[Question #6855] For Terri : Need some final clarity on hsv 1

10 months ago
Dear Terri,

Thanks for all your comments previously. 

I have re-taken the following tests:

@Week 12 & @Week 17:

Lab 1 
Hsv 1 IGG ELISA negative
Hsv 2 IGG ELISA negative

Lab 2 
Hsv 1&2 IGG CLIA negative
Hsv 2 IGG CLIA negative

It has now been about 4+ months and I just want to know if you think this is conclusive for Hsv 1 or whether you think a blot test is required or perhaps I need to wait for some more time and retest using type specific IGG again?

I don't live in the US so would need some guidance on how to send my sample if you think the blot is required. 

Also from your original thread, I had started antivirals on day 14 and stopped on day 35 so it has been more than 3 months since I stopped them and my results are still negative. 
Also my IGM was positive 3 days after the sexual encounter or 6 days after the first kissing encounter if that helps.

I just want some peace on this. 

Look forward to hearing your response. 

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
10 months ago
This is as accurate as the IgG test is going to get.  No purpose would be served by waiting any longer and retesting.
I think you know that the sensitivity of the IgG test compared to the western blot is 70%.  Resting further is not going to make this any better.
I don't know where you live or how difficult it would be to get your blood drawn, spun and shipped to the University of Washington but people do it all the time.  It is not, however, easy.
If you decide this is important enough for you to get the best test, I can help you.  Or you can go with this, recognize that half the population of the US anyway is infected with HSV 1, and go from there.  Your call.  This is in individual decision

Terri
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10 months ago
Dear Terri,

Thank you for your response. I would like to explore the ways to get a western blot test done. I live in India which is miles away and I have no idea how to take this forward. I tried calling the University of Washington but I did not get a response from them. They are very busy with Corona apparently.

We have labs in India which can draw the blood but then I guess where to ship it and how to ensure the sample remains intact and temperature controlled for accurate results is unclear. 

Please let me know. Thanks!
10 months ago
Hi Terri,

I had one more question regarding the sensitivity to hsv 1 igg testing. So what confuses me is why my partner's test showed hsv 1 igg positive but mine does not (assuming I caught the infection). 

Is it because the levels of igg antibodies in my blood are just to low to be detected?

What does the western blot do differently? 

Thanks for your time and patience.

Best, 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
10 months ago
So the IgG test looks for a single protein of the herpes antibody where the western blot looks for all of the proteins of the herpes antibody.  Huge difference.  In addition, the IgG just misses 30% of HSV 1 infections compared to the western blot, a flaw in the test itself. 
If you can find someone to draw and spin one serum separator tube of blood, I can get you the lab requisition that you need to get it done.  You can go to westoverheights.com to find the link to get the test.  You'll have to make up a US address and phone but it's doable - people do it all the time. I'm happy to help you but again, about this infection is common and mostly benign and this is expensive.  Your call.

Terri
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10 months ago
Thanks Terri that would be a great help.

So your comment
"If you can find someone to draw and spin one serum separator tube of blood" - should I ask a lab to get that done? Because that's an unusual request I would think. Am I asking for the plasma basically in a tube?

Once I get it, what temperature control is required? And how do I ship it? 
Best,
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
10 months ago
A serum separator tube gives you serum, not plasma.  And yes, this is what you would ask for.  If you are successful in having that happen, you should buy a cool pack, like you would put in a picnic to keep things cool.  It should be shipped next day air. 

Terri
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10 months ago
Hi Terri, I checked with the lab. They can do it. 

I checked westoverheights.com and the link for a western blot says I need to schedule an evisit with you but there is no link to ordering the actual test. Also not sure about making up an address....is there an alternative? Maybe I can use a friend's address who lives in the US? 

Please advise. Thanks! 

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
10 months ago
You could definitely use a friends' address, yes.  And the thing is, you cannot get the kit sent out of the US.  The lab would have to agree to provide you with a single serum separator tube for this.  It should be really easy for them.  I'm going to close this thread now.  Let me know at westoverheights.com if you have further questions, OK?

Terri
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