Testing with antiviral

[BHW]

After what appeared to be an initial outbreak (still unconfirmed) my doctor began 500mg of generic valtrex daily. It’s been 8 weeks since possible exposure and I’ve tested negative for Herpes 2 twice.

I plan on testing again at 12 weeks (I’ve been told the test is 99% accurate at 12 weeks).

Will my taking antiviral a from the get go affect the accuracy of a 12 week test?

[Terri Warren]

Taking the antiviral will most definitely impact your antibody test, yes. The function of antiviral medicine is to reduce viral replication. If it is working well and doing it’s job, then there is little virus around. However, that means your immune system cannot see the virus and cannot make antibody so you could keep it negative for a very long time and still be infected. If you want to know if you have herpes, you will have to come off the antiviral and test in 12 weeks from then. However, if you test positive now, then your body was able to see enough virus to become positive (the medicine isn’t perfect) so a positive you can believe – a negative you cannot. If you do go off medicine and get an outbreak, you should have that swab tested for accuracy. I’m assuming a swab test was either negative or not done with your first outbreak?

Terri

[BHW]

My doctor never told me that. I went to a urologist about 3 weeks after what could have been an original outbreak. My primary only gave me a 7 day prescription of famlicyclovir for the original and tested me (neg) but told me to retest in 10-12 weeks and suggested I see a urologist. The urologist gave me the suppersent prescription and told me to test in 12 weeks. I’ve been on his prescription of 500mg of generic valtrex for 7 days now.

The problem is I don’t want to tell my girlfriend until I know for sure and yet have avoided sex with her for the past 9 weeks.

I have read other information on the web that suggests the antiviral would not affect test results.

I’m confused and upset.

[Terri Warren]

I use the University of Washington, the leading herpes experts in the world, as my guide. Don’t know what internet sources you are using but I suggest that you consider using the University of Washington as they are the BEST about herpes in the US – Larry Corey, Anna Wald, Christine Johnson, Zane Brown – all world renowned. Every western blot comes with that explanation in result interpretation. But of course, use whoever you wish as a reference. I have a patient was diagnosed by physical exam only, no swab test, she was on suppression for 9 months and never seroconverted. Pulled her off and she was positive in 6 weeks.

Terri

[BHW]

Thanks again.
So here’s the time line:
Oct 14 possible contact
Oct 18 some sores but did not hurt burn or itch and really didn’t look like any of the pictures on the Internet.
Oct 23 saw doctor the when the two sores wete 90% healed and I tested neg and he put me on famlicyclovir for 7 days
Nov 1 I retested neg
Nov 20 I retested neg
Dec 7 saw a urologist who gave me the valtrex which I took daily for only 5 days. He told me to get tested at the 12, 16 week mark from original date of Oct 14

Based on what you have told me and given that I was ONLY taking the valtrex for the past 5 days and this whole nightmare began on Oct 14 in your opinion must I really begin all over with another 12 week period before the lgG test is reliable or will the 5 days on valtrex just make me wait a week or two longer than I originally planned? (I was planning on retesting in 4 or 5 more weeks….making it at total of 14 weeks, including the 5 days on valtrex)??

Based in your previous remarks I will stop the valtrex now, after 5 days.

Thanks again for you answers

[Terri Warren]

So now I”m confused, because your earlier post indicated that you were taking daily antiviral therapy. If you only took it for five days, that is not an issue. This was not clear in your original post.

Terri

[BHW]

Terri:
Sorry to be confusing in my prior question.

To clarify, for weeks 1 through 7 I was NOT on a daily therapy and tested negative twice. In week 8 I took 5 days of daily 500mg valtrex BUT STOPPED IT per your response.

My goal is to take another test in week 12 and 14. So my question is: did I mess up my future 12 or 14 week test result by taking the med for those 5 days?

Thanks and sorry for not explaining better previously.

[Terri Warren]

Great news – you did NOT mess up your future testing with the doses that you took and the duration of the dosing.

Terri

[BHW]

Terri:

I just received my Type 2 testing results at 8 weeks. It was again negative.

It was performed at Quest (lgG test). After I received the results I contacted the testing service to ask for the EXACT number since all they reported was a <.9 result. They said they could not.

