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BranLee55@yahoo.com - 04 Feb 2005 04:20 GMT

Brief history:
I get cold sores (HSV1) every once in a while.
I got a prescription for Valtrex for when I get a cold sore.
I take like 3 pills twice a day for a few days.

I think I get cold sores maybe...2-3 times a year (a lot, a little?),
usually when I have a cold...or when my lips are dry and they start
bleeding. (I peel my lips when they are dry sometimes, bad I
know...that probably causes trauma and "inflames" the HSV therefore
causing a flareup)

Now I went to my doctor for my yearly physical, and decided to get a
full blood work done, and I found out I am positive for both HSV1 and
2!!

According to the results:
HSV 1 IGG Herpeselect AB, the result was 3.42 H (what does that mean?)
Interpretation: Positive.
This was known, since I get cold sores.

HSV 2 IGG Herpeselect AB...4.26 H (again, what does this mean? Is the
number high?)
Interpretation: Positive.

It also says this: (after both tests, so it says this twice)(can
someone translate)
"This assay is type specific and will differentiate between HSV-1 and
HSV-2 infections. A single positive result only indicates previous
immunologic exposure and the level of antibody response may not be used
to determine active infection of disease stage. The test should be
repeated in 4-6 weeks when negative or equivocal results are obtained
in suspected early herpes simplex disease."

Does this mean I might not have HSV 2?

The third test:
HSV IGM AB W/RFX to TITER HSV IGM AB Screen - what is this testing?
The result - "Not Detected"

My doctor told me that I have both HSV 1 and 2.
The IGM test just shows that I did not get it just recently...I have
had it for a while. (true?)

Now I dont believe I ever had an outbreak genitally.
The only pain I ever had down there was pain inside my scrotom about 5
years ago, and the urologist thought it was an infection.
My doctor said an outbreak would feel like a coldsore (tingling, etc)
but on my genitals...I have not experienced that.

So he said that the chance of my suffering an outbreak is pretty low.
(true?)
And the chance of me passing it on is pretty low (since I have not had
an outbreak yet)

He does not think I need to take valtrex for suppression, unless I get
an outbreak. (good/bad idea?)

Advice? Calming words?

I am just suprised, since I have always used a condom except for oral
sex, but that should/would be only HSV-1, so I am suprised/sad that I
have HSV-2 also.

Reply to this Message

M.L.S. - 04 Feb 2005 06:47 GMT

>Brief history:
>I get cold sores (HSV1) every once in a while.
>I got a prescription for Valtrex for when I get a cold sore.
>I take like 3 pills twice a day for a few days.

>I think I get cold sores maybe...2-3 times a year (a lot, a little?),
>usually when I have a cold...or when my lips are dry and they start
>bleeding. (I peel my lips when they are dry sometimes, bad I
>know...that probably causes trauma and "inflames" the HSV therefore
>causing a flareup)

Hello BranLee and Welcome.

Two to three times a year is not a lot, but it's probably more than
most. Most people with HSV just don't have much in the way of
outbreaks. For the people who do have outbreaks, two to three times
a year is probably not that far from average.

Your "inflames" is maybe not entirely precise, but, yes, peeling
your skin, as well as dryness or wind or sun, can be triggers for
outbreaks.

>Now I went to my doctor for my yearly physical, and decided to get a
>full blood work done, and I found out I am positive for both HSV1 and
>2!!

>According to the results:
>HSV 1 IGG Herpeselect AB, the result was 3.42 H (what does that mean?)
>Interpretation: Positive.
>This was known, since I get cold sores.

>HSV 2 IGG Herpeselect AB...4.26 H (again, what does this mean? Is the
>number high?)
>Interpretation: Positive.

