riverstyx

OK, well, I'm seeing somebody new and we're going to have the "STD talk" in which I politely request that we both submit to STD testing before becoming intimate. It's my new policy now. I don't know if you remember me, I had the herpes scare over the summer, turned out OK after I got the Western Blot from the University of Washington. Now I want a test that will give me a clear-cut "negative," and I've found the test that will do just that: the HerpeSelect Immunoblot. The problem is, the doctor that I go to has a lab- a nationally-known lab--that for some reason does not perform the HerpeSelect Immunoblot, even though it performs all of the other HerpeSelect tests. I confirmed this in two ways: my doctor's office called the local Quest lab that does all the testing for them, and they said that no, they don't perform the HerpeSelect Immunoblot, and that there was no herpes "immunoblot" in their catalog. Also, I went on the Quest Diagnostics website searching for the test exhaustively, and didn't find anything on it. Plenty of immunoblots, but none for herpes! I really, really want to take this test. The way it is performed and interpreted, it will give me a clear-cut negative (my Western Blot had 1 reactive protein out of 14, and that 15 months post-intercourse with a woman who didn't even have herpes). Now, I thought I was pretty resourceful about ordering these tests (I got the Western Blot, didn't I?), but I can't seem to find out which labs offer the test, and which doctor's offices have those specific labs that can order the tests for me. How oh how can I find a lab in my state or the neighboring state that will at long last perform this specific test for me? I am looking for the specific brand: HerpeSelect, and the specific testing method: immunoblot, and for HSV-1 and HSV-2. Thanks!

I agree with what has been said here, and as willow said, there are laws in virtually every U.S. state mandating disclosure to a sexual partner before becoming intimate. Best of luck to you, M

I would say that a vaccine would mostly be to reduce the risks of transmission, though not entirely eliminate them. Most current vaccines under development would not eliminate the herpes virus in those who have it. 4-5, definitely 10 years at most seems like a reasonable bet for when the first vaccine(s) will be on the market.

The HerpeSelect ELISA is reasonably accurate, with about 99.7% sensitivity and specificity. But values between 1.1 and 3.5 have a notoriously high false-positive rate, roughly around 50%. So it is worthwhile to be tested again, preferably with the Western Blot, whose sensitivity and specificity are well over 99% each.

2.78 is within the range where false-positives occur about 40% of the time. The first positive test may have been due to cross-reactive antibodies, although it is incorrect as your nurse said that you have it and that "it's just not registering." When IGG antibodies rise to a detectable level, they stay very close to that level for the rest of your life. They do not simply vanish. Like Dancer says, the Western Blot will go a long way toward clearing this up. By now, if you have herpes, the Western Blot should be positive, and/or many of the necessary viral proteins should fall into place. If only one, or at most two, proteins are present, I believe you can be confident this is due to cross-reactivity, and not a sign of the formation of antibodies to HSV-2. Good luck.

Congratulations on your negative Western Blot. It definitely sounds like you don't have HSV-2. After adulthood about 80% of U.S. citizens have an oral infection with HSV-1. In a very comprehensive study with 60,000 participants, 32% of genital infections with HSV were with HSV-1. Here is the study: http://jcm.asm.org/content/48/1/150.full Even so, the number of cases of HSV-1 occurring genitally is far lower than the number of cases of oral HSV-1 infection, for the simple reason that the percentage of individuals infected with HSV-1 genitally, is much lower than the percentage of individuals infected with HSV-1 orally. So the odds are clearly in your favor that it is oral HSV-1. Unfortunately, genital HSV-1 tends to be very tame, and after the first year of infection, the number of outbreaks averaged less than 1 per year, according to one reliable study. HSV-1 orally, you could have had since you were a child, and you may have gotten "cold sores" around your lips then, but you don't now because your immune system has the virus "under control." Good luck to you,

Ok so while you guys are partying hard and...what's this I hear? going clubbing because you want to dance?.......and doing shots at the bar, don't forget to let everybody else know how the weekend was. I really, truly think it is going to be outstanding.

Well, it largely depends on the test. For most of the commercially available tests, turnaround time is usually a few days to a week. If you are getting the Western Blot, however, turnaround time is 2-3 weeks.

Exactly like Dancer said, the responses to herpes among different individuals are as different as they are. Different people form antibodies at different rates. It is a relatively safe bet that you will form antibodies by 4 months. If not, almost certainly by 6. Asymptomatic shedding tends to be highest during the first year after infection, and gradually lessens, until it stabilizes.

That's really wonderful that he was so understanding. Good luck to you!

@victoriaxxx This is really so wonderful to hear. Congratulations to you, and best of luck for the future.

I think that, even though seeker likes the Devil Rays, he makes some very good points, so we should listen to him despite his questionable taste in baseball teams. lol j/k seeker.

The HerpeSelect ELISA takes an average of 23 days to become positive. So, assuming you know the date of your possible exposure, you should wait, I would say, 4 months to be safe, and then you can get that test. Since 23 days is only an average, roughly half of all HSV-positive subjects in the relevant study took longer than 23 days to "turn" positive. I would say if at the 4-month mark the test I mentioned is negative, it is a good sign that you do not have herpes. Then, if negative, get tested again at the six-month mark, as it sometimes takes six months for a detectable quantity of antibodies to form.

@seeker Sorry, but the Devil Rays never really had a shot anyway....every single year you *know* the Yankees will be in contention....but can't really say the same for the Rays...but if it's any consolation, I imagine I would like your city a lot better than I like my city, even though I'll always root for the Yankees...

