. Could this be an early infection?
It doesn’t

3) could a 4 be the results of prior HSV-1 or run down immunity or some other influence?
If truly negative, it is the result of a non-specific protein being present in the blood that is erroneously tripping the test.

4) any idea why labcorps cut off at 5 when the rest of the world uses 3.5?
Some data suggests that that is a more accurate place to make the cut. In my experience, that is true.

5) is shooting pain in tip with outbreak a symptom? Can intermittent sharp stabbing pain be a indication?
It could be but it could be other nerve things as well unrelated as well

Terri

[Mattinhere]

Thank you again. My last follow up as i am mental right now..

1) Given the above – Should I just get used to feeling comfortable with the negative supplement (even with the 4 IGG) as indicative of negative HSV2?

2) Would you recommend retesting again with Labcorp reflex – like the test suggested (2-4 weeks later) or take some other like Immunoblot? or be comfortable per above? i know the blot is the standard – but for various reasons its a challenge to do it which i cant share publicly maybe in the future…

3) finally how common is intermittent mild dysuria as a symptom? nothing else (eg lymph nodes, systemic symptoms etc) (FWIW i was diagnosed with mild prostitis last year)

Thank again.

[Terri Warren]

1) Given the above – Should I just get used to feeling comfortable with the negative supplement (even with the 4 IGG) as indicative of negative HSV2?
I think a negative is likely on the blot but given the relatively high index values, I would definitely confirm with the blot

2) Would you recommend retesting again with Labcorp reflex – like the test suggested (2-4 weeks later) or take some other like Immunoblot? or be comfortable per above? i know the blot is the standard – but for various reasons its a challenge to do it which i cant share publicly maybe in the future…
I certainly would NOT suggest that – it will almost certainly be positive

3) finally how common is intermittent mild dysuria as a symptom? nothing else (eg lymph nodes, systemic symptoms etc) (FWIW i was diagnosed with mild prostitis last year)

Mild dysuria intermittently is likely not related to HSV without any sores at the same time.

Terri

• This reply was modified 9 months, 2 weeks ago by Terri Warren.

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