Testing for hsv

[Naisa84]

Hi Dr. Warren. I did an std panel including hsv 1&2 back in October of 22. Because I saw what seemed to be a small tare on my penis. Everything was negative except that hsv 1 came back at a value of 36.50. Doctor said it was normal it’s just oral hsv that you have. That I’m fine nothing need be done. Fast forward to mid February this year I felt a tingle down in the same area, and looked to see what it was, and I saw really tiny raised bumps. So I got screened for everything again just like back in October, but an hsv igm was also added for testing, and everything came back negative. Except my igg value this time was at 38 for hsv1. So then the bumps got worse over the course of a few days, and I felt absolutely no pain they were just there, and then by day 10 they were gone. 2 weeks later one lesion comes back, and then 3 more right after by a couple days, but they were all separated not in a cluster. So I go to dermatologist, and so they didn’t do a swab, but instead they cut off a piece of the lesion, and did a biopsy, and the biopsy came back positive for hsv. So now I’m totally confused, and devastated. So my doctor prescribes me valicyclovir for suppression, and so I start taking it to present day once a day. I also experience flair ups but nothing crazy just like a little raised red bump that can barely be seen, but it happens here and there. So I pay a visit to my doctor 3 days ago, and I tell him I want to test for hsv igg again. So I did, and the results came back the same for hsv1 at a value of 45. And negative for hsv2. So what in the world do I have going on? Is it hsv 1 or 2 or no hsv, and would my doing the last igg test affect my results because I’m on suppressive treatments. Like I’m so lost Dr. Please help me figure this out.

[Naisa84]

Hello Dr. Warren just waiting on your reply whenever you get a chance. Also will my using suppressive therapy along with protection to have sexual intercourse be decreased to transmit it? If indeed have it because I don’t know I don’t think I do. Hoping to hear from you regarding my initial question was posted regarding the ordeal of testing I’ve went through, and timelines I provided will give me some clarity.

[Terri Warren]

Sorry, I’m in India with limited internet access.
The IgG test misses 8% of HSV 2 so it could be that or you could have HSV 1 genitally. Because a biopsy was done and not a swab, probably typing was not possible. If you get another one, request a PCR swab, not a biopsy, so you can know the type. That would require that you NOT go on suppression yet, but you certainly can after the typing has been identified. You are having a whole lot of outbreaks for HSV 1 genital infection, could you have just been infected genitally? If it is a new infection, not too unusual for HSV 1 to recur like this.

Terri

[Naisa84]

Thank you for the response. I’ve gotten cold sores orally in my lifetime, but very few. So I think I’ve always had ohsv1. Never new I can test for it until I saw the symptoms on my genitalia, and read up on it, and got tested. I also found out that I tested positive for mycoplasma genitalium not too long ago. Can that be a contributor to the recurrences on my genitals? Why I tested for Mgen was because I’m getting a discharge from my urethra, when my symptoms originally started back in October of last year. I thought it had to do with the hsv, but it’s clear it’s from the positive test of Mgen. I’ve been taking antibiotics for it. Also are prodome symptoms the same for both types of hsv before an initial outbreak?

[Naisa84]

I also have to little ones that I’ve on occasion change their diapers before I knew I got infected, and I’m worried that they can get it. Is that a possibility they can? I’m so scared of that happening. I’m an aggressive hand washer always have been. But since knowing my status I don’t change their diapers anymore, and appreciate some clarity on that.

[Terri Warren]

This is very confusing to me because it would be so uncommon to get HSV 1 genitally when you already have it orally. Are you sure it wasn’t positive for HPV rather HSV?
There is no risk of transmission to your children in your situation. Go back to changing diapers!

Terri

• This reply was modified 1 month ago by Terri Warren.

[Naisa84]

The biopsy came back positive for hsv. My contracting the virus genitally is from a relationship I got myself into, and not being responsible, and using protection. We performed orally to each other on occasion. Her more than me, but I don’t know all I know is that this has changed my life, and flipped it upside down. I don’t think it’s hpv because what I got were sores that were tested, and I got the results back for hsv. Are you saying I have something else to worry about now 😳?