You had one of the Herpeselect type specific tests. Most of my
links are busted with age, and the new websites seem sparse with
info, but there's something about testing here:

http://www.herpesdiagnosis.com/blood.html

The results you have above show that the test you had was type
specific, meaning it could somewhat reliably differentiate between
HSV1 and HSV2. The "IGG" in each refers to the IgG antibodies that
your immune system manufactures to fight the HSV virus. Every virus
in the world requires a different immune response, and even HSV1 and
HSV2 get their own specific antibodies as adversaries. So the test
looks for those antibodies. Usually in these blood tests, anything
over a .9 or a 1.0 is considered Positive, so the numbers you have
are not equivocal. It looks like you have both versions of Simplex
to me. Welcome to the club. We're not very exclusive.

>It also says this: (after both tests, so it says this twice)(can
>someone translate)

>"This assay is type specific and will differentiate between HSV-1 and
>HSV-2 infections. A single positive result only indicates previous
>immunologic exposure and the level of antibody response may not be used
>to determine active infection of disease stage. The test should be
>repeated in 4-6 weeks when negative or equivocal results are obtained
>in suspected early herpes simplex disease."

The theory is that when you experience an outbreak, or have a
coldsore, which is a form of outbreak, or when you are undergoing
asymptomatic shedding, which is merely viral activity without the
outbreak, that your immune system wakes up and pumps out more IgG
antibodies, and if you coincidentally have your blood test that day
the results could be extraordinarily high. Conversely, although
it's somewhat more controversial, if you are not prone to outbreaks,
if for some reason your HSV infection is predominantly latent and
therefore there's no activity from it that will trigger your immune
system, your antibody levels could drop.

It's my opinion, however (and I am a complete amateur, even on the
net) that there is usually enough low level viral activity in most
people to keep the immune response at least partially awake and
detectable. The people in the biz, taking the tests, might have a
better feel for that kind of thing than I do, though, but nobody
tells me anything.

>Does this mean I might not have HSV 2?

Not really. Your numbers above are fairly solid. However, like the
sheet says, you should at some point go back for a retest, which
will most likely confirm.

>The third test:
>HSV IGM AB W/RFX to TITER HSV IGM AB Screen - what is this testing?
>The result - "Not Detected"

There are more than one kind of antibodies! There are actually
several kinds of antibodies, but only two are important with respect
to HSV.

The immune system has a quick response to new infections, and a more
permanent response to deal with recurring infections. The more
permanent response, at least with HSV, is the maintenance of the IgG
antibody force. Before that can be established, however, there is a
first line of defense against invaders that have never been seen
before. The first stage response is the production of IgM
antibodies. The IgM defense is only temporary, and when the more
permanent IgG system is set up and going, the IgM response fades
away. By testing for the IgM antibodies, one can tell whether the
infection is a recent one or not. Your results came back "Not
Detected", therefore it can be surmised that you have had HSV in
your system for at least a few months.

>My doctor told me that I have both HSV 1 and 2.
>The IGM test just shows that I did not get it just recently...I have
>had it for a while. (true?)

Yes. The IgM response is the early, temporary one. If it had been
detected it would have meant that the infection was recent.

>Now I dont believe I ever had an outbreak genitally.

Quite a few people with the disease never do, though when people
become aware that they have the disease and learn a little about the
symptoms, they can sometimes recognize things related to it that
they didn't notice before.

>The only pain I ever had down there was pain inside my scrotom about 5
>years ago, and the urologist thought it was an infection.
>My doctor said an outbreak would feel like a coldsore (tingling, etc)
>but on my genitals...I have not experienced that.

You're lucky.

>So he said that the chance of my suffering an outbreak is pretty low.
>(true?)

If you haven't experienced it yet, yes, true.

>And the chance of me passing it on is pretty low (since I have not had
>an outbreak yet)

Well, that's more debateable. Just because your level of viral
activity doesn't rise to the level sufficient to damage your
epidermis doesn't mean you aren't occasionally contagious. And
quantifying the risk there is difficult.

>He does not think I need to take valtrex for suppression, unless I get
>an outbreak. (good/bad idea?)

It depends on the types of sexual interactions you have with people.
Even taking Valtrex for suppression does not reduce the risk of you
transfering the virus to someone else to zero. You need to inform
all your partners and let them evaluate the risk for themselves,
however small you might deem it to be.

>Advice? Calming words?

Life goes on. Sex goes on. Love happens. Be you.

