Test Accuracy

[knowforsure]

I have read that the herpeselect is 97% accurate after 4-6 months post exposure at detecting HSV2 when compared to Western Blot… do we know for sure how accurate the Western Blot is? How many patients have you had that have stayed falsely negative for HSV2 after the 6 month timeframe, Terri?

[Terri Warren]

Your statistics are correct. According to the package insert, the Herpeselect picks up 97% of those infected with HSV 2 by 4 months. We don’t know for sure exactly how accurate the western blot is, no, in terms of how many actual infected people it picks up. We just know that it is better than any other antibody test for herpes.

I have had 9 patients in 32 years of practice that were swab test positive for HSV 2 and western blot negative.

Terri

[knowforsure]

That seems really limited that the gold standard for herpes testing doesnt have any data on accuracy or sensitivity… especially with the amount of info on the specificity of the test. Why is there no data? Is there a safe ballpark? Surely it has to be in the high 90s to be so highly regarded? I assume 9 patienst over the career of your clinic would have to be under 1% of all the many folks youve tested, right Terri? Sorry if I am being a pest, but I feel like this is important, right?

[Terri Warren]

I didn’t mean to say there was no data at all about the test. There just isn’t data about exactly how sensitive the test is because there is not a better test to compare it to. For example, if 1000 people who have no symptoms at all test, and the test says 250 are positive for HSV 2, the question remains, I think, how many of those asymptomatic people actually have herpes? We know how sensitive it is in people who test positive for HSV 2 via some other test, like PCR and there, it picks up greater than 99% of those infected. Do you get the difference I am pointing out?

Nine people over 32 years represents a very very tiny portion of people who have been tested in total, yes.

You have one more question, feel free to ask if you have another one in mind.

Terri

[Terri Warren]

And it is also possible that I don’t know everything about the testing that has been done using western blot.

Terri

[knowforsure]

Hello Nurse Warren,

I know it has been a long time since my last post, but I hope I can still ask another question? If not, I would be happy to pay again. My previous questions about WB accuracy were because I have a past with HSV 2 exposure:

I’ll be as brief as possible. I am a caucasian male who had condom protected intercourse 2 or 3 times with an ex girlfriend while we dated over a 7 month span. We engaged in mutual oral sex, probably twice a week. She has HSV 2 genital. I have oral HSV 1. A year after the relationship ended I had both a herpeselect and a Western Blot. Both were negative for HSV 2 and of course positive for HSV 1. I have watched my genitals now for a few years and have had a few cases of folliculitis (always in the pubic hair area) which I had checked out by my Doctor (and swabbed for assurance) and have always been given the all clear. No sexual contact of any kind since.

I try to temper my worries that everything I see is possibly herpes, but there’s recent event I’d like your view on. I noticed a red bump sort of where my scrotum meets my shaft near the inside of my thigh. It was in an area that did indeed have pubic hair, but not dense amounts, and it was in a spot where my boxers sometimes rub… It was tender and felt just like a pimple or boil feels deep in the skin. I barely squeezed and it ‘popped’ readily. I figured if I saw white pimple-puss (sorry for lack of better terminology) I knew it would be just a boil or inflamed hair follicle. Well all I noticed was mostly blood, maybe some faint white stuff, maybe not… Simultaneously, about a thumbnails distance from the bump was a well defined swollen mass bigger than a marble deep in my skin. Again, I thought it was a boil. The skin wasnt really red or anything, but it ‘felt’ like a very deep, swollen pimple that needed to be popped or drained. I thought maybe it was a furuncle, and the popped bump was a branch from it? Anyway, the first bump healed quickly, in a couple days, and seemed to have originated from a hair follicle, despite there being no hair there, but I cant be sure. The mass much deeper in, and never came to head, but always felt like a deep pimple, and over about ten days it slowly got smaller and smaller and now has healed.
I did not go to the doctor over it, because I had some confidence it was just some typical staph or bacteria related hair follicle issue. But since the boil never came to a head, and I never definitely saw any white stuff, I find myself thinking about it. Was the mass actually a single very swollen lymphnode and the bump an abnormal herpes blister? What are some distinguishing features between hair follicle issues and herpes? My understanding is that herpes blisters are usually like water blisters and they dont really feel like bumps that are under pressure to be popped, but more superficial like a burn blister?

Also, one thing out of curiosity… I got a lot of info from the medhelp.org site and your forum there… that was a great site! Why is it no longer taking questions??

Much love and appreciation for all you do, Terri!

[Terri Warren]

No, this does not sound like herpes to me. That is not the way that herpes generally behaves. Herpes lesions in the male genital area do start out like water blisters most often yes.
MedHelp has been purchased by another company and they no longer employee professionals to answer questions – a shame, I must say.

I’m sorry you are having such a difficult time letting the risk of herpes go. I hope you did pursue getting a western blot test to help reassure you.

Terri

[knowforsure]

Sorry Terri, but I was hoping you would weih in on if my description sounded like a boil/deep folliculitus to you if it didnt sound like herpes. I hope that is overextending my subscription. In any case, this is for sure my last post. Thanks again for everything

[Terri Warren]

I’m not clear that it is a boil or folliculitis. And I really don’t want to take a wild guess if I’m not certain. Sorry but I think speculating just makes things less clear, not more clear.

Terri

[Author]

Posts