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Falls26685

Interpretation of results

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Falls26685

I have had herpes since I was 12 so for 13 years. I had a cold sore, touched it and used a tampon for the first time and it spread. At that time two doctors said it was herpes but my parents don't believe a culture was done. I have had less than 5 outbreaks in 13 years. I believe when I was in college I went to the doctor to make sure it was herpes so I could treat it correctly and not a yeast infection or something. I've never had bad outbreaks since the first one. I get medicine as soon as I can tell one is coming.

So after telling a guy and it not going well, I decided I wanted to find out what type I had. The dr. said it would be tested for type. Get the results back and negative but it wasnt tested for type. So I thought well maybe since it's negative they can't test for type. Had another test done and made sure they tested it for type. Nurse calls yesterday and says negative you dont have herpes. Well I'm sure I do. I know for sure I have gotten cold sores. Both types were negative but for type 1 it said .09. Type 2 was .63. I explained that I'm sure I have it and from what I read I believe it was negative because it has been at least 3 years since an outbreak and supposedly the antibodies go away when the virus is dormant. I asked when I do have an outbreak is it both types since both types had a number and not zero. She said no, type 2.

The second test I had done was not at my normal dr. because she is out of town till next week otherwise I would have asked all my questions already to her. So while I wait for hopefully correct answers from her can anyone tell me if they agree with the nurse that it is just type 2? And is it negative just because I haven't had an outbreak in a few years? If I have to have this, I was hoping for type 1. :( Thanks!

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thiscantbe

sometimes your antibody levels can fall below the level of the test's ability to detect (however, the antibodies are always present; they don't go away). the test that is commonly done is 92% sensitive...

you could always try retesting again and antibody levels do vary over time so you might get a positive result on another test. the best is to get a culture from an active lesion (right after it comes up, before it dries up too much), but it sounds like your OBs aren't very frequent so it might not be very satisfying to wait.

if you've never had sex (oral or other) with other people and your genital symptoms came after your tampon experience, you almost undoubtedly and unfortunately spread it to yourself... if that is the case you probably do have the hsv1 type, cause most childhood oral herpes is hsv1... altho getting a test would be really reassuring.

as for the test results... labs get varying ranges of results, but if the lab called that negative it means that whatever the number beside 1 and 2, the lab counts it as negative (and those numbers are kind of the background "noise" of the test).

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WaxedWrong

3 years is a long time, and can def be the reason for your low results. anything under a .90 is negative, which seems to be retarted because if its anything other then a 0- you have been exposed to the virus, meaning you have it in you- doesnt mean its active or anything just that you have it.

so if you know you have had cold sores, dont trust this test, and keep getting tested or just wait until you have another one and get tested then.

also since your type 2 had a higher number thats most likely what you have.

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again

Question:

So, if you have it in you and it's not active, can you transmit it to someone else? This stuff is so confusing:-?

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thiscantbe

those tests have background noise, really....

theoretically it means you have more type 2 in you, but that's in theory...

sometimes something else in the test sample can cause non-specific (ie not HSV related) reactivity and because of that the tests have a cutoff for what they consider positive... basically anything under a certain amt they are calling background noise... which is where your test result came in... as background noise. If you have a non-zero but overall negative result, it does not necessarily mean you really have been exposed and have antibodies.

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Mr_Smith

The Herpes Select ELISA numeric results really mean nothing, values above 1.10 are considered positive, and values below .90 are considered negative; and you should retest if between .90 and 1.10. Results should not be zero. Some people argue you should retest if you HSV2 results is below 3.5 and you have a preexisting case of HSV1. If never hurts to get a second test for confirmation. There's no difference between a 4.7 and a 7.4, they both positive. Same idea with negative results. If you have two HSV2 test results, and values for both are below .90; you're negative. You can not be more negative or less negative; you're just negative. Regards Mr_Smith

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Falls26685

"If you have a non-zero but overall negative result, it does not necessarily mean you really have been exposed and have antibodies."

I know for sure that I have had cold sores. Supposedly no testing was done when I was first diagnosed. I know I went to the dr. in college and the dr. saying it was a herpes outbreak but again I don't remember if they did testing. So orally for sure I have herpes. I guess it could be questioned if I have genital herpes but I really think I do. So if everything comes back negative and numbers for type 1 and 2 that are negative are considered "background noise" is there a way of knowing what type I have unless I am tested during an outbreak, assuming any more testing without an outbreak comes back with negative results as well? Thanks!

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Mr_Smith
"If you have a non-zero but overall negative result, it does not necessarily mean you really have been exposed and have antibodies."

If a person who had never kissed anyone in their entire life, never had any type of sex in their entire life; a typical Herpes Select test result could look like this: HSV1 = .63 HSV2 = .45 Clearly both values are negative results. Having a non zero number does not mean they were recently infected. Regards Mr_Smith Hope this helps.

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thiscantbe

Some people get false negative results on their blood tests, and it isn't completely understood why (not counting the people who have not had time to sero-convert due to very recently being infected).

What is known is that when the current blood tests were being evaluated for general use, in rare cases some people test negative but when they did a western blot analysis (extremely sensitive, done by lab researches rather than in general medical offices or labs), they were able to detect the presence of antibodies. For some of the blood tests they predict that the false negative rate will be extremely low, while in others it may be up to 10% (more in the older tests).

Why could this be?

  • I saw another article that showed some of these tests worked less well in different populations, so maybe that can even affect the result (cause perhaps people in some localities may commonly have other antibodies/proteins that react or interfere with the test).
  • Also, it is theorized that some people may make antibodies that for some reason don't react to the immunoblot/elisa type tests.
  • While it is true that antibody levels can decay over time, usually for a real viral infection such as herpes, chicken pox, etc (as opposed to some types of vaccine-induced immune response), those antibodies persist over very very long periods of time. However, it is likely that in some people the amount of the antibodies present can be so low that most tests will not be able to detect them.

Anyway, not that it gives you a real answer, but there are still a lot of unknowns despite modern science and technology. Sounds like you are pretty confident that you remember really having oral herpes... so these negative results either aren't accurate or all that time you were wrong, and I'd go with the tests being inaccurate since your memory of the cold sores sounds pretty reliable. One thing you could do is just retest... if the virus activates even a little more (even without outward symptoms) your antibody level will go up a bit and probably (hopefully?!!?) be at a level where the tests can detect it.

Here's a blurb about the western blot test from The Updated Herpes Handbook (from a portland STD clinic). If you are super desperate you could check into it.

The oldest of these, the Western Blot, was developed at the University of Washington by Dr. Rhoda Ashley Morrow, and in the U.S., is still done only at that facility. It is very accurate. Samples can be sent to the University of Washington laboratory from any place in the United States. For more information, you can call #206-598-6066.

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