Waiting for the test--how long?

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SweptUnder - 05 Mar 2005 06:40 GMT

Hi everyone, I had a question about how long I need to wait for an accurate
blood test for HSV. I know the literature says 12-16 weeks, but I'll
expand on my situation a bit further here. If I contracted this virus, it
had to have been from nearly three years ago, as that was my only
girlfriend and person I have been with, and then no dates even after that.
Well I guess I was completely asymptomatic during these past three years,
but three months ago I had what I felt to be a primary outbreak on the
genitals. So somewhere around 14 weeks after this, I went and got tested.
It yielded very mixed results, as they first did a non-type specific IgM
and IgG test, and while the IgM was elevated some (.7), it was still below
the cutoff. However, the IgG for HSV1+2 came up 2.34 or something, clearly
positive. From that data they went on to do a reflex Elisa test for both
type specific tests, and the findings were 0.07 for IgG HSV1, and 0.00 for
IgG HSV2. So basically I'm completely confused in knowing what to think at
this point. There are only a few possibilities as I see it: 1) the non
type-specific IgG test was a false positive (not likely) 2) the non
type-specific test cross reacts with other antibodes that may be in my
body fighting some other illness (my lymphocytes were elevated slightly on
the CBC differential) 3) I have a gG glycoprotein deficient strain not
detected by the type-specific tests (though the documentation states that
there are 5-10% of people who have this, I've heard in reality it is much
less than that) or 4) lastly, that perhaps I need to take the test at a
later date, even beyond 16 weeks, if say, my antibodies are simply
developing very slowly. I guess my original question about the length of
time required for testing was also asked because I figured that since I
had to have contracted this nearly three years ago if I had antibodies,
they'd be there. However, my primary OB was only three months ago...so in
cases of asymtopmatic transmission surfacing much later, do we need to wait
from the time we contracted it or from the first outbreak? I'm thinking
it's the first actual outbreak, as that's probably when the antibodies
develop. I'm not sure if they really get a chance during the intial
transmission from another body, as that's a pretty brief phase. If
someone could shed some light on this, it'd be great. For now the blood
tests have only confused things further for me!!

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Tom - 05 Mar 2005 23:26 GMT

I read your post and I think I might be in a similar situation as you. I
think I might have gotten infected 6 years ago, and had mild outbreaks 4-5
times a year for all that time, and finally decided to get tested. My tests
came back at IgG 0.85 for HSV1, IgG was 0.00 for HSV2, and IgM was 0.00 for
both. The test for IgG was elevated and borderline positive which I think is
around 0.91 for a technical positive, so I am off by 0.06. That test was
after I had one of the mild outbreaks that had been going on. Then all of a
sudden I just recovered from this huge outbreak which lasted 4 weeks and had
all the known symptoms. The huge outbreak happened about a week after one of
the small ones, probably due to stress. During the time I was beginning the
huge OB I had a second test and I am still waiting on the IgG levels. I'm
starting to wonder if I have to wait 3 months from now or what also.

When you mentioned about the IgG glycoprotein deficient strain not being
detected by the type-specific tests, I started to wonder about that. I never
heard of that being possible. Where did you get your research information on
that being a possible occurrence? Just curious. Maybe I am one of the lucky
5-10%.... I managed to get chicken pox as a kid, Epstein Barr in my 20's,
HPV at around 33 and what seems to be genital herpes HSV1 around the same
time. I am still a little lost about the tests. I have noticed that better
nutrition, vitamins and Lysine have made a big difference in getting over
the OB. I do know that I have just about all the known outbreak symptoms
though.

Tom

> Hi everyone, I had a question about how long I need to wait for an accurate
> blood test for HSV. I know the literature says 12-16 weeks, but I'll
[quoted text clipped - 30 lines]
> someone could shed some light on this, it'd be great. For now the blood
> tests have only confused things further for me!!

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SweptUnder - 11 Mar 2005 16:19 GMT

Tom,

Thanks for writing back, as I'm disappointed I pretty much got no response
to my query=( Yes you're result for IgG HSV1 would I guess be considered
equivocal, and they probably told you to get retested at some time in the
future for that? If you had the same tests done as I did, I think .9-1.1
was equivocal, and then above that was a positive. Do your outbreaks
display the typical herpes blisters? That's sort of one problem I'm
having with the diagnosis from doctors...I had all the associated symptoms
of a primary except the blisters--mine looked like little cuts in the folds
where the thigh meets the groin, and this caused several doctors to
diagnose it as a case of jock itch. However, I have my doubts as none of
the medications (over the counter or prescription) for jock itch have
given me any relief. And coincidentally, the symptoms have reappeeared
twice since then, both times immediately after stress-filled nights with
no sleep and lots of caffeine.

