Test Accuracy

[Cmc]

Hello,
I would like to get your opinion on follow up testing. A little background. I have been with my bf for 4 mos (monogamous relationship) and while having sex a couple of weeks ago I experienced a vaginal tear. I had a gyn appt scheduled for the following week for my annual exam. When I went in I told him about my problem which also included occasional bleeding during sex (not painful) he did the exam and said everything was fine and I needed to use lubricant. I felt rushed by the doctor (he took over my old physicians practice), but figured it would heal on its own. Approximately 4 days later I began to feel as if I was getting a UTI, so I went to my primary dr. He did an exam and confirmed it was a tear and not herpes, but did a culture to test for herpes,chlamydia and gonorrhea. The test came back positive for HSV 2 and bacterial vaginosis. I was given Flagyl and within two days I was feeling better. He stood firm that I did not have an outbreak and that I am asymptomatic. I had 1 UTI approx 10 yrs ago, a yeast infection 5 1/2 years ago. I know the culture is the gold standard, but if there are no lesions is it still considered the most accurate way to test an asymptomatic individual? Should I have the igg blood test done to confirm? I’m just very confused and scared. Sorry this is so long thank you for taking the time to respond.

[Terri Warren]

I’m confused – you said the test was positive for HSV 2. What kind of testing was done? Swab test, blood antibody test? Are you sure about your answer?

Terri

[Cmc]

He did a swab in the vagina, but not of the tear that I had. I don’t know if the discharge was tested or what. There was no blood test done. He showed me the result from the lab which just said I was positive for HSV 2. When I asked about the index value he said he didnt know and acted like it was irrelevant. I also want to mention that my bf said he had an std test 5 mos ago that came back negative (though after researching who knows if that included HSV or not). I’m very confused and wondering if I need to do a blood test to confirm the results.

[Terri Warren]

Would it be possible for you to obtain a copy of those test results? I’d really like to see exactly what was done.

Terri

[Cmc]

Yes, I will ask for a copy tomorrow. I am going back to his office to have blood work done for a physical.

[Cmc]

Hi Terri,
I should have the lab results on Monday (office was closed today). How would you like me to submit them to you? Thank you so much for taking the time to help me. I’m going crazy over here, Monday can’t come soon enough.

[Terri Warren]

Well, the best way is to type in exactly what you see I think. Get a copy and post and if I need more info, I’ll tell you.

Terri

[Chachaqueen]

I had something similar. How long did your cut last till it healed?

[Cmc]

Roughly a week. I kept looking at it and pulling the skin apart, which obviously didn’t help matters.

[Chachaqueen]

Me too!! That’s odd that he didn’t swab the cut and was able to tell you based on that you’re positive. Are you sure he didn’t swab it? Usually the swabs require some rubbing of the suspected lesion.

[Cmc]

He initially told me I wasn’t positive and confirmed it was a tear. I am certain he didn’t swab it. I watched him put the swab up before he even looked at the tear. I also would have known if he was swabbing it. The tear was painful when the skin was pulled apart for him to look at it (it was at the vaginal opening). In fact, he told me after the exam that because he knows it isn’t herpes he wouldn’t test for it bc they don’t recommend testing asymptomatic people. When I went back and he gave me the results he informed me the test came back positive for hsv 2. Thats why im so confused by my results. Were you told you are positive? Did your doc just do a swab in the vagina?

[Chachaqueen]

I also had a tear at the bottom of my vagina, but the doctor didn’t swab it because just like you she didn’t think it looked like herpes. Also, I’m under the impression that he would have had to use 2 different swabs. One for the chlamydia/gonorrhea/bv which is an internal swab and then a separate swab where he would’ve had to vigorously kind of rub the cut to separately see if it would grow virus specifically for hsv (and maybe Terri would confirm this as I’m not in the medical field). I am so sorry you are experiencing this! It seems like this Dr. is very uneducated about herpes and really did more harm than good during your visit. I wish you the best. I am also terrified as I await results, but stay away from Google during this time (clearly need to heed my own advice).

<3

[Cmc]

I believe he used two swabs, but def didnt rub my tear. He seems like a good dr just uneducated about this virus. He told me that he would swab for it during my next pap and it may come back negative meaning it’s not in my system. We all know once you have it it’s there for life, so that makes me wonder if he questions the results. I could drive myself crazy with the scenarios. Anyway, I wish you the best as well. Hope your results show you are negative so you don’t have to experience what I am going through. And yes, Google can be good but also add to the confusion.

[Chachaqueen]

I completely agree. The confusion makes it that much more worse. I also tried to get my cut swabbed but it was sort of dismissed. I now wish I was more adamant about it. We’re both swabs used internally?

[Cmc]

Yes,they were, nothing externally was swabbed. He still told me it wasn’t an outbreak of any kind and that I am asymptomatic, so who knows. Waiting for Monday when I have a copy of my lab results.

[Terri Warren]

It does require a separate swab for gonorrhea and chlamydia and herpes. One for the bacterial infection and one from the herpes lesion. I have no idea what was positive.

We will await seeing your results.

Terri

[Cmc]

Hi Terri,
I have my lab results they read as follows

tests ordered: Nuswab VG+, HSV; urinalysis, Routine:urine culture, routine; Please note;request problem

Below that it there are 6 columns: test,result,flag, uwitg, reference interval, lab

Under tests it says: Nuswas VG+, Hsv. The results for the bacterial vaginosis are listed as a high-2 abnormal for three different things.

