[Question #804] Herpes false positive?

51 months ago
Hello,

I need help with a diagnosis. I recently had unprotected vaginal sex with a person who has had multiple partners in the recent past. We were both very drunk and stopped a few minutes after we realized what we were doing. She was having her period at the time. She mentioned std's and said that she had tested positive for Chlamidia in the past, but was cleared after medication. She didn't comment further, and she says she's std-free.

About 5 days after our encounter, I started feeling  irritation/ burning at the penis tip. I examined my genitals carefully, but did not notice anything unusual. At the two-week mark, I started feeling fatigued and dizzy, and I developed digestive issues (bloating, nausea and diarreah, abdominal cramps after eating certain foods, loose stools and low back pain. I still have these particular symptoms except the dizziness.

 I went to planned parenthood and was examined 3 weeks , 2 days after the contact. They found my genital lymph nodes a little enlarged and 
Put me on azithromycin. Tests for Chlamidia, ghonorrea, and HIV rapid test were negative. The penis irritation went away a few days after taking the antibiotics.

I got a white patch (not an open sore and not bleeding )on my lower gums, and went to my GP who examined me and he said none of my symptoms are indicative of herpes. He did not find any blisters, and he thinks periodontal disease on the gums, but I've never seen such a patch before.

I went through an independent testing service and tested negative again HIV Elisa at 6 weeks, 3 days. My Igg HSV-1 results were negative (but the number is in the "equivocal" range. My Igg HSV-2 results are positive at 1.5.

Is this HSV-2 result accurate? Do I have HSV-2? Is there any chance of a false positive or is that wishful thinking? What do you recommend I do at this point? Should I take the IGg again?

Thanks for your help!

Notready2go

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
51 months ago
At 1.5, there is an 85% chance that this is a false positive.  HOWEVER, you may have tested too soon for an accurate result.  If you tested again at 12 weeks, the number might be higher OR it could stay the same or go lower if it is a false positive.  At this point, if you were my patient, I would give you four options:  1) get a western blot now.  If it is positive, then that's that.  You are infected.  If it is negative, then you would need to retest at 16 weeks from the concerning encounter, 2) wait 12 weeks and get another IgG test done and see if the results are significantly different than the first test , 3) wait until 16 weeks have passed and then get the western blot or 4) encourage (and offer to pay for) testing for this other partner.  If she is negative, and you've had no other partners in the recent past (16 weeks) then you can do the western blot now with confidence in the result.  What you decide may be based on financial considerations.

Let me know if you have other questions.
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51 months ago
Hi Terri,

Thanks for your response.  I will try the iGg again at 12 weeks to see if I get different results.  I would also like to do the Western Blot test at 16 weeks.  Are you still doing a study comparing the WB with the IGg test? If so,I would like  to participate if it lowers the cost for the WB test. Otherwise, can you tell me the normal process for getting the WB done?

Thanks!
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
51 months ago
Well, that study may or may not go on.   Quest my stop it.  You can contact UW directly, though, to get a kit sent to you for western blot

Terri
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