Reply To: A confusing, depressing, and difficult five years

[takeiteasy]

Hi Terri,

Thank you for the reply. I have a few follow up questions.

1. You said “Maybe go straight to the blot if you can afford it”. It is my understanding that the WB is very accurate (and indeed the gold standard), but it won’t tell me what part of my body my HSV is on and it won’t tell me if any current skin lesion is HSV related. Sure, it will give me a clue that the skin lesions I am experiencing are more likely to be herpes related, but that’s all it is, a clue. Many of my symptoms are atypical. Multiple doctors have said it isn’t herpes related. That being said, I am coming to the conclusion that almost all doctors are clueless when it comes to herpes, testing, and diagnosis.

Say I did get the WB, and it came out positive for both HSV-1/HSV-2, how likely would you say that my recurrent penile lesions are genital herpes of one kind or another?

2. You wrote that 8% of people who have an IgG test, do so in a range that is prone to false positives.

However I read that the US Preventive Services Task Force published a statement saying there is a 50% false positivity rate for the most common serological HSV test, the Herpeselect. I am providing the link and quote below:

https://jamanetwork.com/journals/jama/fullarticle/2593575

“Serologic screening in asymptomatic persons will likely result in a large number of false-positive results. Given the limitations of currently available tests, 1 of 2 positive results may be false. Given the test characteristics of the most widely used serologic screening test for HSV-2 and a population infection prevalence of 15%, screening 10 000 persons would result in approximately 1485 true-positive and 1445 false-positive results.”

It sounds like you are saying false positives are more in the 5-10% range for the IgG, but that’s not what the JAMA article says.

What do you make of the above statement by the USPSTF? Am I missing something?

Thanks for all of your help thus far. I’ll consider the WB.