please interpret my lab results

[bigtex]

Hello,

I had a brief encounter that included no genital to genital contact but skin to skin contact. I began to get paranoid a week and a half later and got STD tested. My igg blood test for hsv2 came back positive with a reading of 1.6. This is 13 days after the incident. HORRIBLE.

I decided to get tested again 4 days later for confirmation. This result is also positive, but lower, at 1.38.

I am wondering if I should feel confident in the test results. And if so, is it possible or likely that I was already positive as my igg level was detected earlier than normal and actually went down.

thank you.

[bigtex]

Some details I forgot to add.
The encounter included brief protected sex.
I tested negative for HSV1 both time I was tested.
I am also wondering the best course of testing at this point.

[Terri Warren]

How long ago was the encounter?
You have what is known as a low positive index value. Between the values of 1.1 to 3.5, half the positives are false positives and the closer the value is to 1.1, the more likely it is to be a false positive.
You need confirmatory testing to confirm this low positive, but it is best to wait 3-4 months after the encounter to be certain you are not in the process of developing antibody and the numbers will go higher.
Can you tell me about the timing of the encounter?

Terri

[bigtex]

The timing of the encounter?

It was 13 days before the first test (1.6) and 17 days before the second test (1.38).

Is the difference in these number statistically significant? If I was building antibodies, wouldn’t the second testing be higher?

Can a person test positive in an igg blood test in less than 2 weeks? If not, and I am indeed positive, would that indicate that I was already positive? (I have never been tested for herpes prior to now)

How many low positives should I have before I am convinced that I am positive? At what point should I get the Western Blot?

I am not showing any dramatic signs of the virus save for ones that could be caused by the stress of being told I am positive. The mild feverishness (no actual temperature) I have gotten could be panic attack related, as could constipation and nausea.

I do have 3 small red dots on the shaft of my penis, I will upload a photo later. Could this be the beginning of lesions?

Do I need to re-up for all these questions to be answered?

thank you

[bigtex]

One final question.
How long can a person go without showing symptoms of HSV2? I am 44. There were many times 25 years ago that I could have been exposed. I am wondering how likely it is that I could have walked around with HSV2 for that long and not known it, if I am indeed positive.

[Terri Warren]

Is the difference in these number statistically significant? If I was building antibodies, wouldn’t the second testing be higher?
The difference is not significant. The next test would not necessarily be higher no.

Can a person test positive in an igg blood test in less than 2 weeks? If not, and I am indeed positive, would that indicate that I was already positive? (I have never been tested for herpes prior to now)
The soonest I have seen someone become positive after infection was about 10 days, and that was a low positive result of 1.1
Could a person have a 1.6 within 2 weeks? yes

How many low positives should I have before I am convinced that I am positive? At what point should I get the Western Blot?
I would recommend getting the western blot about 4 months after the past possible date of infection.

I am not showing any dramatic signs of the virus save for ones that could be caused by the stress of being told I am positive. The mild feverishness (no actual temperature) I have gotten could be panic attack related, as could constipation and nausea.

I do have 3 small red dots on the shaft of my penis, I will upload a photo later. Could this be the beginning of lesions?
It could be, but without a swab test, we can’t know what is going on here.

How long can a person go without showing symptoms of HSV2? I am 44. There were many times 25 years ago that I could have been exposed. I am wondering how likely it is that I could have walked around with HSV2 for that long and not known it, if I am indeed positive.

It is possible yes, it is.

This is the last question on your subscription. If you have more questions, feel free to renew.

Terri

[bigtex]

Terri,

I renewed. A couple more, thank you.

Just how likely would it be for a person to test positive for HSV2 with an igg reading of 1.6 after only (exactly) 13 days?

And, what are the odds that a person could have HSV2 for more than 2 decades and not know? I.E., is this common at all?

I am trying to determine infection time if indeed I am.

Finally, I uploaded a photo of a couple red dots on the shaft of my penis. Does this look like HSV2 to you? They have no sensation what so ever.

Thank You!

[Terri Warren]

Just how likely would it be for a person to test positive for HSV2 with an igg reading of 1.6 after only (exactly) 13 days?

We have no data on that at all – too soon to know.

And, what are the odds that a person could have HSV2 for more than 2 decades and not know? I.E., is this common at all?

Very common -80% of those infected with HSV 2 don’t know they are infected

I am trying to determine infection time if indeed I am.

Finally, I uploaded a photo of a couple red dots on the shaft of my penis. Does this look like HSV2 to you? They have no sensation what so ever.

Do you always have those? If not, they could be herpes, yes.

You have two remaining posts.

Terri

[bigtex]

I had another test done (with routine bloodwork)

It shows IGG of 1.2 and IGM .9

To recap, after possible exposure-

13 days- 1.6 IGG
17day- 1.38 IGG
20 day 1.22 IGG .9 IGM

Can anything be extrapolated from these numbers or is it too soon to tell?

Do my multiple low IGG readings have any bearing on the possibility of them being false? Since I keep getting them it is more likely not a false reading OR no bearing at all. I understand that a large number of positive IGG readings under 3.5 are false.

Wouldn’t my IGM levels be high if a recent exposure?

If I had recent exposure, shouldn’t my IGG numbers be going up?

I did not previously have those red spots on the penis. Is it possible they are chafe from running (sounds like a stretch I know). Will they necessarily turn into lesions if they are herpes (they appear to be receding.)

If a person has mild/no symptoms during a first outbreak, does that set a trend for the future?

thank you Terri

[bigtex]

One more-

If I am HSV2 positive, should I worry about kissing my children?