The Western Blot can tell a lot. If it is "indeterminate," then the banding pattern on the test strip will go a long way in telling you if you are seroconverting, or just have some cross-reactive antibodies. For the Western Blot, not all proteins are equal: some are more important than others. So if more than say, two of the "key" proteins fall into place, it's a good bet you are seroconverting. If however only one is reactive, then that was almost certainly caused by a cross-reaction with other antibodies in your blood, not related to herpes.

@whitedaisies Hockey tickets!! Well, I hope they're tickets to a New York Rangers game!! If not hockey, then definitely baseball (Yankees, of course), or football (NY Giants)!! Are there really any other teams to root for?!??!

@whitedaisies When I was in college, we once partied through the entire weekend. We didn't stop. Not for anything. We went from Friday night, to Sunday. It was really awesome. "Polite" partying? An interesting idea.....you'll have to say more about that, as I'm not sure precisely what that would involve. Lots of polite conversation over soda? Lol I'm just kidding. Aneeway, it's late, and I have to go to bed. I'll talk to you tomorrow daisies! And I'll be in touch with my friend and ask about the herpes cure. You say 10 years; I say 17-25. What's the prize for the first-place winner who guesses correctly?

@Tryingtostayzen The best course of action is to get a blood test. I would say one of the commercially available immunoassays are called for at this point. Just ask your doctor which type of blood test is being offered. He will say "IGG antibody test." Yes, that's good, but you also want the *brand name* of the test. Ask him that, and then come back on here and I'll see what I can find about it.

lol is that an invitation?

@whitedaisies Thank you, I wish I could be there too. But the demands of work and school will not allow me to get away. Yes, I too am EXTREMELY glad I do not have h!!! But we should all get together sometime just for the sake of getting together, it doesn't have to be about h. In whatever city we all meet, we can show them how to party. I'll bring the booze and party drugs!

Drinks? Dancing? People flying in from all over the world? Talking about it as a ritual? Sounds like you guys are really gonna party hard down there in Raleigh!

@Tryingtostayzen You should ask the man if you can see his blood work. Only you know whether he is likely telling the truth or not, but given the confusion and uncertainty surrounding your possible diagnosis, I would ask to see it to verify that he is in fact negative. Is there anyone else that from whom you could have possibly contracted this? Just because you started having symptoms in July, does not mean that was when you contracted herpes. It could have been months or even years earlier. Often an initial outbreak, or recurrences, happen long after infection. How long after the appearance of symptoms (whether during your first or second outbreak) did you get the area swabbed? If blisters formed, but then started to crust and heal, then a swab would not at that point be accurate. A visual diagnosis of herpes is accurate only about 80% of the time. That means that for every four instances of genital herpes that the doctor correctly identifies, s/he misdiagnoses one. So I would not rely too much on a visual exam. Different blood tests will become positive at different time intervals following infection. The Western Blot, the most complicated, but also the most reliable, of such tests, take about 68 days to "turn" positive. On the other hand, the HerpeSelect ELISA "turns" positive on average 23 days post-exposure. Since these are only averages, roughly half of patients require longer to test positive. It should also be noted that the ELISA only looks for antibodies to one viral protein: gg-2 for HSV-2, and gg-1 for HSV-1, and that the immunoassay method of the ELISA is less accurate than the Western Blot. Nonetheless, the ELISA correctly indicates infection with HSV approximately 95% of the time. So I would say that there is insufficient evidence at this point to offer a conclusive diagnosis of genital herpes.

Also, be sure to tell him to give you the paperwork from his STD tests. Check to see if he was tested for herpes. Most doctors do not test for it, even when a patient tells the clinician to test for "everything," because testing is not recommended by the CDC.

This topic is really so very fascinating, I so like to keep up on the very latest medical and technology news. I know someone who is very knowledgeable about research in the medical field, and he knows the politics and b.s. that go into so many questions of funding and research, so I'll send him an email and see what he says about when people can reasonably expect a cure.

@lifeislovely Most reputable studies, including those out of the University of Washington, have shown that that the risk for acquiring HSV and HIV correlates with one's lifetime number of sexual partners. Generally, the greater the number of lifetime sexual partners, the higher one's overall risk for acquiring either or both of HSV and HIV. However, that does not mean that all or most people with HSV or HIV have a large number of partners. Rather, the risk spans from as few as one partner, to many more. The relevant studies have shown that risk correlates with number of partners, simpliciter, meaning, without any special qualifications about that causal link being added on. I would say the prudent thing to do is for the both of you to get tested together for each other. HIV tests can be done very quickly after infection. While most antibody tests still take approximately four weeks from the time of exposure to test positive, there is another test, an RNA test by PCR (polymerase chain reaction), that looks for the virus itself and can detect HIV in the blood even just a few days post-exposure. It is definitive at 11 days post-exposure. Moreover, it can detect an extraordinarily low number of viral copies per ml of blood- as few as four. As for HSV, different tests will "turn" positive after different time intervals post-exposure. The Western Blot is the most authoritative blood test, but it takes an average of 68 days to "turn" positive, given the greater number of viral proteins it looks for, as well as the greater complexity of the technique of western blotting. I would say ask him when he ended his relationship with his very last sexual partner, and then, wait the requisite number of months, for herpes, generally around 4 is good, but for some people, it can take as long as 6 months to produce antibodies, and then, both of you can get tested.