[Question #5031] Testing
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78 months ago
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Hi, I had sex with someone who was just diagnosed with herpes last month. We didn’t use protection because we thought we were both std free. I went in for a Pap smear three days after and was told everything was normal. But when I told my doctor about my partner she looked more into my Pap smear and notice a comment that there appears to be cell changes due to HSV. I took a blood test a week after the Pap smear and it came back negative. I was wondering if I should get retested? I haven’t had any symptoms and my doctor said it appears I haven’t been exposed to the virus as the blood test came back negative and a Pap smear can not be used to diagnose the virus.
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Terri Warren, RN, Nurse Practitioner
78 months ago
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A pap smear isn't the best method for diagnosing herpes because it is not as sensitive, say, as a culture. But if a specific kind of cell is noticed on the pap smear, it can be useful in starting the discussion and testing for herpes. If you are newly infected, the antibody test would not yet be positive, and I want you to be certain that the testing done was IgG, not IgM, which is inaccurate and should not be done. If you have new infection, it would be worth repeating in about 6 weeks. Do you know if you had sex with someone who is infected with HSV 2 or HSV 1?
Terri
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78 months ago
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Hi, I believe it was HSV 2 . I emailed my doctor about what test was done and I am waiting to hear back. It’s been a little over six weeks since I’ve been with him and I’m thinking about getting retested. Should I get retested this week to know for sure?
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Terri Warren, RN, Nurse Practitioner
78 months ago
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I like 12 weeks for final testing from any concerning encounter. But at 6 weeks past a concerning encounter the results will be 70% accurate - that is, there is a 70% chance that the results will be the same as they would be at 12 weeks. So you could test this week to see where you stand. I am going to leave this thread open so you can send me your test results.
Terri
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78 months ago
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The test that was taken was the IgG. I received the test results and it was positive for HSV 2. My doctor said this doesn’t mean I have herpes. But I thought an exposure means that I have herpes?
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Terri Warren, RN, Nurse Practitioner
78 months ago
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A positive IgG combined with your pap smear results indicates that you are indeed infected with HSV 2. Your doctor is incorrect about the meaning of this test result. Here is what the CDC STD 2015 treatment guidelines say about this situation:
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.
It would be optimal for you to go to this website and print this out for your physician so they do not make this error with future patients. I'm sorry about this news but many people live full and loving lives with HSV 2. You can read a brief booklet about this on my website, westoverheights.com, as a starting place for gaining information.
Best,
Terri Warren
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