[Terri Warren]

If you are HSV 2 positive, you can definitely kiss your kids.
You are still in that low positive range, nothing has changed. And yes, 50% of the positive values under 3.5 do not end up confirming by western blot ( false positives). The IgM test is not useful and in fact has many false positives – I would not recommend you repeat it at all. If this is new infection, yes, the numbers might well be going up. But not every time. And it could be old infection and just be your normal value. We just can’t tell from this. I think you are going to need a western blot to sort this out.

That was your last question on this subscription. If you wish to ask more questions, please feel free to renew your subscription.

Terri

[bigtex]

Hello again,

the red spots in the above photo have not changed much, perhaps receded slightly. Would a herpes spot necessarily turn into a lesion?

I continue to be symptom free, if I am positive, would this set a trend for future outbreaks?

The reason I originally got tested was I had a day of frequent urination. Is this a symptom?

thank you

[Terri Warren]

If the red spots haven’t changed much, it doubt that they are herpes lesions. If you are symptom free, then yes, that could be your case in the future as well. Frequent urination is NOT a sign of herpes, no. That is a bladder symptom, and if you had herpes causing urinary symptoms, it would be pain with urination, from the urethra, not the bladder.

Have you arranged to get a western blot?

Terri

[bigtex]

Thank you Terri.

I have not arranged for Western Blot, it has been four weeks since the event. Is it not too soon?

What percentage people in their 40’s will experience a primary outbreak when they have a 1st exposure? Prodrome?

I am trying to diagnose myself. The only symptoms I have had were a couple of days where I felt mild nausea and feverishness/clamminess. I never had a temperature ( I checked multiple times). In fact, I was a little cool. At his time I was also suffering panic attacks and hyperventilating a bit.

Does this sound like prodrome? Do people have prodrome without actually getting any other symptoms?

your insight is much appreciated

[Terri Warren]

Yes, drawing the western blot now is too soon. You’re right.
I don’t have an answer for your second question.
Nausea and claminess are not symptoms of a new infection. Nausea has nothing to do with the “flu” symptoms you have read about – that’s a different “flu” you are thinking about. But anxiety can certainly cause that kind of symptom.

This does not sound like prodrome to me, no, not at all

Terri

[bigtex]

One other question.
Is groin tingling misdiagnosed?
I honestly can’t/couldn’t tell if I had/have this. It seems like the more I think about it, the more likely it seems like it is there.
And would going tingling necessarily lead to other symptoms?
I have no pain on any kind, however.
thank you

[Terri Warren]

Tingling by itself is really vague and could be many things, including genital anxiety. If the tingling leads to lesions then you should be concerned but not otherwise, if that is your only symptom.

Terri

[bigtex]

Hello Terri,

I have a couple more questions, if my account is still active, or I can renew.

I tested .9 IgM. Does that mean I have some type of positive herpes activity?

I have been in a monogamous relationship with children for 27 years and have regular unprotected sex. How likely would it be that we have both been positive and asymptomatic for this long? Or that my wife has such minor symptoms that they remain undiagnosed? I don’t think she has been tested, unless it is done during pregnancy. She will get tested soon though.

thank you

[Terri Warren]

You have paid for 9 posts, and the post above is # 11. You’ll need to renew to ask more questions, please.

Terri

[bigtex]

I renewed again, thank you

I found out that the testing I got was Herpeselect Chemiluminescence Immunoassay. Can you comment on the accuracy of this test?

Also, the ability to detect seroconversion?

There is a chart in this study (http://www.medscape.org/viewarticle/563696) that shows Herpeselect Focus seroconversion to be 60% at 21 days, maybe 8% at 14 days. It this data applicable to the Herpeselect Chemiluminescence Immunoassay? Are there any charts or data for a detectable seroconversion with Herpeselect Chemiluminescence Immunoassay?

Do people who test negative for HSV1 seroconvert more quickly?

thank you again

[bigtex]

I have one more, and will renew should you tell me to.

If a person tests false positive due to other proteins in the blood, are they likely to continuously test false positive? What is the source/cause of these proteins?

sorry to take so much of your time, this may be the worst thing that has happened to me and I am consumed with it.

[bigtex]

Ok, I renewed again, I think I wasn’t specific enough in a previous question.

Do you know the rate of low false positives in the Herpeselect Chemiluminescence Immunoassay specifically?

Also, when people seroconvert, do their IGG levels ramp upward? Is there a typical movement in levels?

thanks again

[Terri Warren]

About 5% of people who take the herpeselect test, test positive in the 1.1 to 3.5 range. Of those who test positive in this range, 50% are false positives (they do not confirm with western blot). Once this happens, it continues to happen, usually. When a person serocconverts, the index values normally do climb, yes.
The proteins are just part of your cellular makeup, they are not due to anything in particular.

Terri

[bigtex]

“About 5% of people who take the herpeselect test, test positive in the 1.1 to 3.5 range”
Do you mean that most people that test positive test higher than 3.5 with this particular test?

Also, per a previous question- I tested .9 IgM. Does that mean I have some type of positive herpes activity?

And, do you know if the referenced Medscape chart holds true for Herpeselect?

thanks you!

[Terri Warren]

It means that the rest either test negative or with an index value greater than 3.5
I believe that the cutoff for negative is 0.9 and there is likely a < sign in front of that. Yes, the chart reflects the herpeselect IgG. I believe you are once more out of questions here. Terri

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