The results for Candia, trich, chlamydia, gonorrhea, and hsv 1 are reported, all show negative and say negative under the reference interval. Below the HSV 1 results, it says HSV 2 NAA-positive abnormal, no score is listed then it says negative under the reference interval.

Page 2 discusses the urine culture and says there was no growth. Below that it says:

Please note
The date and or time of coercion was not indicated on the requisition as required by state and fed law. The date of the receipt of the specimen was used as the collection date if not supplied.

Please let me know if you need any additional info.

[Cmc]

I just spoke with the dr and he said this was a cytology test the only difference from a pap is that he didn’t look for cancer bc I had a pap done on 12/19/14 (came back normal). I asked if he thought I should do the Igg test. He was dismissive of it saying that even if it comes back positive there is nothing to do. I asked about suppressants bc I don’t want to transmit it (if I indeed have it). He said there was no need because I am asymptomatic and he doesn’t think I would transmit it. I know from research on your website that I could in fact transmit it, even being asymptomatic. I also read that it isn’t uncommon for cytologist to come back with a false positive for HSV when done with a pap. I am clearly dealing with someone who is not as educated with this virus, I certainly don’t want to run around for the next year (he said he would retest at my next pap) thinking I have this, if I dont. If I do, I want to do whatever I need to to reduce the chance of transmission. Please let me know if I need to put more $ on my account. Thanks.

[Terri Warren]

Yes, the computer didn’t catch it by you are well over the three questions. Please pay for three more questions and you have used them all already, by the way, with this last post from me.

Oh boy. There are errors here all over the place. So he did a pap of your cervix and it came back suggestive of herpes. First of all, a pap, when not used to look for cancer, simply looks for a type of cell called giant cells with many centers. I wonder if he could be confusing HPV and HSV? Can you get please get an actual copy? It certainly could never type the virus and it is not great at diagnosing herpes – there are false positives and false negatives using a pap smear. However, having said that, I think it is important that you get a clear diagnosis. Without a sore to swab specifically the best test is a herpes IgG antibody test. You do not need IgM testing ever. You can order your IgG test online through a number of different services. I recommend healthcheckusa.com as one option.

If you are positive, I fear that you are going to need a different doctor to prescribe your antiviral therapy, at least it sounds that way to me.

Terri

[Cmc]

Thank you, Terri. I paid for the three additional questions, which I understand I have already used, plus an additional three on top of that. I appreciate your response and will get the Igg test done, stat. I do have an actual copy of the results, if you would like to see them or need me to give additional info.

[Terri Warren]

You know, from your test results that you posted, I have no idea what to make of it.
What lab performed the testing?

I have no idea what Nuswab is

Terri

[Cmc]

Labcorp performed it. I googled Nuswab + and it appears to be a test they offer for BV. I am guessing he asked them to add the hsv on top of the BV test. There is a disclaimer under the BV and Candida results saying,”The test was developed and its performance characteristics are determined by Lapcorp. It has not been cleared or approved by the FDA. The FDA has determined that such clearance or approval is not necessary.” I just had the IGG test done. Should have the results by Thursday. To say I am confused by all of this is an understatement. I am definitely getting a new dr. Thank you for all of your help.

[Terri Warren]

That must be an inhouse LabCorp test. I did look it up and you can add herpes to that test. So that looks like what he did, yes, and they say they recovered HSV. Which a totally different thing than doing a pap looking for herpes so forget what I said about that. I still think doing an IgG antibody test is a good thing to do. The Nuswab test is produced by a reputable company so I think you should prepare yourself for a positive. If it turns out negative, great, but looking into this test it looks like it possible the test for HSV 1 and all the others with a single swab. This is true for the lab that we use also but herpes is not normally included. I am however skeptical because of the lack of FDA approval. Maybe that just applies to the BV and yeast part and not the herpes part? Because those kinds of herpes test DO need FDA approval. We are ahead of ourselves here. Let’s see what the IgG test shows, OK?

If it is positive, you will cope. I can help you.

You’ve still got one more question.

Terri

[Cmc]

The disclosure I mentioned is only below the candida and BV results so that may be. I will let you know when I get my results. Thank you.

[Cmc]

Hi Terri,
My results came back; hsv1- negative, Hsv 2 IGG 11.5. It is what it is. If my bf comes back negative, based on sexual history and statistics (though no guarantee) I have had this for at least a year. I will make an appt to see a new doctor regarding his thoughts on meds, etc., and count my blessings that I have never had an outbreak or a noticeable one at least. After doing a vast amount of research it really is more about the social stigma. We have probably all been exposed on some level yet society views those of us with HSV2 as lepers who engage in ‘risky sexual behavior’. I would love to know how many of the individuals with this mindset requested proof of a proper herpes test prior to kissing, oral sex, etc. At the end of the day the majority of the population has some type of it and those who don’t have simply been lucky. –end rant. I had to vent. Thank you for all of your help Terri.

[Terri Warren]

Yes, I kinda thought it might be positive. And I am guessing that the tear was herpes and there was enough virus around that a swab of the general area picked it up. I’m thinking the tear might have been an outbreak. Let’s see what your boyfriend’s test show.
I like your views on herpes – they are healthy.

Terri

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