[Question #10077] HSV1 Question (Negative Western Blot)
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26 months ago
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Hi Terri, I did the western blot through you recently and was negative for HSV1 and 2.
1) I read that the western blot sensitivity for HSV1 is 96%. With the past sores under my foreskin that I have described to you, can I still assume with a high degree of certainty that I am negative for HSV1? The symptoms happened 10/2018, 7/2019, 11/2021. I was under the impression that if my western blot was negative I could move forward knowing that if I get similar "symptoms" in the future, they are not due to HSV, however the 96% sensitivity for HSV1 has scared me. I remember you telling me in past posts that if I received a negative western blot I would know that in the future these kinds cuts are not due to herpes and that it would give me a clear answer on my HSV1 and HSV2 status'. Do you still think I can move forward under this assumption?
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Terri Warren, RN, Nurse Practitioner
26 months ago
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I wish that I could give you certainty about this, but I can only give you an answer based on the sensitivity of the test. Did you have these sores swab tested? I can't tie this conversation to anything that may have happened with western blot orders from westoverheights.com. I so wish I could give you 100 certainty, but it just isn't possible.
Terri
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26 months ago
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I had the one in October 2018 swab tested (not pcr) and it was negative. So it is true that the sensitivity is 96% for hsv1? I know nothing can be 100% certain, but just want to know if I can put this behind me and assume the past symptoms were not hsv1.
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Terri Warren, RN, Nurse Practitioner
26 months ago
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Yes, the sensitivity is 96% for HSV 1.
The thing is, even if the lesions are HSV 1 and the western blot missed the infection, and you've had it since 2018, you are shedding virus very infrequently! So my recommendation is to move on as if the test is correct and if you get another lesion, have it swab tested. And live normally!
Terri
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26 months ago
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Just to confirm, the swab that was done in 2018 was a culture, not pcr.
I will try to move on. It is just that the prospect of having to pursue a PCR swab and reopen this anxiety and worry if another symptom does arise in the future makes it hard. Even if these symptoms have nothing to do with HSV they could still arise in the future and I would then have to once again pursue clinical action. I'm sorry if that sounds irrational or childish, it just makes it very difficult to move forward, pursue relationships, live my life, etc.
A few follow-up questions:
1) Being negative with the 96% sensitivity of the test, do you think it is more likely that the past symptoms were not HSV1 or more likely that they were and the test missed them? Also, how was that 96% figure discovered?
2) If I did have HSV1 since 2018 (with three past outbreaks, the most recent of those being November 2021) would I likely be shedding only 4 days out of the year at this point?
3) My last sexual encounter (condom-protected intercourse and non-condom oral received) is obviously not the encounter I was worried about but happened to fall exactly 11 weeks and 6 days before I had my blood drawn for the WB. It is just under the 12 week mark but is it safe to assume it is as accurate as if I had waited the 12 weeks?
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Terri Warren, RN, Nurse Practitioner
26 months ago
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1) Being negative with the 96% sensitivity of the test, do you think it is more likely that the past symptoms were not HSV1 or more likely that they were and the test missed them? Also, how was that 96% figure discovered?
I believe it was determined by looking at patients who test positive and negative on the blot as compared to swab tests that have been done.
2) If I did have HSV1 since 2018 (with three past outbreaks, the most recent of those being November 2021) would I likely be shedding only 4 days out of the year at this point? Likely, yes
3) My last sexual encounter (condom-protected intercourse and non-condom oral received) is obviously not the encounter I was worried about but happened to fall exactly 11 weeks and 6 days before I had my blood drawn for the WB. It is just under the 12 week mark but is it safe to assume it is as accurate as if I had waited the 12 weeks?
Yes, definitely. Most people who are going to make antibody will do so by 8-10 weeks, but because a few make antibody later, they moved the timing to 12 weeks.
I recognize that this is frustrating for you and I sure wish I had a crystal clear answer for you. If I were you, I would order an HSV PCR kit from someone like 24/7labkit and have the swab at home so you can swab using the best test right away when you get a symptom.
Terri