[Question #1030] Question regarding HSV Testing

50 months ago
Hi, I have a question regarding HSV testing. A couple of years ago (minimum of 18-24 months) I had shingles. My immune system was low due to cancer and chemotherapy. I believe I took Valtrex for about a month and then stopped. I recently had an interaction that I can't entirely recall so I wanted to have a battery of tests done. At 8 1/2 weeks, everything came back negative, including HSV 1 and 2. They do not give and are unable to provide specific amounts only that you are either negative <.91, unequivocal .91-1.09 or positive >1.09. I have an obsessive personality and am constantly checking and looking into symptoms. I recently noticed something similar to a skin tag or mole I believe that is in the "fold" of my groin under/to the side of my scrotum. Between that and thing my thighs are tingling, I think I definitely have some mental issues to work through. With that said:

1.) I will retest again at 12 weeks, but how reliable would that result be? Test was an ELISA through Labcorp (STDcheck.com). I also tested at 4 weeks, same results. I know I am obsessive regarding this and have started with a counselor.
2.) Would prior use of Valtrex well over a year ago impact results now?

Thanks in advance.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
50 months ago
A test done at 8.5 weeks is probably about 80% accurate - that is, if you test again at 12 weeks, there is an 80% chance the test will stay the same - negative.  The valtrex you took previously will have no impact whatsoever on testing now for a recent exposure, nope.

Terri
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50 months ago
Terri, thank you. 

1.) I was wrong, it was 9 weeks but I'm sure this would only minimally change the 80% figure.
2.) My inner thighs are burning/itching, primarily my left. I do not see any overt redness or anything of that nature. Assuming this would be unrelated since there have been no other lesions or anything? Other answers seem to be that initial infection is on the penis?
3.) Would previously suffering from cancer impact results at all?
4.) Would a 12 week igg be sufficient or should I follow that up with a WB? Those seem to be for those with confusing results.
5.) How are PCR tests done? Blood? Would that be more reliable than a igg?

Thank you for your time.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
50 months ago
1.  Minimal change, but in the good direction of more certainy
2  Yes most initial infection in males would be on the penis or anus,if that was the exposed body site
3.  not really, but active Chemo would
4.  a 12 week result for HSV 2 compared to western blot would be about 93-95% accurate
5.  Only a PCR from an active lesion would be appropriate - it should NOT be used for blood

Terri
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50 months ago
Sorry, just to confirm....if I'm having itching/burning in my inner thighs, notice it more at certain times over the past couple of weeks, would this be indicative of herpes? No sores.

And 93-95% for HSV2 testing at 12 weeks, what would Western Blot be at 16 weeks?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
50 months ago
The western blot would be better, we don't have a percentage but likely 4-5% better. 
Itching of the thigh could be herpes but it is more likely to be other things like fungal infection.

Terri


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