[Question #3089] Time for Western Blot?
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92 months ago
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Sorry to return to the forum. It has been 4 months since potential exposure, and the only remaining worry would appear to be HSV1.
While I have still not experienced a traditional cold sore, lips and other facial areas continue to tingle daily. Single, irritated bumps have appeared occasionally (on nose, around lips), but recede after a few days. (No bursting, oozing, crusting, etc.)
The initial IGG test was not type-specific, so the low-positive reading (1.9) was not helpful. A follow-up (type-specific) IGG was negative for both types. A re-test last week had the same result.
Since IGG misses 30% of HSV1 infections, it would seem the only way to know for sure if true cold sores are imminent is to take the Western Blot. I’ve scheduled a visit next week with my PCP, and will inquire about the WB. (I am in RI.) This should finally help me determine whether I need Valtrex, Lysine, Abreva, diet changes, etc.
Since there was no clear “initial breakout” in the first few weeks, is the virus just taking longer than usual to get started? Are the occasional irritated bumps that recede a preview of worse breakouts coming?
The stress from this experience led to severe anxiety and depression, and nearly much worse. (I realize this was an overreaction to a common and relatively minor condition.). Really hoping to put all this to rest and head into 2018 with a renewed commitment to protect my health at all costs!
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Terri Warren, RN, Nurse Practitioner
92 months ago
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Since you are an adult with a test indicating neither one nor two, if you acquired HSV 1 at this encounter, I would think you might have more remarkable symptoms than what you have reported.
The issue is that if you do a western blot, and it is positive for HSV 1, you can't know if you've had it since you were a tiny child or recently acquired it, if it is oral or genital. Before you arrange for the blot, you should give some thought to what it would actually give you in the big picture and how you will use that information. Right?
Terri
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The issue is that if you do a western blot, and it is positive for HSV 1, you can't know if you've had it since you were a tiny child or recently acquired it, if it is oral or genital. Before you arrange for the blot, you should give some thought to what it would actually give you in the big picture and how you will use that information. Right?
Terri
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92 months ago
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Thank you, Terri. I really appreciate your feedback on this.
I am nearly 48 years old, and do not recall ever having a cold sore. The prospect of having one is debilitating. (Again, I realize this is an overreaction, and am working on the underlying psychological issues.)
The occasional painful bumps and constant facial tingling/burning could be stress/anxiety.
Is it common for HSV1 breakouts to resolve themselves before following the usual progression (bumps receding rather than continuing to next stage?)
I’ve stopped worrying about the genital possibility, since the urethra irritation has resolved and there have been no visible symptoms in that area.
With the negative type-specific IGG and lack of “definitive” breakouts after more than 4 months, I would love nothing more than to put this all behind me. The only reason I can think of to pursue the WB would be to implement the necessary lifestyle changes to minimize recurrences (no sunlight, alcohol, stress, wheat, caffeine, arginine, etc.)
Appreciate any additional thoughts you might have.
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Terri Warren, RN, Nurse Practitioner
92 months ago
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I think most often cold sores do progress through the usual stages of blister, ulcer, crust but I'm sure there are exceptions.
Many of things that you list to reduce recurrences of HSV 1 have no real basis in fact - everything past sunlight, in fact. Maybe stress that is prolonged can be a factor. In your case it wouldn't be to prevent recurrences - it would be to prevent a first outbreak, right?
The western blot needs to be your call, balance all the factors here - the relief if you are not infected vs the distress if you area and then not knowing the location of the infection is it is positive. If you decide to do it, I can help if you need it.
Terri
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Many of things that you list to reduce recurrences of HSV 1 have no real basis in fact - everything past sunlight, in fact. Maybe stress that is prolonged can be a factor. In your case it wouldn't be to prevent recurrences - it would be to prevent a first outbreak, right?
The western blot needs to be your call, balance all the factors here - the relief if you are not infected vs the distress if you area and then not knowing the location of the infection is it is positive. If you decide to do it, I can help if you need it.
Terri
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92 months ago
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Thank you, Terri. Visited with my NP today, and she ordered the DNA Qualitative Real Time PCR via Qwest Labs. The feeling is this would be the most accurate (short of WB.)
Is this your view as well? Are you comfortable with this testing strategy?
I realize a positive result would not help determine time of exposure or location of infection. If I don’t have HSV1, the tingling/burning and sporadic painful bumps would have to be something else. With any luck, actual cold sores never develop. Just want to move on.
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Terri Warren, RN, Nurse Practitioner
92 months ago
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The PCR is to be used only on a swab test, never a blood test. Herpes not normally in the blood.
Was it a swab test or a blood antibody test? I think she ordered the wrong test if it was on blood. Can you get it stopped?
Terri
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Was it a swab test or a blood antibody test? I think she ordered the wrong test if it was on blood. Can you get it stopped?
Terri
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92 months ago
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Thanks, Terri. I had a feeling this was the wrong test.
It was a blood test. (At this point, I haven’t had an open lesion to swab.)
Unfortunately, the sample has already been sent to the lab. I’m guessing I should ignore the result?
Sorry for all the questions. Just hoping for confirmation one way or another, but It doesn’t look like that is going to happen.
Maybe I should just wait to see if I ever have an actual breakout. With any luck, it never comes.
If I feel tingling or burning, would you recommend refraining from kissing?
Thank you for all of your help.
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Terri Warren, RN, Nurse Practitioner
92 months ago
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The result will be negative so yes, ignore.
Since the majority if the population already has HSV 1, I don't know that it is necessary to refrain from kissing.
Terri
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Since the majority if the population already has HSV 1, I don't know that it is necessary to refrain from kissing.
Terri
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