Positive to negative? Really confused

[Katie2222]

Around 7 months ago i tested positive for type 2 swab test. Since then i have put myself on suppression therapy as i do not want to experience another outbreak and want to minimise passing it on. Last week i had a igg blood test which has come back negative. I also have not experienced another outbreak since the first time however i have been taking a lot of natural herbal supplements that I have researched on. What is going on

[~Minerva~]

My understanding is that the swab test is the most accurate as it looks for the HSV virus within the sample taken. My guess is because you are on daily suppressive therapy, you simply do not produce enough antibodies to register on a blood test. Are you comfortable enough with your medical provider that you would be able to ask them for their professional explanation?

[mr_hopp]

Hi @Katie2222! Ah, probably a false negative. IgG is rife with false negatives and positives, unfortunately. (IgM is even worse.) And 7 months should be more than enough time to establish enough antibodies to be detectable on a blood test. Western Blot is the gold standard when it comes to a herpes blood test. Check this article out for more on that herpes blood tests.

[My thoughts]

There are podcasts with Terry Warren, who is one of the top researchers about herpes.
There are two here, and other one in youtube. Try to watch them.
I remember her saying that making a test while getting antiviral medication can come back negative.
I would suggest to make a new test, just IGG. IGM is worthless. Make sure it is three months after the last exposure at least.

[NJRunnerMom]

Is it true that if the swab is positive then there's really no need to go any further?  That's what my doctor said when my blood test results came back negative.  He said it was too early to show up in my blood but the positive swab was enough to know that I have HSV-2 and positive is positive and there's no need to test again. 🤷‍♀️

[My thoughts]

Most likely. A swab test from the sore is more relaiable  and it is recomended when you go to the doctor with symptoms. If it was a primary infection, yes. When you catch the virus for the first time, it can take from 21 days up to three months to show a positive blood test.
Science is science and nothing is 100%. You can take the blood test, three months or more after last exposure to confirm if it makes you fell better psychologically. 

[Katie2222]

Thanks everyone, 

the test i done was a IGg test in which was negative. Maybe you are right and it is the daily suppression ! Even though my doctors tell me it cannot interfere.

[TBarr]

The current statement from Anna Wald is that anyone exposed to HSV1 or HSV2 who has had multiple blood tests (3-4) and tests negative at 6 months post exposure does not have the virus. I would try 1 year to be 100%. Note a 6 month western bot UW test is a good idea however the IGG test currently (2/2021) from Labcorp follows a very stringent protocol to eliminate igg false negatives. This is especially true for the majority of people who are or may have been  exposed who have frequent burning and tingling and heat and small red spots/redness but never any "fluid filled blisters" or "sores". Valtrex does not affect antibody production if you have any symptoms this is a sign that your body is confronting a virus that is replicating. Now valtrex might knock down a 20,000,000 copy HSV replication down to a much much more manageable couple thousand or less but the immune system still must clear those cells and it does it with anitbodies. For a theoretical case of a mild primary exposure with a positive pcr swab and then your virus never ever attempts to replicate again (lucky you as you would have ZERO symptoms and a normal life without pain or suffering)  it might be theoretically possible to have no antibodies. Most people get the igg test because they have recurrent troubling symptoms that dont fit the "fluid filled blisters" model and thus never any positive pcr swb tests.

 

 As always communicate  with a local infectious MD specialist (not a nurse; not a medical GP) and make sure that Infectious specialist MD communicates regularly with the anti-viral department at UW. Not the nurses there, but the micro-biologist Phds and the MDS.

[Katie2222]

Thanks everyone, 

the test i done was a IGg test in which was negative. Maybe you are right and it is the daily suppression ! Even though my doctors tell me it cannot interfer

On 2/7/2021 at 10:52 PM, TBarr said:

The current statement from Anna Wald is that anyone exposed to HSV1 or HSV2 who has had multiple blood tests (3-4) and tests negative at 6 months post exposure does not have the virus. I would try 1 year to be 100%. Note a 6 month western bot UW test is a good idea however the IGG test currently (2/2021) from Labcorp follows a very stringent protocol to eliminate igg false negatives. This is especially true for the majority of people who are or may have been  exposed who have frequent burning and tingling and heat and small red spots/redness but never any "fluid filled blisters" or "sores". Valtrex does not affect antibody production if you have any symptoms this is a sign that your body is confronting a virus that is replicating. Now valtrex might knock down a 20,000,000 copy HSV replication down to a much much more manageable couple thousand or less but the immune system still must clear those cells and it does it with anitbodies. For a theoretical case of a mild primary exposure with a positive pcr swab and then your virus never ever attempts to replicate again (lucky you as you would have ZERO symptoms and a normal life without pain or suffering)  it might be theoretically possible to have no antibodies. Most people get the igg test because they have recurrent troubling symptoms that dont fit the "fluid filled blisters" model and thus never any positive pcr swb tests.

 

 As always communicate  with a local infectious MD specialist (not a nurse; not a medical GP) and make sure that Infectious specialist MD communicates regularly with the anti-viral department at UW. Not the nurses there, but the micro-biologist Phds and the MDS.

thank you so much for this information.

before i got tested via pcr swab i was in agony. I did have blisters but I thought thats done to me using every cream under the sun to get rid of it thinking it was the regular thrush that i would get after periods. However i got tested positive. I wonder if pcr swab can be false negative sometimes. Since then ive had 3 blood test igg all negative 0.510 so not even close to the borderline. I do really hope this has been a mistake. I will get a test done at 1 year again. Unfortunately in the uk ive not found anyone that does the western blot test. And although i havent had another outbreak i am too scared of coming off aciclovir and really do hope it does not interact and be giving me false negative blood results. I will look for a infectious doctor for more clarity. 
 

i do appreciate everything you have said 

thank you

[HSV_2_Newbie]

I have a similar story. I had no symptoms, but I had had unprotected sex in December. So my GP ordered a full STI screen in January. I:

1. Tested HSV2 positive by pcr on urine 5 weeks post exposure

2. Tested negative for igg at week 8 post exposure. 

My GP says to wait till 6 months. She also says I may not have seroconverted.

I'd like to do another igg test at 12 weeks because I can't deal with the uncertainty. Surely antibodies will have developed by 12 weeks. 

[Katie2222]

On 2/15/2021 at 8:19 PM, HSV_2_Newbie said:

I have a similar story. I had no symptoms, but I had had unprotected sex in December. So my GP ordered a full STI screen in January. I:

1. Tested HSV2 positive by pcr on urine 5 weeks post exposure

2. Tested negative for igg at week 8 post exposure. 

My GP says to wait till 6 months. She also says I may not have seroconverted.

I'd like to do another igg test at 12 weeks because I can't deal with the uncertainty. Surely antibodies will have developed by 12 weeks. 

Yh it is all very annoying and causes alot of anxiety not knowing what to believe.

let me know how that goes for you

I think im going to test myself once more at 1 year and if i test negative via blood again im going to try believe it really is negative