Question and Advice about Low Positive IGG after 7.5 weeks

[donewaiting]

Hi Terri,

Sorry, this is going to be a long post, but I want to try and give you as much detail as possible about my situation:

PRIOR TESTING
– I may or may not have been tested for Herpes a few years ago. I do not remember the specifics, and since it was done at school at the time, I don’t know if I can go back and ask since I have graduated. If I did get the test, I was NEGATIVE. I got the testing after being with a girl that I’m not sure was really faithful, so I can’t say for sure if I may have contracted it and it didn’t come up. I don’t know if it was IgM or IgG.
– I tested about 5 months ago as part of a comprehensive screening. They said it was NEGATIVE, but when I looked at the report the test said it was “HSV1″… No indication for HSV2 testing.
– I am in a monogamous relationship with a girl, and she had gotten tested before we started having sex and said that everything was clear. I’m unsure about herpes testing because I know some doctors won’t order it unless specifically requested or if there are sores present. We have unprotected sex one or twice a week.
– I have not had anything prior that would lead me to believe that I had herpes. I occasionally had ingrown hairs or pimples in the pubic region, but nothing eye-popping.

CASE SPECIFIC BACKGROUND

7.5 weeks ago I had sex with a worker at a legal brothel in Nevada. We had unprotected oral and protected oral. It was my understanding that oral also needed to be protected, but I was a bit flustered and went with it. Immediately after though, I started looking at possible STDs I could get and freaked out about herpes, since I now know that even without sores (it was a dark room, but I didn’t notice any in her mouth or vagina. However, given that it wasn’t my main concern, I could be mistaken.) herpes can be transmitted through asymptomatic shedding, I freaked out.

I read up about the symptoms, and fretted about it almost every day for about 10 days. Looking back, I don’t think there was anything that was caused by herpes, but they were:

1. Throat dryness and occasional itchiness during the first week (which I figure might be attributed to the Vegas air and the anxiety)
2. Occasional back soreness and soreness in the left buttocks (Now, this is a bit tricky because I had developed some back and possible sciatica a week or two prior to the encounter. I determined that this discomfort was not related to the encounter)
3. A bump by my waist that looked like a pimple, to be honest. It’s stayed red for a few days, but there was no liquid, and it didn’t burst and didn’t hurt.

About 10 days of fretting, I went to my primary care doctor and asked about bumps inside my mouth (he said it wasn’t herpes) and looked at my pubic region (he said they looked like folliculitis or ingrown hairs or pimples, which I was inclined to believe). He also said that typically if they were I would know (which, from reading some of the resources you’ve provided and your and other doctors provided on the on the old MedHelp community, I was a bit skeptical about) and that my rate of infection was pretty low.

Still, that didn’t really reassure me of anything, but I went through and got tested for everything else (HIV at 3 and 6 weeks, came in negative, that was a huge relief!) but I held off on the herpes because I couldn’t get free testing for it anywhere. During that time, I went and got checked for:

1. some pimple like bumps in my pubic region (nurses at STD clinic said they didn’t look like it) and some red bumps that would appear for a day or so in on the tip of my penis on the rim or on the foreskin (Nurse said it didn’t look like it, and a swab came back negative, though it didn’t burst or crust up or anything).
2. Got my sore throat looked at by a Ear, Nose and Throat doctor, who told me everything looked fine, no sores or anything.
3. All the while, my back has been tingling a bit, but it was more upper back and has been consistent. There hasn’t been any shooting pain, but it’s been consistent. I’m pretty sure it was from my weightlifting incident before the encounter) I went to an orthopedic surgeon and his diagnosis was
4. Some red bumps all over my hands and sometimes on my body. Dermatologist said that it was just eczema (I’ve had a similar problem a few years back).

Each specialist I’ve checked and talked about herpes said through visual cue (and the one swab at 3 weeks) has told me that my chances of getting Herpes are extremely low. I figured I didn’t have it, but since reading up online (and taking a look at the handbook), knowing that not all symptoms need to be serious and can be misconstrued as other symptoms, I took every doctor’s words with a grain of salt and decided to take the test at 7 weeks and 2 days.

TESTING AND RESULTS.

I ordered the test online, and the testing was done at LabCorp with the Captia HSV1 and 2-Specific Ab, IgG; Venipuncture.

My results were as follows:

Test (Req #8352919) Value Range Result Test Date Results Date
Herpes Simplex Virus Type I <0.91 0.00-0.90 Negative 10/21/2014 10/22/2014
Herpes Simplex Virus Type II 1.66 0.00-0.90 Positive 10/21/2014 10/22/2014

I’m a little bit shocked, to say the least. After 7 weeks of no crazy painful sores, I thought I was fine… However, seeing this in the morning jolted me up quite a bit. I did some research again, consulting some responses from Dr. Handsfield and Hook on Medhelp, asking the community, and reading the information pdf that the site that did the testing provided, I wondered if it was accurate. Now again, I know having no symptoms doesn’t mean anything, but I’ve been hearing a lot of conflicting things from doctors and std counselors alike:

1. It’s unlikely that the test is wrong. It’s highly accurate – Primary Care Doctor
2. You probably have HSV-2, but you don’t need medication unless symptoms flare up – Physician at immediate care clinic
3. I don’t know what to tell you, a positive is a positive, but you not having strong symptoms is a good sign – STD counselor
4. Well, if it’s under 3.5 and given your situation, I’m pretty sure it’s a false positive – medhelp contributors
5. You’ll know if you have herpes – others

I’m torn, and a positive result is not helping me out.