I’m wondering if I really need the exact number or if it would really mean anything to me and how reliable are tests or optimistic should I be at the 8 week mark?

The wait is very difficult.

[BHW]

I just wanted to make sure that my lgG tests at 15-16 weeks will be accurate given my medication history.

1. When I first saw my doctor there was nothing he could swab so he gave me 7 days of FAMCICLOVIR (500mg 3 times a day)

2. 4.5 weeks later I saw a urologist who gave me generic valtrex (500mg once a day) BUT I STOPPED IT after 5 days based on your comment that it could affect my tests

So my question is: given the meds and duration I took them will my lgG test results (if negative) at 15-16 weeks be accurate and trustworthy?

Thanks again.

[Terri Warren]

Yes, your results at 15 weeks is accurate – the amount of antiviral therapy does not impact your test results. And you do NOT need the exact number, less than 0.9 is fine.

I see you’ve posted another question under this name. It get very confusing when you do that for me to keep track. How about you don’t do any more new threads, Ok?
I’ll answer the questions that you post.

Terri

• This reply was modified 7 years, 1 month ago by Terri Warren.

[BHW]

Is it possible for a person to have BOTH type 1 & type 2 residing in the genitals? And if so, would having Type 1 genitally FIRST have any effect on aquiring type 2 genitally?

[Terri Warren]

Yes, a few people have both HSV 1 and HSV 2 genitally. I have had those patients. Having HSV 1 genitally first would likely reduce the likelihood of symptoms of HSV 2, should HSV 2 be acquired after a person has genital HSV 1.

Terri

[BHW]

Terri:

This past Monday (Dec. 28th) I took my 4th test since October 14th’s possible exposure to HSV2. That test was also NEG but it was only 11 weeks and 5 days from October 14th.

On Dec. 17th you replied to my question of the same date saying that my taking of the anitvirals for a short time would not affect the accuracy of my testing.

One item I failed to mention is that I also tested positive on the very first test back in October for HSV 1. I have no idea where my HSV 1 is located, but I can’t ever recall having a cold sore as an adult and I have no memory of them as a child (but obviously I could be wrong about that).

My question is: Given that I also have HSV 1 and my short periods of medication at the end of October and a few days at the start of November when can I truely feel that my tests will be accurate? (14 weeks, 15 weeks or the 16 week mark)

One other item to mention: For the past 4-5 days I’ve been experiencing a slight “feeling of senstivity” at the head of my penis. It’s not pain, there’s no pain during urination, there are no sores or red marks around or inside the tip, no itching, no swelling, everything looks fine. It’s just a slight sensetivity that comes and goes. Taking Ibuprophen seems to help. I’m wondering if it could be related to possible herpes or perhaps something else.

[Terri Warren]

This is a very fine line question. Not a big picture question, which is fine, but just saying. People who are positive for HSV 1 take slightly longer to seronconvert to HSV 2 than people who have no hSV 1 infection. The difference isn’t huge – maybe 2-3 weeks? And when we look at seroconversion time in general, I’m sure we are looking at the overall time for people including both people with and without HSV 1. I’m not worried about the “sensitivity” given your negative test at this time. I’m betting with a good deal of certainty, that you wills stay negative.

Terri

[BHW]

I recently again tested negative (lgG) for HSV-2 at 12.5 weeks from exposure.

I have read various “testing window” times and I’m trying to figure out which is accurate. Your handbook says “probably 3-4 months” other sources say 3-6 months and still others say even shorter or longer “Windows”. Is there no recognized standard?

I plan on testing again at 14 weeks and if needed again at 15.5 weeks but was hoping (if still negative) to resume my normal sex life.

So what’s the real trustworthy “window” for me?

Btw…I took 10 days of Famcyclovir in mid October and 5 days of generic valtrex in early November but stopped it per your suggestion.

[Terri Warren]

The IgG test window is 12 weeks – most everyone who is going to serconvert will do so by 12 weeks. With western blot we want 16 weeks. 15 days of therapy is not going to throw off the test at this point. If you want to test again, you can, but I would be very surprised if it is different – I would say 95% of people will seroconvert, or more, by 12 weeks on the IgG test. but great news so far, right?

Terri

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