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Avatar universal

Valtrex cause false negative two years after outbreak? second opinion please.

I have oral hsv-1, very severely. i take valtrex almost daily when i can get a prescription, sometimes letting it slide. i am an actress so cold sores are just the worst.

two years ago i wasn't taking the valtrex. i had protected sex with two partners and unprotected oral sex with the same two guys, over the course of a year. one encounter each. a month after the last encounter i felt two hard little bumps beneath the skin of my labia after a day or two they came to the surface and it seemed that herpes was the only explanation i could come up with. Unfortunately i didn't see a doctor for about 5 days. by then it was hard to visually diagnose, he said if i didn't think it was razor burn then he couldn't think of anything else it would be besides herpes. the swab came back negative.

i didnt get a blood test at that time, just became depressed and let two years go by. i have been taking the valtrex as often as i can, and when i forget for a few days a cold sore usually starts to tingle or presents itself. i have had two or three cold sores in the last two years, but never another outbreak below the waist.

last week i decided i had to start having sex again, but before i slept with someone off the herpes website i wanted to see in writing that i had hsv-2, so i got an elisa type specific test. the results came back negative, under .9

terri warren told me the valtrex could be the culprit for a negative test result and that i should wait four months without valtrex before i retest. this is awful because my cold sores are guaranteed to pop up without valtrex. not really worried about sores popping up down there because they havent in the last two years.

do i really need to wait an entire four months before i can trust the test results? its been over two years since the initial outbreak
4 Responses
Avatar universal
I certainly understand the importance to a working actor of prevention or fast resolution of oral herpes outbreaks. Some thoughts about your situation.

First, I doubt your transient genital problem was herpes, which doesn't really cause symptoms like you have described. If it was herpes, almost certainly it has nothing to do with your apparent oral HSV1 infection. Both sites can be infected, but only at the same time. Once someone has had HSV of either type for more than a few months, it is almost never auto-inoculated to another body area.

Second, not having a positive HSV1 antibody test doesn't necessarily have anything to do with valacyclovir treatment. A few percent of people with HSV1 infections never develop measurable antibody, whether or not they have taken anti-HSV treatment. And science really doesn't know how frequent a problem this is after treatment. As far as I know, there has been no research on it, only the impression of experts like Terri; and most of that experience is with HSV2, not HSV1.

Third and most important, why is antibody testing so important to you? If you definitely have oral herpes, you can be confident you have HSV1. Whether pos or neg, an antibody test won't change anything. And if there is any doubt about the diagnosis, the best way to confirm it is not by antibody but with a swab test (culture, or preferably PCR) during an outbreak.

Why not go online to Terri Warren's clinic (www.westoverheights.com)? You may be able to arrange for testing with them, with self-collected swabs. It may be worth the trouble, even if it means choosing a time to stop treatment when an acting gig isn't coming up.

Good luck!
Avatar universal
Or you can ask Terri the same questions directly. Although MedHelp's herpes expert forum is defunct, she has continued to provide online advice on her own forum. Same internet address as above.
Avatar universal
sorrh, to clarify I had a negative Hsv 2 test. I didn't even bother taking the Hsv 1 test because I know I have it, but j wanted to be sure I had the other kind too before sleeping with someone who I know for sure has hsv2. Terri warren recommends waiting another four months without antivirals before I can trust a negative Hsv 2 test result. Wondering what someone else might think. Thank you for responding!
Avatar universal
On rereading your message, I was misled by your opening comments about oral herpes and didn't pay enough attention to later statements about HSV2. Sorry! If you don't care about confirming oral HSV1, you can disregard most of my reply.

As for HSV2 confirmation, I'm really not sure you need worry about it. Herpes really isn't a likely reason for the transient bumps you describe, and there are other more likely causes. But if you feel you need to do it, probably the best option is the one you suggest yourself: stop valtrex and plan on staying off for 3-4 months, then have a blood test. However, even if negative, I don't know how reliable it will be. The last part of my advice still makes sense:  ask Terri, either on her forum or by establishing yourself as a Westover clinic patient.

Sorry for the initial misunderstanding. Good luck.
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