[Question #502] Confusing info from doc. Should I retest?
108 months ago
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Here were my tests and results: HIV AG/AB, 4th Gen: Non-reactive; HSV 1 IGM screen: negative; HSV 2 IGM screen: negative; Chlamydia RNA, TMA: not detected; Gonorrhoeae RNA, TMA: not detected
1 Do you recommend I retest for HSV 1/2?
2 Do you recommend I retest for HIV?
3 Do you recommend I retest for anything?
I just want to know that my results and the information I receive about my tests are accurate. Thanks for help!
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Terri Warren, RN, Nurse Practitioner
108 months ago
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Terri
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108 months ago
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I'm fairly confident that they didn't have IgG testing done--the lab report says this, quoted:
HSV 1/2 AB (IGM), IFA W/RFL TO TITER
-HSV 1 IGM SCREEN: NEGATIVE
-HSV 2 IGM SCREEN: NEGATIVE
There's then a note section that says: "The IFA procedure for measuring IgM antiodies to HSV 1 and HSV 2..." blah, blah, blah. The test was developed by Focus Diagnostics. Frustrating they didn't know what they were doing...
Ok, I will get an IsG test done to rule out HSV 1 and 2.
1. Where do you recommend I get the test?
2. Should my wife also retest then?
3. What about the HIV test I was given? Is that accurate?
Thank you!
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Terri Warren, RN, Nurse Practitioner
108 months ago
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Here is what the CDC says about herpes testing: you could quote it for him/her.
"
Type-Specific Serologic Tests
Both type-specific and type-common antibodies to HSV develop during the first several weeks after infection and persist indefinitely. Accurate type-specific HSV serologic assays are based on the HSV-specific glycoprotein G2 (HSV-2) and glycoprotein G1 (HSV-1). Providers should only request type-specific glycoprotein G (gG)-based serologic assays when serology is performed for their patients (329-331).
Both laboratory-based assays and point-of-care tests that provide results for HSV-2 antibodies from capillary blood or serum during a clinic visit are available. The sensitivities of these glycoprotein G type-specific tests for the detection of HSV-2 antibody vary from 80%–98%; false-negative results might be more frequent at early stages of infection (330,332,333). The most commonly used test, HerpeSelect HSV-2 Elisa might be falsely positive at low index values (1.1–3.5) (334-336). Such low values should be confirmed with another test, such as Biokit or the Western blot (337). The HerpeSelect HSV-2 Immunoblot should not be used for confirmation, because it uses the same antigen as the HSV-2 Elisa. Repeat testing is indicated if recent acquisition of genital herpes is suspected. The HerpeSelect HSV-1 Elisa is insensitive for detection of HSV-1 antibody. IgM testing for HSV 1 or HSV-2 is not useful, because IgM tests are not type-specific and might be positive during recurrent genital or oral episodes of herpes (337).
Because nearly all HSV-2 infections are sexually acquired, the presence of type-specific HSV-2 antibody implies anogenital infection. In this instance, education and counseling appropriate for persons with genital HSV infections should be provided. The presence of HSV-1 antibody alone is more difficult to interpret. Many persons with HSV-1 antibody have oral HSV infection acquired during childhood, which might be asymptomatic. However, acquisition of genital HSV-1 is increasing, and genital HSV-1 also can be asymptomatic (318-321,338). Lack of symptoms in a person who is HSV-1 seropositive does not distinguish anogenital from orolabial or cutaneous infection, and regardless of site of infection, these persons remain at risk for acquiring HSV-2.
Type-specific HSV serologic assays might be useful in the following scenarios: 1) recurrent genital symptoms or atypical symptoms with negative HSV PCR or culture; 2) clinical diagnosis of genital herpes without laboratory confirmation; and 3) a patient whose partner has genital herpes. HSV serologic testing should be considered for persons presenting for an STD evaluation (especially for those persons with multiple sex partners), persons with HIV infection, and MSM at increased risk for HIV acquisition. Screening for HSV-1 and HSV-2 in the general population is not indicated.
I don't think your wife needs to retest unless you think she could have it independent of you?The HIV test is fine.
Terri
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