Low positive

[Cat0711]

Last year I went to doctor for a bump in my genital area that seemed to linger longer than a normal hair bump. Dr said it looked like an infected hair bump and nothing to be concerned about and prescribed bacterim cream and cleared it up literally within 24 hours. While the dr assured me it was fine I disclosed about a previous assault to doctor that had happened 10 years plus previously in college and it just worried me due to the incident. She said we could do a blood test just to confirm it was nothing. Unfortunately the blood test came back positive for hsv2 (1.25) and negative for hsv1. The dr was shocked as was I because I have a high stress life (special needs/medically fragile child) and to my knowledge I have never had an outbreak. I have been in a monogamous relationship for 10 years so this would not be a new infection. The doctor completed an additional test and the numbers came back a little higher 1.4 and then an assay test which was also positive. The dr stated that I was for sure positive if the assay was positive. I’m curious if this is accurate information because everything I have read states anything below 3.5 could be questionable. My husband has not been tested as he was not sexually active before me and he doesn’t care either way but he has never had an outbreak or symptoms either. I’m curious if this is an old infection would the numbers be higher than the 1.25? I currently take an antiviral daily now, how long do I need to be off antivirals if I do the western blot. I’m scared I passed this to my medically fragile child who I cath daily since I was unaware previously of being infected. If the Assay was positive should I still get western blot. If husband is tested and is negative can I assume I’m negative too? We have been married for over 10 years. Can an outbreak be a single bump in the genital area? Or could this be something else. I was negative for all other STDs to my knowledge.

[Terri Warren]

While an outbreak can be a single bump in the genital area, with an index value of 1.4, the CDC says you need a confirmatory test and the best one is the herpes western blot. You need that. If the index value is between 1.1 to 1.5, the chance of a false positive is 85%. Since your husband is negative, I feel the odds are very much in your favor that this is a false positive. What lab did your testing, please?

Terri

[Cat0711]

The test was performed through Quest. My husband hasn’t been tested. Before completing the western blot should I have him tested and then if he is showing positive as well then to just assume that those results are accurate? Since I take a daily antiviral, how long do I need to be off the antiviral before I take western blot? What do I need to do to get the western blot? Should I be concerned that I passed this to my children?

[Terri Warren]

So you are saying you’ve been taking antiviral medicine since last year, every day? The thing is, we only worry about the taking of antiviral medication when it is started immediately after someone is diagnosed visually with a new infection. If you’ve not been with anyone sexually except your husband for several years prior to this bump, then a new infection isn’t possible for you so the medicine daily won’t make a difference.

If your husband was a virgin when you got married, and has had no other partners besides you, then you didn’t get HSV 2 from him.

I am going to be completely honest with you. This has been mishandled. The CDC is very clear that anyone who obtains an index value between 1.1 and 3.5 needs a confirmatory test, not another IgG test. And someone with an index value of 1.4 has an 85% chance of having a false positive on the IgG. And both of your index values were well below 3.5, obviously. And given your sexual history, this made no sense. I suspect that you have been living with this error and this fear for a year. And I’m so sad for you because it sounds like you’ve had so much else on your plate. Now if there is an 85% chance that this is a false positive, that means there is also a 15% chance you are actually infected so I can’t say with 100% certainty that you are not infected with HSV 2. But really, I think it is so unlikely for so many reasons. You could have your husband get an IgG test, yes, but I’m betting he will be negative. So you are left with still getting the western blot. Your call of course.

Terri

[Cat0711]

Yes this would not be a new infection. I’ve been concerned that this has been an underlying issue due to no symptoms since the assault which was before my husband and I were married. My husband doesn’t care either way, which I’m thankful for, but he has agreed to get the Igg test as well. I would still prefer to get the western blot test regardless to confirm if I’m truly positive or not. How do I go about obtaining that through you or my doctor? She doesn’t seem knowledgeable about it and feels that due to the positive inhibition assay test that I am truly positive. I have been taking daily antivirals since my diagnosis last year. How long do I need to not take them before getting the western blot?

[Terri Warren]

I can help you obtain the blot but your doctor can too. You would order the kit from UW at 206-685-6066, then take the kit to your doctor and they would fill out the lab req, draw and spin your blood, and ship it off. If that doesn’t work out for you, I can do it.
Because this would not be new infection, you do not need to wait to take the blot. Please see paragraph one of my response above about why you don’t need to wait.

Terri

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