Next Steps? False positive? Please help

[Goddard123]

Hi Terri,
I recently was diagnosed with HSV2. But I am unsure of next steps and whether it is a false positive.

On on a Friday, I had unprotected oral and vaginal sex with a woman. On Monday, she told me she developed sores in her mouth on Sunday. She has not informed me of her results bc she just got tested. I immediately got tested for herpes. The LabCorp IgG w/RFX gave me an HSV2 igg index of 2.05. They did not run a supplemental test due to a lack of them. Curiously, my HSV1 igg was negative (<0.91) despite my long history of oral cold sores since childhood. I have never and do not have any genital sores, lesions, or any physical indication of genital herpes.

I see the 2.05 index says I am in the false positive range and need of a supplemental test. I also have read you say oral HSV2 is rare. (1) Is there a chance this was a false positive? (2) Why did it not detect my likely HSV1 evidenced by my long history of oral sores, could this have messed up the reading? (3) Am I deluding myself in hoping it is? (4) What should my next steps be? Western blot? Supplemental test? (5_ Who does supplemental testing, a PCP? This has been a devastating few days and I could really appreciate some guidance.

[Terri Warren]

I see the 2.05 index says I am in the false positive range and need of a supplemental test. I also have read you say oral HSV2 is rare. (1) Is there a chance this was a false positive?

There is definitely a high chance that this is a false positive, yes
(2) Why did it not detect my likely HSV1 evidenced by my long history of oral sores, could this have messed up the reading?

The IgG test misses 30% of HSV 1 infections compared to the gold standard western blot

(3) Am I deluding myself in hoping it is?
Not at all

(4) What should my next steps be? Western blot? Supplemental test? (5_ Who does supplemental testing, a PCP? This has been a devastating few days and I could really appreciate some guidance.
I have heard that LabCorp is out of Biokits for confirmation so right now, your only option is the western blot, correct.

Terri

[Goddard123]

Hi Terri, providing an update and more questions. I got a different igg test with Quest two days after my LabCorp test mentioned above. I got a 1.84 igg for HSV2 but tested negative on the inhibition assay. My PCP was useless and did not even acknowledge the negative supplemental test, just said “well, it still says you’re positive.” I was satisfied that the negative supplemental combined with never seeing any physical symptoms meant I was negative.

But I have a new issue. About 5 weeks after my last sexual encounter that prompted the initial testing, I have developed red, irritated skin around the edge of my glans. I started applying an antifungal cream but that has not improved much. I do not and have not seen any blisters, but there are ridges and bumps but I think it’s just dry, irritated skin. It’s not around the entire glans, only one side of it. It does not burn or itch, but it is uncomfortable, 1/10 pain.

Then, about 5 days after developing the red irritated skin, I developed a little discomfort when urinating. No burning, just mild discomfort with a lot of drops of urine after I stop peeing and my penis feels uncomfortable in my pants. I have had it for 3 days. I went to a different PCP who examined my penis and said she does not think the redness or the urethral problem are caused by HSV and did not see any classic HSV symptoms. She did a dip test on my urine and it came back negative for everything including leukocytes. My urine is also being sent out for cultures. She does not suspect herpetic urethritis and thinks I am anxious because of my elevated igg tests. She said the redness is likely caused by contact or another kind of dermatitis on my glans (perhaps from overexamining my penis) and to use vaseline and ascribed the urethra issues to non gonococal urethritis.

What do you think? Considering this and the previous post, elevated iggs, neg inihibtion assay, red irritation on glans and urethritis, does this sound like herpes? Next steps if any?

[Terri Warren]

I don’t think that these latest symptoms are related to herpes. Trust the negative testing you had done recently.

Terri

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