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Confused Canadian - low positive
Here's my HSV drama story. This has been an emotional roller coaster for almost a year. I'll try to stick to the facts. I'd appreciate your advice as I am still utterly confused.
June 2012: unprotected sex. Found out later that partner had genital HSV.
Symptoms: vaginal soreness and a cut but no bumps or itchiness. Unclear whether this was due to rough sex, lack of lubrication and condom use or if it was HSV symptom. Also, fever! Parter said he had the flu. Confusing whether this was caused by flu or exposure to virus. Swab test done on the cut. Result: negative.
8 weeks after:; blood test done. HSV iGG. Result: reactive. "evidence of past infection with HSV. This assay does not distinguish between antibody to HSV 1 or 2. Then, HSV Type 1 Specific EIA and HSV Type 2 Specific EIA: weak hsv igg eia screening. hsv type specific serologies non-reactive, suggest repeat hsv serology in 2 months.
I asked for the specific values. "what does "weak" mean? they took forever to give me an answer. nobody has a clue abotu this, not my doctor, not the lab. finally I got this:
hsv igg siemen test: .60 (neg if minor than 0.02)
hsv-1 igg focus test 0.01 (neg if minor than 0.9)
hsv-2 igg focus test 0.04 (neg if minor than 0.9)
after that, I did lots of research and decided I needed to retest and get the actual values.
retested. doctor and lab did not communicate. lab result: reactive. did not get the specific values. i asked for them, by the time they got to it my sample had expired.
abroad for 6 months.
back in canada. blood test. asked for specific values.
verbal results: hsv igg: reactive but weak
hsv 1 and hsv 2: negative
I called to get actual numbers. nurse didn't know. finally someone at PHSA lab talked to me. she said she;s not a std specialist but wanted to ensure to me that:
the general igg test they use is the gold standard, so if it says reactive I can be sure it's positive. It doesn't matter if it's 1 or 2 cause 1/2 can be genital/oral and viceversa. The reason why the values are so low is that this was an exposure long time ago. She could give me the values but they won't make sense to me because they use thir own range and this range cannot be compared to other test. It doesnt' make sense except for them. The second tehst they to (EIA) that came out negative is less sensitive than the first one. That might explain why it comes out as negative. Again, she's not an expert she says but she can ensure that this is not a false positive.
After reading this forum, and after not having any symptoms (except for the occasional symptoms of something similar to yeast/vaginosis infection) , I am very tempted to think that this is a false positive and that I should put this behind.
I'd love to do a western blot for confirmation... but they no longer do this in canada, I believe. I would be happy to test privately... though as I said, I am inclined to put this behind.
During this past year I have read lots about it and I had time to reflect in that, regardless of the results, it's not the end of the world! It's something that it's out there and tons of people have it. At the same time, confirmation of a proper diagnosis would be nice, especially cause I don't want to be taking unnecessary meds.
What do you think?
June 2012: unprotected sex. Found out later that partner had genital HSV.
Symptoms: vaginal soreness and a cut but no bumps or itchiness. Unclear whether this was due to rough sex, lack of lubrication and condom use or if it was HSV symptom. Also, fever! Parter said he had the flu. Confusing whether this was caused by flu or exposure to virus. Swab test done on the cut. Result: negative.
8 weeks after:; blood test done. HSV iGG. Result: reactive. "evidence of past infection with HSV. This assay does not distinguish between antibody to HSV 1 or 2. Then, HSV Type 1 Specific EIA and HSV Type 2 Specific EIA: weak hsv igg eia screening. hsv type specific serologies non-reactive, suggest repeat hsv serology in 2 months.
I asked for the specific values. "what does "weak" mean? they took forever to give me an answer. nobody has a clue abotu this, not my doctor, not the lab. finally I got this:
hsv igg siemen test: .60 (neg if minor than 0.02)
hsv-1 igg focus test 0.01 (neg if minor than 0.9)
hsv-2 igg focus test 0.04 (neg if minor than 0.9)
after that, I did lots of research and decided I needed to retest and get the actual values.
retested. doctor and lab did not communicate. lab result: reactive. did not get the specific values. i asked for them, by the time they got to it my sample had expired.
abroad for 6 months.
back in canada. blood test. asked for specific values.
verbal results: hsv igg: reactive but weak
hsv 1 and hsv 2: negative
I called to get actual numbers. nurse didn't know. finally someone at PHSA lab talked to me. she said she;s not a std specialist but wanted to ensure to me that:
the general igg test they use is the gold standard, so if it says reactive I can be sure it's positive. It doesn't matter if it's 1 or 2 cause 1/2 can be genital/oral and viceversa. The reason why the values are so low is that this was an exposure long time ago. She could give me the values but they won't make sense to me because they use thir own range and this range cannot be compared to other test. It doesnt' make sense except for them. The second tehst they to (EIA) that came out negative is less sensitive than the first one. That might explain why it comes out as negative. Again, she's not an expert she says but she can ensure that this is not a false positive.