As for the IgG glycoprotein deficient strain, I too was completely unaware
of it until I got my lab results back. I went to my doctor's office and
asked for a copy of my lab results. On the lab results is where it stated
that 5-10% of infected people would not show up in the type-specific test
because of this deficient strain. I guess the only way to know if you had
this would be a Western Blot test, a positive swab test, or the positive
combined IgG (like I had)--however the positive combined IgG doesn't tell
you if it's HSV1 or 2, so I'm probably going to try for a swab next. Keep
me updated on what the next IgG levels are that you get.

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M.L.S. - 11 Mar 2005 16:59 GMT

>Tom,

>Thanks for writing back, as I'm disappointed I pretty much got no response
>to my query=( Yes you're result for IgG HSV1 would I guess be considered
[quoted text clipped - 10 lines]
>twice since then, both times immediately after stress-filled nights with
>no sleep and lots of caffeine.

>As for the IgG glycoprotein deficient strain, I too was completely unaware
>of it until I got my lab results back. I went to my doctor's office and
[quoted text clipped - 5 lines]
>you if it's HSV1 or 2, so I'm probably going to try for a swab next. Keep
>me updated on what the next IgG levels are that you get.

Hello SweptUnder,

There really isn't too much to add to what you already know.

Outbreaks that look like tiny cuts are, while not the most usual
presentation, one way for the disease to show itself.

Also, if you can afford it, I think I'd go for the Western Blot. A
culture of a swab might leave you again not knowing for sure, since
they are notorious for false negatives. On the other hand, a
postive culture would be a definite. On the other hand, a Western
Blot should give you a definitive result one way or the other.

I wasn't aware of the "IgG glycoprotein deficient strain" myself,
for whatever that's worth.

Take care,

Mike

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Tom - 12 Mar 2005 01:00 GMT

Hello SweptUnder,

I got the second wave of results back only to find that the doctor didn't
order the right test that was supposed to display the IgG levels, so I kind
of give up. I know my first IgG levels were in the borderline category for
HSV1, and since all my symptoms are in the genital area, I'm going to say
that with an educated guess I do have genital herpes, but for some reason I
have a lower than normal IgG output. Something I have to add is that I have
had outbreaks about 4-5 times a year and this has been the case for about 7
years and its always pretty much the same and in the same place on my body,
except for this outbreak I just had which was the worst. I also know that
the person I was with when the symptoms started, has the same symptoms and I
also know that her ex boyfriend was diagnosed with genital herpes.

Usually when I am under stress or not taking good care of myself, I start to
feel tired and run down, then I get this extreme itching feeling as if I
have poison ivy, and a tingling sensation that feels like the skin is warm
and tight feeling. Then I get 2-3 hives or bumps that look a little red and
then they open and get extremely sore and turn into wet ulcers for about
7-10 days and then they heal. I never had the blisters until I had this past
outbreak when I had both small clear and slightly bigger red blisters, all
of which dried up in 4-5 days without breaking. Then I had 2-3 small pimples
on the left inner thigh near the groin that were itchy and prickly feeling
and they lasted about 3 days. On this outbreak I also had other things that
I never got like flu like symptoms, burning pains down the leg all the way
to the foot and aching in the testicles and groin and inner thighs. I also
had severe lower back pain, and in the buttocks to the point I almost
couldn't move that well. I also had some burning in the skin area all around
the genitals and also when I urinated.

I'm going to talk to my doctor soon, tell him the whole story and tell him I
think I need something to keep the outbreaks away.

Tom

> Tom,
>
[quoted text clipped - 22 lines]
> you if it's HSV1 or 2, so I'm probably going to try for a swab next. Keep
> me updated on what the next IgG levels are that you get.

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M2slo2cht@nospam.invalid - 15 Mar 2005 03:47 GMT

>how long I need to wait for an accurate
>blood test for HSV. I know the literature says 12-16 weeks,

Right.
From time of infection.

>guess I was completely asymptomatic during these past three years,
>but three months ago I had what I felt to be a primary outbreak

Not an unheard of scenario

>somewhere around 14 weeks after this, I went and got tested.
>It yielded very mixed results,

There are a lot of tests on the market. Some more accurate than
others. Some of the older ones aren't accurate at all.

>So basically I'm completely confused in knowing what to think at
>this point.

I think somebody has already suggested starting over with a Western
Blot. That'd be the gold standard. There's also the Herpeselect. It's
almost as accurate as a WB, easier to get, and less expensive. But
just get the IgG and don't bother with the IgM test.

>Ihave a gG glycoprotein deficient strain not
>detected by the type-specific tests

This is news to me. Sounds like one of the older tests. I'd try
something else.

>I figured that since I
>had to have contracted this nearly three years ago if I had antibodies,
>they'd be there.

You figured right.
They WOULD be there.

>do we need to wait
>from the time we contracted it or from the first outbreak?

From when you were infected. Most people that test positive have never
had an outbreak and never will. The antibodies are in their blood
though.

M2

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