Western Blot? How? Back to Front?

[Oak Tree]

Hi! Glad to find this. So this is the story: Recently went into clinic to investigate recurring sore located near where a pilinoid cyst may be, but the doc said it probably wasn’t that. Anyway, went in about 24-72 hours after symptoms occurred and had HSV 1/2 culture, and also HSV 2 antibody IgG and IgM ELISA done. Doc said it didn’t look like HSV, but it could be. Very certain this was sent out to Quest lab.

So, when the results came back the viral culture was negative and the IgM test was negative. The HSV 1 was negative (Index value .09), but the HSV 2 IgG test was positive (Index value 1.56). The results also reported that a reflex to titer was “not indicated.” I’m assuming they didn’t confirm the results then, unless that was just misleading. The standard range was listed as (<.9) so I’m assuming it’s the HerpeSelect IgG EIA since that is what quest has on their site.

I should probably mention that I have been arbitrarily intimately inactive for over 24 months, mostly do to other priorities, so if I was infected it would most likely have been older than that. Although, I think the bum sore has been coming and going for a couple years, but I have never noticed anything in a different spot. No noticeable sores on genitals, and I have never had a noticeable cold sore.

Anyway, when the nurse called to tell me the results she said that she could tell I had been exposed, but that it was unknown if I was infected. She also said it was not known if I could get re-infected, and there was no way to know for sure if I had contracted the virus. Well, I started reading everything I could find and determined I had better call back and see what someone else had to say. So, I ended up talking to another nurse and a PA who thought the results were definitely positive. I could never get a hold of the doc, although eventually I received an rather ambiguous email that said “I was positive in that I had been exposed, but had no current infections.”

From my own research, I am under the impression that I have not really learned anything, and although the sore was a little suspicious, it’s really a coin toss if I’m positive with HSV 2. Is it possible my interpretation is accurate? I’m suspicious of the medical staff giving me contradicting info. Do I need a Western Blot HSV 2 test?

How do I order the test? (Since I can’t get a hold of the doc and they are not showing any interest in my concerns at the clinic)

Also, could I have contracted such an infection through heterosexual intercourse (symptoms on behind)? And If I am positive, and the infection turns out to be shedding in the intergluteal region, what are the odds of spreading the infection to my genitals if I have unprotected/protected heterosexual intercourse with someone who has outbreaks on their genitals, or have no symptoms? Odds of me spreading the virus through my own genital region?

[Terri Warren]

My goodness you have received some varied opinions about the meaning of your test results.
IF you have a true positive on the IgG antibody test, it means you are definitely infected and infectious to others. There is no such thing as having a positive antibody test and just being exposed but not infected. Period.
However, your index value is at the low end of the positive spectrum and in that spectrum we see a fair amount of false positives. So if it has been 4 months since your last sexual contact, I would strongly encourage a western blot, yes. You can do this by obtaining a kit from the University of Washington, having your doctor draw and spin your blood and return the kit to UW OR you can set up an appointment with our clinic to become a patient of ours and we will arrange a blood draw for you at a lab near you and they will send the blood to UW.

Many straight people have outbreaks near the anus or on the buttocks. The virus establishes latency and can come out on any branch of that nerve. That nerve supplies the area between the waist and midthigh and outbreaks in any of those area with HSV 2 are genital herpes outbreaks. Since the virus is already all in that nerve group, you cannot spread it any more to those areas.

Please let me know if you have other questions.

Terri

[Oak Tree]

Thank’s Terri,

So it sounds like I interpreted the results correctly. If it says HSV2 IgG ELISA Index value 1.56 and it was done at quest it’s fair to assume that this is in the low positive range for sure? I will figure out how to order the Western Blot. Modern health care is so weird!

Anyway, assuming the sore on my buttocks was in fact a symptom, your saying the whole sacral nerve plexus is essentially infected, so I would just happen to be having the symptoms on the buttocks arbitrarily?

Serious question: I’m a straight male, if an HSV 2 positive women had touched an area of her body that was shedding and then touched my buttocks, could that been the source of infection? And if I’m only having symptoms in the buttocks, would I be likely shedding the virus in my genital region without symptoms also?

Than’s Again for your response, Terri!

[Terri Warren]

You got infected genitally, not through the buttocks by someone touching you with herpes on their hand. The virus cannot penetrate the buttocks skin unless there is a significant break in the skin. It is far more likely that you got genital acquisition and it recurred on the buttocks, if indeed you have herpes. Even if your outbreaks are only on the buttocks, you will shed virus from the penis as well.

Terri

[Oak Tree]

Ok. That answers my questions. I know I can get all this sorted out. Thank’s

[Terri Warren]

You are most welcome.

Terri

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