Confused with test results

[maleck]

Dear Dr,
A year ago I had a relationship with a girl, whith whom I enroll in unprotected sex. The last time we were together was a Friday. The following Saturday I wake up with me penis red and burning, and at the afternoon I got a blister with white liquid. I applied acyclovir (like 8 months before, I had an infection that the clinic physician mistake with herpes but did not react to acyclovir and seems more like balanitis, so I got the medicine at hand). The blister dissapears in less than two hours. Some red skin bump keeps present for two weeks. I never had any ulceration.

The girl that was with me claims that I give her HSV. However, I got tested for STDs including HSV2 after 11 weeks of the incident, and I get a clean result.

The HSV test was a SMC test (sensotronic memorized calibration), which reports 6.7 Ul/ml. Undetermined rank is 20-25 and results greater than 25 are positive. They screen for Igg antibodies.

The following six months I was completely clean. But in January I had another irritation, Once again clinic professional sent medicine for herpes, but test give negative for IgM (HSV I) when the irritation was just starting to heal.
In this occasion I got desperate and use Listerine to burn the bumps and get small ulcer. Again STD test (HIV, Syphilis, Hepatitis B) where negative.

Since then, I got permanent irritations (red skin). Having enough of clinic physicians (never seems to take the case seriously), I went directly to three urologist and one dermatologist (sadly, symptoms ever disappear just before the meeting). I took photographs of my penis and show  them to the doctors.  The first urologist diagnostic was  balanitis, and I start medication. I got better quickly, but in the process I got my first blister that turns into ulcer. So I freaked out again and went to one dermatologist and one urologist in the same week. The dermatologist said it was balanitis that get in contact with urine and developed the blister. The urollogist said it looks like herpes and sent a Tzang test.

Tzang test came back negative, but with the "low cellular sample" note.

I keep having small blisters, that do not get ulcerated, do not respond to acyclovir.  I went to the last urologist, who did not sent a new HSV test, claiming that I got enough negative results and should stop worring. He insist in the balanitis diagnostics.

However, although the balanitis medication hold my penis free of irritation, some tiny blisters are appearing in a continuous basis.

So I went to a clinical laboratory and order the IgG test. It came back positive with a value of 1.3 in a scale where 1.1 is positive. They do not provide major information about the test used. It reads: Herpes II ACS IgG 1.3

How can be this clinic history be interpreted? did I get HSV from this girl? or can it be that I got it before and without knowing I give the virus to her? How reliable are this last results when we take the whole history into account?

thank you very much.

[maleck]

I am in  south America. My health provider use an ALEGRIA ANALYZER, the technique was ELISA, technology SMC.
I did not receive the specs for the test I have asked for directly to an independent clinical laboratory.
One again. Thank you so much

[maleck]

Thanks for the answer. The first test was anti-HSV2 IgG. I have not taken a IgG test for HSV1

[Fleetwood20]

There are signs here that are suggestive of the need to either confirm or eliminate herpes here as a cause of the symptoms.

Let's start with the first test 11 weeks after the episode with the partner you mention that occurred about a year ago. The SMC is a technology that is used by ORGENTEC and products are used throughout Europe. Does this seem right?

If so, then the tests you needed at that time were:
Anti-HSV-1-IgG
Anti-HSV-2-IgG

You must confirm that these were the tests you actually had. Was it? or something else? This is critical as it will determine whether you were negative for HSV1 and HSV2 at that point. The test looks reliable if you had the right one.

The IgM test is not useful in diagnosis and does not add any value, it is not suggestive of positive or negative in a standalone context.

The latest is positive and therefore suggestive that there is a HSV2 infection. It is perhaps a low positive and would need confirmation in any event.

I'd suggest that you obtain a further test, IgG for both HSV1 and HSV2. Perhaps you could find a place that sources the Euroimmun test that would be available where you are.