血检疱疹的准确度 [复制链接]

The large majority of people (especially at your age) with positive HSV-1 blood tests have had oral infections, typically in childhood -- which is consistent with your past history of cold sores in your youth.  It is very rare for anyone to acquire a new HSV infection with the type they already are infected with, anywhere on the body.  Therefore, the chance you have acquired genital HSV-1 is extremely low.  Statistically, it is likely that some of your oral sex partners over the years indeed had oral HSV-1 infections, but for the reason just stated, very unlikely they infected your genital area.

If and when you meet a new prospective sex partner, you should tell her you probably have oral herpes, as do more than half the adult population; that you have not any known outbreaks for years; and that you probably will never infect her.  And in any case, if any such person had herself had HSV-1 in the past, she will be immune to catching your presumed infection.

For all those reasons, this isn't something for you to be at all worried about.

I hope these comments have been helpful.  Best wishes--  HHH, MD .

嘴上得过hsv1的，传染上阴部的hsv1的概率rare
请怀疑hsv1的坛友关注

还有这样的
.In 2012.12 I did something very stupid. I slept with a sex worker. In summer of 2013 I experienced bumps on the glans (glands) of my penis, on and off. The bumps did not look like blisters, just small bumps. They didn't hurt or break, never form scab. They always came with inflammation of the whole glans (glands) due to poor hygiene, and shrunk and disappear in a few days when the inflammation got better. After then I paid more attention to hygiene. Since last October the bumps never reappeared.

I did a series of tests, because a doctor I saw suspected herpes. I had a few PCR swabs on bumps as soon as I saw them, all negative. I also did ELISA tests:
2013.06 (Trinity) - HSV1 Pos, HSV2 Pos
2013.08 (Trinity) - HSV1 Pos, HSV2 Neg
2013.10 (Trinity) - HSV1 Pos, HSV2 Neg
2013.12 (Euroimmun) - HSV1 Pos, HSV2 Pos
Finally, I did two HerpeSelect and two Western Blot (UW Lab) last month:
2014.01.14 Westover Heights Clinic
HS: HSV1 Pos (9.179), HSV2 Neg (0.506)
WB: HSV1 Pos, HSV2 Indeterminate
2014.01.15 Public Health Clinic at Harborview
HS: HSV2 Neg (0.78)
WB: Pos for HSV1 and HSV2

I was greatly surprised by my last WB result, since after the first WB result, my doctor already said I don't have HSV2. From last June, I paid much attention on herpes symptoms, but found nothing except the occasional bumps. I'm a male with oral herpes from young. This encounter with the sex worker in Dec 2012 was the last time I had sex.

My questions are:
1. Could you help me interpret these conflicted results please?
2. I read in another post that the WB test involved subjective interpretation. Given that there's only 1 day between my blood draws, why did the results differ this much? Could this positive be a 'borderline'? Is there room for error?
http://www.medhelp.org/posts/STDs/Negative-HSV-2-HerpeSelect-but-indeterminate-Western-Blot/show/248125
3. Given my conflicted test results and absence of typical symptoms, will it benefit me to confirm-test again? .

Welcome to the forum.  Thanks for your question.

I see absolutely no reason for any concern you may have oral HSV-2.  Presumably "I am positive for hsv1 but not hsv2" means you had a blood test, right? The HSV blood tests are extremely accurate in detecting antibody to HSV-2, so your negative result is strong evidence you don't have it.
As for your symptoms, it seems possible your oral lesion was a herpes outbreak (cold sore) -- i.e. I agree with your dermatologist it possibly was herpes, and that it's too bad you tried to treat it before it was examined.  (Tea tree oil is useless for herpes anyway.)  However, if it was, almost certainly it was due to your known HSV-1 infection.

I doubt the forehead lesion or the one near your nose were herpes.  Oral/facial herpes cold sores generally recur each time in more or less the same spot, give or take an inch or so.  If the lower lip lesion was herpes, then that's where you would expect all additional future outbreaks.

I don't know what you mean by "having sensations all around my face".  But herpes, whether HSV-1 or 2, doesn't do that.

My advice is that you not take Valtrex.  Wait until you have another facial blister or sore and then promptly visit a dermatologist who can test it for HSV, including a test to determine virus type (if positive).  Do not treat it in any way before being examined.

In the meantime, since you may have oral HSV-1, I would advise you to not kiss or perform oral sex on your girlfriend if and when you're having another OB.  But for sure don't worry about HSV-2.

Best wishes--  HHH, MD .

不打算发了，改自学了。
毫无相应

Good afternoon,
I really do agree with Hunter on this - I think it is very unlikely that you are infected with HSV 2 but with an indeterminate western blot, that is truly hard to say for certain.  However, we are starting a study this summer of a different test called a flow cytometry test, to look at those indeterminate western blot folks to try a different way to sort through confusing test results.  If you are interested, please call and leave Dr. Taulbee a message indicating you are interested in participating.  When the study starts, we would get you a consent form and arrange to have your blood drawn and sent to us for this purpose.  

I know this must be so frustrating for you!  You are definitely not alone in this situation.  We are trying all we can do to find out a way to sort out these kinds of test results as we know that people want to move on and live lives that are full and rewarding, sexually, and these test results can get in the way of all of that.  

I can't say that the results of this study will be a 100% clarification, just perhaps one more piece of the puzzle to confirm or not confirm your infection.  The fact that you have a negative inhibition assay is also very hopeful.  Rarely, do I see a positive ELISA on the herpeselect and negative inhibition assay.  Generally, in my opinion. the problem with false positives that plague the ELISA also plague the inhibition assay.  The fact that yours was negative is, I think, really hopeful about this being a false positive.

Thank you Dr. Handsfield, for allowing me the opportunity to post on your board on this issue.


最新的实验测试方法！！！！！！！！试验阶段用于

有说在灰区的话 是会有1型抑制2型的说法。
总体来看westernblot确诊度还是可信的，2%的人不出抗体。这个算不算公认

have had 9 patients in 32 years who are negative on the western blot and positive by swab, not just any blood test.  There is a difference.  I have seen people who test negative on ELISA who test positive by western blot, yes, but not very often for HSV 2.  Mostly HSV 1.  

My final thought on this is that you should pull together your person strength, find the money and get a western blot!  For heavens sake, if the past several years, how many cups of coffee have you purchase?  You could probably have acquired several western blots!  You've got yourself all tied up in knots because you don't have the courage to find out what is really going on with your own body.  OK, you can't count on that guy to test.  Period. End of discussion.  But you can take your own future into your own hands here!  

In the 9 people that I have seen who produce no detectable antibody by western blot, their frequency of recurrence is no different than the general population of people with herpes.  I feel like you have built this whole reality of your own about your skin lesions and it probably has nothing to do with reality.  I hate to sound harsh, but my goodness, girl!  Solve your problems.  Find the money to do PCR.  Get a western blot.  When it is all negative, move on.  Life is so short, believe me, I feel it more and more these days.  If you are thinking about something five times a day, this is pretty much classic OCD thinking.  

In addition, the law requires that now you have health insurance.  Quest labs will bill your insurance for the western blot.  You might have to pay for part of it yourself, but so be it.

This is my final post on this thread until you have western blot or PCR test results to share with me.  I feel like continuing to write to you about this is only making me complicit in this situation.

坊间30年9个错的，是不是从这里来的

1型10%的漏诊，2型2%漏诊，这是比较公认的说法吧。你说呢？