>I am just suprised, since I have always used a condom except for oral
>sex, but that should/would be only HSV-1, so I am suprised/sad that I
>have HSV-2 also.

Condoms are good, but not 100%. Oral sex is a big culprit in
transferring HSV. It's rare to have or get or give HSV2 orally, but
it's probably not impossible.

In my opinion, there's not a lot of difference between having HSV1
or 2 (and I believe I have both). Either one mandates a more
careful approach to sexual relationships.

I'm sure you'll have more questions, but I hope this helps
somewhere.

Take care,

Mike

Reply to this Message

BranLee55@yahoo.com - 04 Feb 2005 19:56 GMT

> >According to the results:
> >HSV 1 IGG Herpeselect AB, the result was 3.42 H (what does that mean?)
> >HSV 2 IGG Herpeselect AB...4.26 H (again, what does this mean? Is the

What do the numbers (3.42 and 4.26) mean?
Im suprised (and saddened) the HSV 2 is higher.

> >"This assay is type specific and will differentiate between HSV-1 and
> >HSV-2 infections. A single positive result only indicates previous
[quoted text clipped - 13 lines]
> therefore there's no activity from it that will trigger your immune
> system, your antibody levels could drop.

Why does that matter? Isnt the test a Yes/No type of thing?
You have it, you dont have it. What does the levels have to do with
it?
Its like "you cant be a little pregnant"

> Quite a few people with the disease never do, though when people
> become aware that they have the disease and learn a little about the
> symptoms, they can sometimes recognize things related to it that
> they didn't notice before.

Like what? Now you have me thinking I might have had an outbreak
before and not recognized it.

> >The only pain I ever had down there was pain inside my scrotom about 5
> >years ago, and the urologist thought it was an infection.
> >My doctor said an outbreak would feel like a coldsore (tingling, etc)
> >but on my genitals...I have not experienced that.
>
> You're lucky.

> >So he said that the chance of my suffering an outbreak is pretty low.
> >(true?)
>
> If you haven't experienced it yet, yes, true.

Of course this is dependant on how long I had HSV2 for right?

If I just caught it within the last year (even though I have no IGM
detected, but thats only the last 3 months), then my chance of getting
my first outbreak is a lot higher than if I caught it 10 years ago and
have not had my first outbreak yet.

Reply to this Message

M.L.S. - 05 Feb 2005 01:00 GMT

>> >According to the results:
>> >HSV 1 IGG Herpeselect AB, the result was 3.42 H (what does that
>mean?)
>> >HSV 2 IGG Herpeselect AB...4.26 H (again, what does this mean? Is
>the

>What do the numbers (3.42 and 4.26) mean?
>Im suprised (and saddened) the HSV 2 is higher.

I don't know specifically what the numbers represent, other than a
rough sort of antibody count. I don't think it's important that one
is higher or lower than the other, and, in fact, may fluctuate to
some extent. The numbers probably can't be used to guess your day
to day infectiousness, either. Their only purpose that I know of is
for diagnosis. Above 1.00 and you've got it. Below, and you might
not.

>> >"This assay is type specific and will differentiate between HSV-1
>and
[quoted text clipped - 5 lines]
>obtained
>> >in suspected early herpes simplex disease."

>> The theory is that when you experience an outbreak, or have a
>> coldsore, which is a form of outbreak, or when you are undergoing
[quoted text clipped - 6 lines]
>> therefore there's no activity from it that will trigger your immune
>> system, your antibody levels could drop.

>Why does that matter? Isnt the test a Yes/No type of thing?
>You have it, you dont have it. What does the levels have to do with
>it?
>Its like "you cant be a little pregnant"

No, it doesn't really matter. I was just throwing out more
information.

If your numbers had been down close to 1.0 though, you might have
been able to hope that the test was returning an errant value
somehow.

>> Quite a few people with the disease never do, though when people
>> become aware that they have the disease and learn a little about the
>> symptoms, they can sometimes recognize things related to it that
>> they didn't notice before.

>Like what? Now you have me thinking I might have had an outbreak
>before and not recognized it.