After reading this forum, and after not having any symptoms (except for the occasional symptoms of something similar to yeast/vaginosis infection) , I am very tempted to think that this is a false positive and that I should put this behind.
I'd love to do a western blot for confirmation... but they no longer do this in canada, I believe. I would be happy to test privately... though as I said, I am inclined to put this behind.
During this past year I have read lots about it and I had time to reflect in that, regardless of the results, it's not the end of the world! It's something that it's out there and tons of people have it. At the same time, confirmation of a proper diagnosis would be nice, especially cause I don't want to be taking unnecessary meds.
What do you think?
I went from clinic to clinic, took me a year. Did my research and finally got a hold on a nurse who had enough common sense to realize she didn't know enough to answer my legitimate questions. So she put me in touch with the lab head who could not answer either. I insisted and finally got a phone call from the head of the health centre because he understood the results didn't make sense. He offered to send the sample to the national lab in Winnipeg and I said yes. He said alternatively, a few private labs do run the blood tests but there's a charge. I don't have the name of the labs. If you're close to the border, I understand you can get a test in USA, but not sure where.
I live in Canada as well but two doctors have now told me there is no way I can get a blood test for herpes. I'm a male if that matters. How and where did you go about getting a blood test? That would help me out so much.
Life 360 and fleetwood, I really wanted to thank you for replying to my questions. This forum has been the only place where I was able to get any useful information.
I feel like the docs and nurses just want to cover their butts and they have no clue.
I'm still not 100. Percent sure of what hsv 1 I have but It's reinforcing to have at least some certainty that I do t have the 2 type.
Is there a good thread with info about hsv1?
Should I be moving this story to the false positive thread in case it's useful to other people? Or this wouldn't fit in there?
Thanks again!
Seeking answers, you might want to repost your question in a separate tread to get more answers... Sorry I can't help, I don't know.
I feel like the docs and nurses just want to cover their butts and they have no clue.
I'm still not 100. Percent sure of what hsv 1 I have but It's reinforcing to have at least some certainty that I do t have the 2 type.
Is there a good thread with info about hsv1?
Should I be moving this story to the false positive thread in case it's useful to other people? Or this wouldn't fit in there?
Thanks again!
Seeking answers, you might want to repost your question in a separate tread to get more answers... Sorry I can't help, I don't know.
I was given a HSV IgM I/II and the result was equivocal at .96. My HSV I IgG and HSV II IgG were both negative at <.91. My last relationship ended at the end of July and I had a unprotected fling at the end of september. I have been dating a girl and we had unprotected sex for the first time this past weekend; is she at risk even tho its an IgM equivocal?
On a side note my di@kface doctor had these results since 10/22 and did not bring this finding to my attention until this past wednesday!
I feel terrible about possible infecting someone else...
On a side note my di@kface doctor had these results since 10/22 and did not bring this finding to my attention until this past wednesday!
I feel terrible about possible infecting someone else...
That is the most plausible explanation. You have oral HSV1 from your youth and you do not have HSV2.
I have reread your test results and I cannot see anywhere a suggestion that your HSV2 antibodies had a low positive reading. Your combined 1/2 did but that is consistent with being caused by the HSV1 infection. Any HSV2 specific test looks to have been a clear negative.
The commercial testing is missing your HSV1 infection.
It is possible that you have genital HSV1 but I think this quite unlikely.
I have reread your test results and I cannot see anywhere a suggestion that your HSV2 antibodies had a low positive reading. Your combined 1/2 did but that is consistent with being caused by the HSV1 infection. Any HSV2 specific test looks to have been a clear negative.
The commercial testing is missing your HSV1 infection.
It is possible that you have genital HSV1 but I think this quite unlikely.
Wow, this is crazy. I have read lots about the confusion and misdiagnosis with type 1 and but somehow I failed to connect the dots.
