Test Result: Should I test again

[simple]

History:

I had unprotected sex with my boyfriend a few times over the past year. The last time was January 18th.
I got scared because I had had a confirmed yeast infection Jan 3rd, 2015 and then on the 19th a really bad bladder infection which was also confirmed on Jan 20th with ecoli. Then again I got a yeast infection because of the antibiotics.

The man I was seeing had a small sore on his penis December 18th. I remembered seeing it and he put it off onto all the sex we’d had which was quite a bit. After getting these infections I decided to be safe, get an STD test. I did this online and opened a huge can of worms, apparently.

I got the test done on Jan 22. (ordered online through RPK Services

Returned: IGG HSV 1<.90 Negative
IGG HSV 2 1.21 Positive Done by Labcorp.. No test name on the results.

I immediately went into a panic… as most people do, I suspect. I called the man I had been seeing and told him. He had no symptoms or none that he thought were symptoms. He ordered the test but went to Quest and got the Herpes Select.

Results: IGG HSV 1 <.90 Negative
IGG HSV 2 >5.0 Positive

When we got this result I went into my gynecologist. He ordered another test. This was done on February 4th. Done by Quest Herpes Select.

Results: IGG HSV 1<.90 Negative
IGG HSV 2<.90 Negative

But this doctor also did the HSV 2 IGM with reflex titer test. That one came back positive. 1.160

This doctor told me Yes, I have herpes and put me on Valtrex suppressive dose 1 g a day.

I never had anything that resembled the typical outbreak of blisters. I’ve had constant pains on the right labia, even while on the Valtrex. The pains feel like paper cuts. This would feel better for a day or two and then I’d go a week to ten days with this feeling then get another day or two break. Never a sore, never a discharge, never a smell, never any crusting. I have had three or four small bumps pop up on my buttocks. The first one lasted for a month straight. Dermatologist said it looked like a cyst. Then a few more on the same side, they don’t look like the typical blisters. Left side of the buttocks.

After going online to your forum, I read about the tests possibly giving a false positive and that the IGM test shouldn’t be used, I found a new doctor.

This doctor tested my hormones on Feb 20th. Said I’m low on estrogen put me on Estriol. He did a thorough exam said he didn’t see anything that resembled herpes. Pain continued. He did say to stay on the suppressive dose if I was having sex with my partner who appeared to be a definite positive as this may prevent me from getting herpes.

I went back into the doctor two days ago, still having pain, and he suggested a pinched nerve in my lower back as my back has been hurting and he showed me on a diagram where a nerve runs to the labia from the back. I’m still taking the suppresive therapy at this point.

Yesterday 4/11/2015, 15 1/2 weeks past last sexual encounter, I decided to do another Quest Herpes Select Test for HSV 2 alone.

Results: <.90 Negative.

OKAY QUICK RECAP:

1/22 Test Labcorp

HSV 1 <.90 Negative
HSV 2 1.21 Positive

2/4 Test Quest Herpes Select

HSV 1 <.90 Negative
HSV 2 <.90 Negative

IGM w/ reflex titer Positive for HSV 2 at 1.160

4/11/2015 Test Quest Herpes Select (15.5 weeks past possible exposure)

HSV 2 <.90 Negative

QUESTION: Do you think that I should retest at this point or do you think there has been sufficient time and I should let this worry go? Also, could the Valtrex skew the results and prohibit my IGG’s from rising?

[Terri Warren]

oh dear. You’ve certainly gotten some questionable herpes information!
First, you are correct, the IgM is not useful for diagnosing new infection. The 2014 CDC guidelines are very clear about that. So please ignore that. Also, you taking Valtrex CAN interfere with antibody development, yes. If the medicine is doing its job of not allowing virus replication then there is no virus, at the moment, for the immune system to see so you don’t make antibody to be detected on the test. Do you follow me on this?

In you were my patient I would ask that you discontinue Valtrex. If you have a lesion, that can then be swab tested. If you don’t, then you can repeat your test in a few months for accuracy. However, if you continue to have sex with a partner who is HSV 2 positive, then you are always at risk and things may change. If he uses condoms and take daily antiviral therapy (it is NOT useful for you to take it), then your risk of acquiring herpes is low.

Terri

[simple]

Thank you for all of your help. You really do a great service. It amazes me how little accurate information there is and how uneducated our medical profession is in regards to this virus.

Okay, a couple more questions. The last possible exposure was Jan 18th. That’s the last time I have had sex or even been undressed with anyone. I did not get put on the Valtrex until February 20th. Wouldn’t I have built up detectable antibodies for a test by then? That was almost 6 weeks past exposure. Previous possible exposure was December 26th. If I had built up the antibodies, would the Valtrex then reduce them?

Also, you say the IGM is not a good test to indicate recent infection. I understand one reason is because the body can and will produce IGM any time the virus becomes active. So basically the IGM can and will fluctuate high and low in anyone that has the herpes virus. Does this mean that the test is still a good indicator that you’ve been exposed? It just can’t tell when? Or is the IGM test unreliable because it can produce false positives? I see so many comments that the IGM should be dismissed. Is it because it is an inaccurate test or is it just because many doctors assume that when the IGM comes back positive that means “recent” exposure?

[Terri Warren]

There was a month or almost two months between your last possible exposures and the medication beginning. That’s good but not prefect. Valtrex would not reduce antibody, it would just reduce the likelihood of making more, when taken daily.
Some people produce IgM with recurrences, others do not. And yes, it will fluctuate and can most assuredly cause false positives. It should be dismissed because it causes false positives AND because doctors interpret those false positives as new infections. A total mess.

You have one more question available on this subscription.

Terri

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