Confusing diagnosis, I don't know what to do...

[eyelash]

Hello,

 

About 7 months ago I was "diagnosed" with HSV2. I use quotation marks because I'm not entirely convinced it was a definite diagnosis. Here’s the (long) story…

 

Before the diagnosis, I was hooking up with a guy and it kind of fizzled out and we don’t really talk anymore. A few weeks after our last hookup, I started feeling itchy and noticed some discharge. All the signs & symptoms pointed to a yeast infection, so I went to a gyno to get medication. During this time, I was volunteering abroad for the year so I kind of chose a random gyno from a list and I wasn’t able to see my gyno at home whom I know and trust. This gyno that I went to did an exam, confirmed it was a yeast infection, and gave me the necessary meds and told me it should be gone within a week. A few weeks later, the symptoms had come back, though they weren’t as intense, and I went back to the same gyno to see if something else was wrong. He did another examination and told me he must have missed it before but he it looked like Herpes (which he announces in a fairly blasé fashion). He said he noticed a semi-healed lesion, but the actual infection had mostly passed so he couldn’t perform a culture. He gave me a prescription for Aciclovir and no other information. Of course I was freaked out and confused with the 2 VERY different diagnoses a few weeks apart, so a few days later I went to see a different gyno for a second opinion. He didn’t do a physical examination since at that point all my symptoms were gone, but I told him what had happened and he said he couldn’t be sure it was Herpes from the symptoms I described to him, and it really might have just been a yeast infection (hooray for more confusion!) Right after this was happening, I was meant to be traveling for 3 weeks and I couldn’t go and get a blood test right away, so the gyno prescribed me more medication in case my symptoms started again while on my trip (thankfully they didn’t). When I got back from traveling, I tried to get a blood test done, but the cost of doing it internationally was WAY out of my budget and my insurance wouldn’t cover it, so I decided to wait until I got home. I’ve been home for 2 months now, and have seen my doctor, and she told me I can get a blood test here (there is also a big cost, though not as high as it was abroad), but she doesn’t really recommend it. She says the results are notoriously unreliable, and the only thing that would give me peace of mind is if they came back negative, but since so many people are affected by at least one strain of HSV I couldn’t rely on the results. She said that the best way to find out if I have it or not is to do a culture when I have an outbreak, but since my original diagnosis 7 months ago I haven’t had a single outbreak or any abnormal symptoms. So now I’m at a crossroads… should I spend the money on a test that is likely to come back inconclusive, or just do nothing and assume I have HSV2? I’ve already gone through the trauma of learning my status, and I tried dating a little while after I found out but I got immediately rejected after sharing my status with the first guy I dated. The thought of dating fills me with so much anxiety and fear to the point that I’ve now been completely avoiding it, and I’d like to get over that but I haven’t been able to. I’m not sure what to do… is it worth getting the blood test so late after a diagnosis and symptoms? Has anyone else been in a similar situation? Any and all advice is so appreciated.

 

[HikingGirl]

A lot of doctors are really reluctant to test for HSV. (A lot of doctors are also grossly uneducated about herpes.) Even the CDC doesn't recommend testing for it in the absence of symptoms. I can see their viewpoint, but at the same time I find it pretty insulting when a doctor or medical organization assumes I'm too fragile to handle the truth about my own health. I'll be the first to admit I did not take my own diagnosis well initially, but eventually it became a huge blessing.

 

There's gynecologists on every corner it seems, so I'm sure you could eventually find someone to give you the blood test, or have the blood drawn at a lab and send it off yourself. Others have mentioned using testing services without going through a doctor (I'm sorry I can't remember specifics), which might be cheaper. Do you have insurance? STD panels are commonly covered as part of preventative care on many plans.

 

The IgM blood tests--still commonly used by many docs, sadly--are notoriously unreliable and inaccurate. The IgG blood test is what you want to ask for. I think @optimist once said the IgG is 95% accurate in detecting HSV2 and around 70% accurate in detecting HSV1 (hopefully she'll correct me if I misquoted those figures! :) )

 

Since you have not had a swab test or a blood test, I would not assume you have HSV. Maybe. Maybe not. Lots of things (like yeast infections) can mimic HSV symptoms, so honestly, anything is possible. I went undiagnosed for 20+ years because I was attributing my symptoms to yeast infections (which I was having on occasion, just not nearly as often as I thought I was).

 

I think the bigger question here is how well a blood test would work IF you had a relatively new infection but have been taking antivirals ever since. Blood tests measure the antibodies your body produces in response to the actual virus. It takes time after a new infection for your body to build those antibodies and I think I've read that antivirals can interfere with that, potentially giving a false negative result. I hope someone who is more up to date on that subject will chime in as I'd hate to confuse you further!

 

If you do have symptoms again, I would go in to the doctor and ask them to swab any possible lesions for a PCR test. If it's an open lesion and they can get a good sample, the test is measuring the virus and would not be subject to the potential questions surrounding the blood test I mentioned in the previous paragraph.

 

You're the best person to decide if you want a definitive answer on whether or not you're positive for HSV, and, if so, which type you have. Personally speaking, the uncertainty of being told two different things would drive me insane and probably impact my ability to move forward. {{{hugs}}}