I was misled to thinking it was type 2 1)because of the contact with a person who actually has it 2) confirmation from one physician that I had tested positive for hsv 2 (though with low value).
I know my mom has cold sores; she gets them 2-3 times a year in her mouth. Had had that forever. But I never had one.
What you are saying is that I most likely have that from my mom but never showed symptoms and that I've been living in hell for the last year thinking I had hsv2- genital?
I was misled to thinking it was type 2 1)because of the contact with a person who actually has it 2) confirmation from one physician that I had tested positive for hsv 2 (though with low value).
I know my mom has cold sores; she gets them 2-3 times a year in her mouth. Had had that forever. But I never had one.
What you are saying is that I most likely have that from my mom but never showed symptoms and that I've been living in hell for the last year thinking I had hsv2- genital?
I didn't see your message shootingstar until now.
As with confused, the likelihood is that you have an oral HSV1 and because you were infected as a child you just do not remember any cold sores if there were any.
Commercial tests do miss about 1 in 10 HSV1 infections. The WB does not, less than 1% are missed. If you have no recollection of any cold sores than as Life suggests, the overwhelming majority of these people have a long term oral infection.
As with confused, the likelihood is that you have an oral HSV1 and because you were infected as a child you just do not remember any cold sores if there were any.
Commercial tests do miss about 1 in 10 HSV1 infections. The WB does not, less than 1% are missed. If you have no recollection of any cold sores than as Life suggests, the overwhelming majority of these people have a long term oral infection.
Hi if youve never had any symptoms then its most likely oral that you received as a child. Until you know otherwise this is what the most obvious.
I never had a cold sore so I don't think this is the oral type; I could technically have hsv-1 in the genital area, I understand. I haven't had any symptoms (except for what looked similar to a bacterial vaginosis last year--see details above).
So....what confuses me is why none of the tests before picked up the hsv-1; the tests actually picked up hsv-2 with low values.
Perhaps I picked up hsv- 1 just recently? I haven't had sex since July though. And at that time it was protected sex and only once.
WB is supposed to be the gold standard, so I am pretty sure the HSV-1 diagnosis should be right. I am just puzzled as to the questions above.
Help?
So....what confuses me is why none of the tests before picked up the hsv-1; the tests actually picked up hsv-2 with low values.
Perhaps I picked up hsv- 1 just recently? I haven't had sex since July though. And at that time it was protected sex and only once.
WB is supposed to be the gold standard, so I am pretty sure the HSV-1 diagnosis should be right. I am just puzzled as to the questions above.
Help?
Today I heard back from the virologist--after my blood sample at at the lab since July.
He told me they did a Western Blot. And the results were positive for HSV-1 and negative for HSV-2.
If I was confused before, now..how should I put it.
He told me they did a Western Blot. And the results were positive for HSV-1 and negative for HSV-2.
If I was confused before, now..how should I put it.
I agree that a double negative after a positive combination is unusual in the sense it doesn't happen all that often. But it does happen.
Another possibility is that the type specific IgG test for HSV-1 is not picking up the infection which also happens in about 10% of cases. This would more likely be an oral infection if this happened to be true.
All the same, a retest is the best idea to remove speculation.
To shootingstar79, yes you have had a combination test. A positive test result will usually be indicative of an infection, but false positives do occur. This isn't overly helpful though as many people unknowingly have an oral HSV-1 infection from their childhood. I would certainly be considering type specific IgG testing to settle the issue for you. I can't help you with cost. That can differ on provider and even your means.
Another possibility is that the type specific IgG test for HSV-1 is not picking up the infection which also happens in about 10% of cases. This would more likely be an oral infection if this happened to be true.
All the same, a retest is the best idea to remove speculation.
To shootingstar79, yes you have had a combination test. A positive test result will usually be indicative of an infection, but false positives do occur. This isn't overly helpful though as many people unknowingly have an oral HSV-1 infection from their childhood. I would certainly be considering type specific IgG testing to settle the issue for you. I can't help you with cost. That can differ on provider and even your means.
To Needhelp, I should add that I did have chicken pox when I was a kid (it was very common those days).