I guess my questions are:

1. I read in the handbook that it’s possible that this number is due to my early testing time, and that after 3 months the number will be bigger. How likely is that to be the case (7.5 weeks tested)? If unlikely, what are the odds that it’s a false positive?
2. If I am positive, shouldn’t I be on suppression medication now? I am sexually active with a girl that I do not want to infect, and we usually have unprotected sex (condom use is another issue I know, but most condoms irritate her physically, and one that would help (lambskin condoms) don’t offer STD protection as far as I know. The immediate care physician told me that I shouldn’t unless sores are present because it can reduce the medication’s effectiveness, but I didn’t tell him I was sexually active.
3. If I wanted a confirmation test, do you know of any locations in Chicago that would help facilitate a Western Blot or maybe Biokit? Would it still be too early to do those tests? My Primary Care doctor and the doctor at the immediate care center said they would not follow through with the WB procedure, and I’m unsure of how to proceed outside of waiting the extra month to get rechecked again, which is not desirable.

Thanks in advance for reading this long and winded post, and thank you for helping out.

[Terri Warren]

oh my goodness, that is a long story! I can see why you are concerned.
At 1.66, there is about a 75% chance that this is a false positive. It is slightly more concerning since your HSV 1 test is negative (we see a few more false positives when the HSV 1 is positive than when it is negative). Having said that, the test may have missed an HSV 1 infection – it misses about 1 of 10 cases.

I think a western blot is definitely in order here. You can order a test kit directly from the University of Washington to be sent to you but if no one there will help you with it then that is not going to work. If you call the clinic and set up a phone consultation to become a patient of ours, we can order the test for you at a location in Chicago. Honestly, with a low positive like that, I can’t think of what else you can do. And I think you need to know your true status to deal with the possibility of infectiousness to a new partner. Has this new partner been tested to know if she has herpes?

If you are truly infected, then condoms will certainly reduce the risk of transmission, even if all you can use is lambskin. And yes, if you are truly infected, and she has had a herpes test and is not infected, then you being on daily suppressive medication will reduce the risk of infecting her, yes. But I wouldn’t advice that you start suppression without knowing if you are infected or not because the medication can impact the testing and make it less clear what is going on. Have you spoken with this new partner about your situation?

Terri

[donewaiting]

Hi Terri,

Thanks for responding.

In the beginning she told me that she tested clean for everything. However, since I’ve read that some doctors won’t usually order the herpes test unless there is some evidence of lesions. In speaking with the doctors mentioned above, they wouldn’t even prescribe suppression medication, so I’m going to avoid sexual contact with my partner until I figure this out. I haven’t spoken about the situation to her yet, though I know that talk has to come, especially if I do come back positive.

Knowing that I can have your clinic set up a Western Blot test is reassuring, especially since going on a wild goose chase in Chicago has proven to be tiring and anxiety-inducing. I’ll definitely be calling the clinic. A question though: Is 8 weeks too early for a Western Blot, or can I go ahead and give the call asap?

Thanks,

[Terri Warren]

Eight weeks post exposure is not enough time for an accurate western blot result, unless the results are positive, which you could then rely upon. If you want the most accurate test, I would recommend waiting 16 weeks from the exposure, which is what the University of Washington includes on their test report as their recommendation as well. However, if you want to do one now and one later, people do that. If you are negative now, then there is about a 70% chance you will stay that way.

Terri

[donewaiting]

Hi Terri,

Thank you for your previous response. It’s been a while now, so I thought I’d update you:

At 10 weeks, I went and got a WB through your clinic setting it up (so awesome, by the way). The result came back that both HSV1 and HSV2 were negative. I’m at 14 weeks now, so hopefully I’ll finally get it resolved in a few weeks.

Now, I know you say it’s likely that at 8 weeks, there is a 70% chance that the result would stay that way at 16. What about at 10 weeks then?

Thanks!

[Terri Warren]

I think it is very likely that the results that you obtained at 10 weeks will stay that way. I can’t give you an exact percentage, however. I’m guessing 90% certainty?

This is your final post with this subscription. If you have need of more questions, please feel free to renew your subscription.

Terri

[Sid101]

Did you get tested at 12 weeks or get to conclusion on this?

Im having very similar symptoms.

[Terri Warren]

This post is closed, sorry

Terri

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