Itching, tingling, maybe red dots, or very small pimples, or maybe
very small cuts like paper cuts. Some people get various nerve
pains, or slight numbnesses. Upon first becoming infected, many
people experience flu-like symptoms, swollen glands, lethargy, etc.
Lower back pain can be part of it. Something called neuralgia can
be part of it, too, which sort of feels like a sunburn without
having been in the sun.

Or, you could be one of the lucky ones and never experience any of
that.

>> >The only pain I ever had down there was pain inside my scrotom about
>5
>> >years ago, and the urologist thought it was an infection.
>> >My doctor said an outbreak would feel like a coldsore (tingling,
>etc)
>> >but on my genitals...I have not experienced that.

>> You're lucky.

>> >So he said that the chance of my suffering an outbreak is pretty
>low.
>> >(true?)

>> If you haven't experienced it yet, yes, true.

>Of course this is dependant on how long I had HSV2 for right?

To some extent, yes, but as you get older, your body will change,
your lifestyle will change. It is not impossible that a long
dormant herpes infection can rear its head sometime down the road
just as if you had recently caught the thing. More often than not,
however, if it doesn't bug you from the start, it won't later on.
Most people that start out getting outbreaks have them slowly taper
off over a number of years.

>If I just caught it within the last year (even though I have no IGM
>detected, but thats only the last 3 months), then my chance of getting
>my first outbreak is a lot higher than if I caught it 10 years ago and
>have not had my first outbreak yet.

Probably, yes. Most people who get outbreaks will get them in like
two to twenty days after infection.

Take care,

Mike

Reply to this Message

Tim Fitzmaurice - 07 Feb 2005 16:04 GMT

>>> According to the results:
>>> HSV 1 IGG Herpeselect AB, the result was 3.42 H (what does that
[quoted text clipped - 4 lines]
> What do the numbers (3.42 and 4.26) mean?
> Im suprised (and saddened) the HSV 2 is higher.

ELISAs work on an arbitrary scale. So numbers from different tests are not
comparable. The test is set up to have the best dynamic range for testing,
and there will be a cutoff value.

Anyhow somewhere they will have 3 answers bounded by two numbers
on the scale of the readout for the test, definite negative, definite
positive and the equivocal in the middle.

The values will give a relative idea of the amount of antibody floating
about. Which measures on a relative scale how much your body has responded
down that route for that virus.

Antibody levels can fluctuate in an individual and the two antigens used
to grab the antibodies in your blood sample will work differently.

>> therefore there's no activity from it that will trigger your immune
>> system, your antibody levels could drop.
>
> Why does that matter? Isnt the test a Yes/No type of thing?
> You have it, you dont have it. What does the levels have to do with
> it?

Its to do with the cutoff and probability ofthe test being accurate. The
positive cutoff will be N% accurate (around 99% or so for most clinical
tests). Once you get above it - yup its largely irrelevant but the machine
will read that scale and they will print it out so you can see they have
done the test correctly.

Its more an issue if you fall into the equivocal and want to retest....the
change in numbers or not makes you start having to think what the numbers
are saying.

Tim
--
When playing rugby, its not the winning that counts, but the taking apart
ICQ: 5178568

Reply to this Message

Grant - 04 Feb 2005 13:11 GMT

Hi BranLee,

Yeah, it can get rather complicated.

But the tests show that you have both type 1 and 2. There are a whole lot of
people out there that have genital herpes and have no idea that they have it
because they've never had "classic" symptoms. However, you can still pass the
virus on through asymptomatic shedding. If you are with an uninfected partner,
then taking Valtrex suppressively might be a good idea. But that is up to the
two of you.

However, the longer you've had it, the less you will shed asymptomatically - so
that's good news.

The other possibility is that you have type 2 orally. It's rare for it to be
there, but not impossible.

Take care,
ar

>Brief history:
>I get cold sores (HSV1) every once in a while.
[quoted text clipped - 58 lines]
>sex, but that should/would be only HSV-1, so I am suprised/sad that I
>have HSV-2 also.

Reply to this Message