[Terri Warren]

No, I’m not saying that, I just wondered because normally HSV is not diagnosed via biopsy but HPV is and is a very common STI. I am a bit confused about the timing of your antiviral medicine use and your repeat IgG testing. For how long did you take antiviral medication and how long was the time between your first IgG test and your second IgG test.If you took an extended course of antiviral medication, it can interfere with IgG test results, causing a false negative. Also, if you test too soon after symptoms appear, that can cause a false negative. Let me know these answers please.

Terri

[Naisa84]

Hi Terri. So my first igg test was on October 15,2022. My second igg was on March 6, 2023. I had sores appear in my genitalia at that time. March 15,2023 I decided to go the dermatologist, and they were confused because it didn’t look like herpes. Actually every doctor I went to thought it was Lancon plantus or a rash. In May of 2023 I started taking valicylovir because the biopsy came back positive for hsv, and doctors prescribed me the anti virals. On October 12, 2023 just shy from a year when I did my first igg. I did another one, and it was negative again for hsv 2 all 3 times NEGATIVE, but positive for hsv1 all 3 times.
Please help me make sense of this Terri.

1st igg test:09/15/22
2nd igg test:03/06/23
Biopsy: 03/15/23
Antivirals: in May of 23 to present day.
3rd igg test:10/12/23

[Naisa84]

Please excuse the typo my first igg test was 10/15/22 not 09/15/22. Also I started taking the antivirals faithfully end of June beginning of July, but I was prescribed the medication in May.

[Terri Warren]

The antivirals that you’ve taken MAY be interfering with antibody development and giving you a false negative IgG, if I’m reading the timing correctly, but it all depends on sexual activity around that time. I would recommend that you consider coming off the antivirals and retesting in a few months. However, if you are having sex with someone who is uninfected, and you do have genital herpes, this puts them at greater risk of infection.

Biopsies cannot tell actually if you have HSV 1 or 2 or even if this is herpes simplex. Biopsies would look for something we call multinucleated Giant cells that are present with shingles infections as well. you case is really confusing to me, honestly

Terri

[Naisa84]

Hello Terri. I was involved in a relationship with someone from the beginning of August of 2022 until November of 2022, and then took a break from one another for most of November, and then on, and off with each other until the beginning of January 2023. Since then I’ve had no sexual activity at all until present day. Now I’m regards to the biopsy from what I gather from what you said the biopsy is not totally accurate in diagnosing hsv. For all we know it could be genital shingles is that an accurate assessment on my part? Because I did have chicken pox when I was a child. I don’t know I’m just so confused, and devastated. This is really consuming me. Also with my just sharing my sexual status with you does that still mean the antivirals may have interfered with the last igG blood test I took a few weeks ago October 24,2023 if I’ve been taking them from late June to present day?

[Terri Warren]

The biopsy could diagnose a herpes virus, but there are eight of them. So just not sure. A biopsy should not have been done but rather a PCR swab of any concerning lesion. I think you need a herpes western blot to get clear on this. Chicken pox would not show up in a biopsy, no, but chicken pox in an adult can show up as shingles which is sometimes but rarely genital.

Given you’ve had no sexual activity since January and you started the antivirals in June, I doubt that it has interfered.

I really can’t help you any further with this without a western blot for clarification.

Terri

[Naisa84]

So how do I get a western blot. Can you prescribe it for me? How do I get it? Id be willing to pay for it?

[Terri Warren]

You can sign up for an appointment at this website – follow the link to get a western blot. I am full at the present as I am out of the country but will be adding more dates for visits soon. Do you live in the US?

Terri

[Naisa84]

Yes I do live in the UNITED STATES. I will be sure to do that thank you, and I’m open to any further guidance on your to help me get to the bottom of my issue, and hopefully resolve. I also wanted to ask you on if you have any knowledge or data regarding the consumption of kratom, and how it may or may not interfere with testing specifically the igG testing for hsv?

[Terri Warren]

I have no knowledge about kratom at all.

You have now paid for nine posts and have posted 10 times, I am closing this for now.

Terri Warren

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