To fleetwood, I was reading your response and it interested me. I had a boyfriend for 4 years who I had 2 kids with, and he had hsv . Not sure which 1 or 2, but I think the last test I received was a combo test because the results said I was in the positive range.I was tested over a year ago with what was considered a pos result yet my doctors office failed to inform me until I nagged the hell out of them today. The antibody level was 2.3 making it positive, and it said it was positive for hsv 1 and/or 2. So that pretty much tells me it was a combo test. Is there a possibility of a false pos with a level of 2.3 or is it less likely?I have never had any symptoms I recall, so I guess if I do have it i'm an asymptomatic carrier...so far. Also, I went to the link you posted of the tests, and was curious how available and how expensive the serological glycoprotein tests are.
Update: a clinical virologist from the provincial lab called me today to follow up on the results. He said that having 2 positive results with negative specific results is an "unusual situation". He still thinks a false negative is rare and he's pretty sure the positive result is correct... but he can't explain the unusual results. So.. he said that if I was concerned he would send the sample to a national lab in Winnipeg for retesting. I said go for it. I'll know in a couple weeks.
I would think you have had the proper testing. If you have a type specific test result of negative more than 12 weeks after the last sexual encounter with this person you are very likely to be negative.
Combination HSV tests are pretty useless for a number of reasons, including a proportion of false positives and the fact that a majority of people have HSV-1 already.
Combination HSV tests are pretty useless for a number of reasons, including a proportion of false positives and the fact that a majority of people have HSV-1 already.
I really appreciate your response.
It'd be useful to hear directly from the experts, i guess I have to post on the paid section of the site? I'll consider this, though at this stage I am pretty sure they'll tell me the only way to get a proper diagnosis is to take teh proper test.
It'd be useful to hear directly from the experts, i guess I have to post on the paid section of the site? I'll consider this, though at this stage I am pretty sure they'll tell me the only way to get a proper diagnosis is to take teh proper test.
If you're really worried you could post in the ask an expert forum. I had a similar experience, with a weakly positive combination test and negative type specific tests. I read pretty much everything i could about the combo tests - the CDC actually recommends against using the igg combo tests for screening for HSV because they have a very high false positive rate (anywhere between 40% and 15% false positive, depending on the test). The type specific tests are supposed to be much more specific (meaning a lower false positive rate) AND more sensitive than the combo tests. Apparently all the combo tests do is create a world of worry.
If all your tests were igg, i'd be sure you don't have it, especially with two negative sets of type specific results. That nurse doesn't know what she's talking about. Some of the type specific igg tests might be considered gold standard (i think - that and/or western blot at u wash), but the igg combo tests are definitely NOT. Seriously. You can see the sensitivity (percent ability to detect virus) and specificity (percent able to accurately confirm negative result) tables of the different tests here: http://cid.oxfordjournals.org/content/35/Supplement_2/S173.full
Lots of weird things can cause a false positive on the combo tests, including past infection with chicken pox or shingles (also its just a crappy test).
Also, the chances of you being infected from a single encounter from someone who has no lesions is something like 1 in 10,000. 50% of people who have had over 50 sex partners are hsv free. In monogamous couples where one person has HSV2 and the other one doesn't, after 10 years of having sex 2-3 times a week, only half of the uninfected partners will have seroconverted, and the other half will still be hsv2 free. So transmission risk is relatively low (I am gathering this from reading Dr Hook and Dr Handsfield's posts in the ask an expert section).
So. Don't worry about it. I'd be 99% sure you're in the clear, which is the most you can really ever be anyway.
If all your tests were igg, i'd be sure you don't have it, especially with two negative sets of type specific results. That nurse doesn't know what she's talking about. Some of the type specific igg tests might be considered gold standard (i think - that and/or western blot at u wash), but the igg combo tests are definitely NOT. Seriously. You can see the sensitivity (percent ability to detect virus) and specificity (percent able to accurately confirm negative result) tables of the different tests here: http://cid.oxfordjournals.org/content/35/Supplement_2/S173.full
Lots of weird things can cause a false positive on the combo tests, including past infection with chicken pox or shingles (also its just a crappy test).
Also, the chances of you being infected from a single encounter from someone who has no lesions is something like 1 in 10,000. 50% of people who have had over 50 sex partners are hsv free. In monogamous couples where one person has HSV2 and the other one doesn't, after 10 years of having sex 2-3 times a week, only half of the uninfected partners will have seroconverted, and the other half will still be hsv2 free. So transmission risk is relatively low (I am gathering this from reading Dr Hook and Dr Handsfield's posts in the ask an expert section).
So. Don't worry about it. I'd be 99% sure you're in the clear, which is the most you can really ever be anyway.
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Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
