Herpes 2 Testing Followup Question

[youngatheart1962]

I received the answer from Dr. H this week  that I should get either a Biokit Test or a WB Test from UW.  (My score was 1.99).  Is either test better than the other to confirm?  My OBGYN doesnt' seem interested in any of this, so what type of specialist should I contact to get these tests done?

[Edward W Hook, MD]

The strategy you outline is the best way to determine where your infection may be.  One study shows that following a positve blood test such as you have experienced, about 40% of persons with HSV-2 will then note an outbreak of some sort that will be culture or PCR positive.  One other comment.  If you plan to do this, it might be worthwhile to "scout out" the availability of swab tests in advance to make sure that they are available (PCR tests are more sensitve than culture but a little less available and some health care providers may not be aware when they are.)  Also, should you have a lesion you want tested, please know that the lesion does not need to be a "water blister" or sore to be positve in culture. "  

Regarding your questions about past mouth and genital sores, it is hard to make a judgement about any single past sore or irritation.  EWH

[youngatheart1962]

Thanks.  So I need to pay very careful to my body and have a culture if anything orally or genitally appears, right? Now that I think back, about 10 years ago I did have sudden onset of bumps and sores all over the inside of my mouth and tongue, and it lasted 4-5 days then went away and never had it since.  None were blisters and none were on outside of mouth.  Could that have been an oral outbreak?  Had 1 "cut" genitally back then but it was tested for HSV and was negative.

[Edward W Hook, MD]

While I suspect this is not the information you hoped for, it is helpful.  It indicates that at some time in the past you have acquired HSV-2.  You indicated earlier that your husband may have had genital herpes.  If so, that may be where you got your infection.

Of persons in the U.S. who have not been tested with the antibody tests, about 80-90% of persons with HSV-2 are not aware of their infection.  This may be because they have attributed outbreaks to causes other than HSV-2.   Most HSV-2 infections occur in the genital area but not all.  Some people mistake HSV outbreaks for yeast infections, chaffing from exercise or tight clothes, etc. .  If you have never had an outbreak you will not know where on your body the infection occurred.  EWH

[youngatheart1962]

I got the WB blot test results and it says Negative HSV1 and positive HSV2.  I never had any symptoms either oral or genital...so how do we know 100% for sure I have Genital Herpes?

[Edward W Hook, MD]

You did  the follow-up fine.  If you and your Ob-Gyn are not in tune with one another, perhaps you should consider another Ob-Gyn.  You need to have a doctor you feel will support you and your needs.  On the other hand, if you like this Dr. otherwise, any primary care provider - an internist, a general practioner or perhaps someone at your local Health Deprartment STD Clinic can help you with follow-up.  EWH

[youngatheart1962]

I don't know how to do a followup question so I hope this is the way.  I've ordered a WB kit from UW and have the phone number to call to find out about a biokit....  But what type of doctor do I call now since my OBGYN doesn't seem interested in followup...

[Edward W Hook, MD]

Welcome back to the Forum.  This question could have been asked as a follow-up to your original question.  It did not require you to start a new question as it was seeking a clarification related to your original question.

The standard test, to which all other tests have been compared to thus far is the Western Blot test performed at the University of Washington.  This test typically costs a bit more and takes up to a month for test results to come back but it as close to a "gold standard" as any currently available HSV antibody test.  It can be ordered through most commercial laboratories by just about any doctor.  The Biokit is typically less expensive and is not available everywhere.  The results are typically back on the same day or soon thereafter.  It correlated well with the Western blot results but not perfectly.  To find out where a Biokit assay is available in your area, I suggest you seek advice on the MedHelp Herpes Community site or through the American Social Health Association (ASHA) web site  (disclosure-both Dr, Handsfield an I are members of the ASHA Board of Directors).  

Hope this helps.  EWH