Low Positive to Equivocal …

[equivocal tester 321]

A few weekends ago I made the horrible mistake of having un-protected sex with an Herpes at-risk partner. Putting aside the fact that she didn’t warn me about her condition and I cheated on my wife, I’m confused with testing. I found out the next day that I was at risk for Herpes so the next day I walked into a local Urgent care for blood and urine tests (two days after unprotected sex). Roughly three days I was given results of a negative HSV1 test and positive 1.48 test for HSV2.

I was devastated and wanted to get re-tested immediately. So the I walked into my local Kaiser and was re-tested for HSV2 (six days after unprotected sex). I just received my results from the Friday test and was told that the test result was equivocal (uncertain result). Unfortunately, Kaiser doesn’t give the numbers out and although I requested the number, I was told that the tests for Kaiser only state negative, equivocal and positive. Thankfully, my wife requested her own HSV1/HSV2 tests and was negative for HSV2 (we already knew she had HSV1).

My confusion is the difference in testing results. I can understand that these were done at different labs but don’t know if going from low positive to equivocal is a good or bad thing. The only “symptoms” that I’ve had include random ‘tingling’ feeling in the genital area and random ‘heat’ in the genital area. Please share your feedback.

In addition… We have kids and I’m afraid that I can pass something to them. We’re changing diapers as well and my son had what we think is a pimple on his testicles (picture attached). I’ve washed my hands with bacterial soap and water after every restroom break/touching of genitals… but should I stop changing their diapers? Please share your feedback.

I have an appointment with my primary doctor on 6/17 and will take your feedback to that appointment. Thank you!

[Terri Warren]

If you contracted herpes from this contact, it would not show up in a blood test three days later. So several things could be going on here

1) first, 1.48 and something in the range of 0.9 to 1.1 9 (the equivocal range) are very close together values, are not significantly different.
2) you could have had herpes for years and just have a low index value
3) you could have contracted herpes in the situation you describe but this is not reflected in the results of your antibody test
4) it is likely a false positive result (about a 85% chance this is a false positive).

So do you know that the woman you had sex with has HSV 2? The odds of contracting herpes at a single encounter are very very low indeed, even if she has herpes.

My recommendation would be to consider getting a western blot now and then repeating in 4 months from the encounter. Again,t he 1.48 is NOT reflecting a brand new infection one day after the encounter. The western blot now would rule in or out old herpes infection in you that you don’t know about and that your wife did not contract. I would not worry about your baby – just use normal handwashing after using the restroom.

terri

[equivocal tester 321]

Thank you, Terri.

1) don’t know if that’s encouraging
2) with my wife never testing positive for HSV2 (two tests with our two kids and the recent test) I don’t think I have had HSV2
3) this is what I’m worried about and plan to take your advice on the testing
4) what triggers false tests?

I’m also concerned about kissing my wife and kids on the lips. During the un-protected sex, there was oral sex performed – I was inside her then she gave oral sex and at some point we kissed. Should I stop kissing my wife and kids on the lips even if there are no signs of outbreaks around my mouth?

Why do you say that the odds of contracting herpes on a single encounter are low? It has been confirmed that this woman has HSV 2. But I haven’t been able to find out if she had an outbreak (or whatever it’s called) that night.

I have my doctors appointment tomorrow and will inquire about the Western Blot testing. I’m hoping that Kaiser is able to provide this type of testing. Thank you and I look forward to your response.

[Terri Warren]

First Kaiser definitely does not provide western blot testing. The only place in the US that does the testing is the University of Washington. You can either contact them directly to have a kit sent to you, you take it to your healthcare provider and they draw your blood, spin it down and ship it, or our clinic can arrange for the western blot to be drawn at a Quest lab near you and shipping to UW. We are the only site in the US that has this arrangement with Quest at the current time. If you want us to help you with this, you can visit this website again and arrange for a phone consultation. Remember that you have two options here in terms of timing: you can wait 4 months from the encounter and do the testing then or you can test now and if it is positive you stop testing. If it is negative, then you would need to retest in 4 months from the encounter.

I don’t think the index values are particularly different but you could also redo that test again at some point and if it has gone way up, you don’t need to do the western blot at all (if it goes over 3.5). It is good that the second number was lower than the first, for sure.

I don’t think you need to worry about kissing your wife and your kids if you have not had any oral symptoms.

I said the risks are low because people with herpes are not always giving off virus. This is a periodic thing, not a constant thing. The likelihood that you would have intercourse with her on a day when she is shedding (about 15% of days) is low. If you had sex with her twice a week for a year and you knew she had herpes and avoided sex during outbreaks, there would only be a 4% risk you would acquire herpes in a year. So you can see that it is low anyway. The biggest transmitter is the person who doesn’t know they have herpes and have sex with symptoms they don’t recognize.

Terri

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