血检疱疹的准确度 [复制链接]

回复 119楼微笑的人生的帖子

那么久才复发搞不好是一型呢

我也看看

如果你有症状，而且复发，个人感觉查血没有必要。如果没有症状，想排除，查血是有意义的。

Hunter Handsfield, M.D. ..Western Blot Test Accuracy:.Hello, I have a question about the Western Blot test and it's accuracy.  I've read that the Western Blot Test is 98-99% accurate, with possible "negative" results occuring when someone has been exposed to HSV within the last 14-16 weeks or the levels of antibodies are too low to be detected.

I'm in the unfortunate situation of having been infected with HSVII, due to my partner's negative Western Blot test result.  When tested, he had been in a monogamous relationship for over 6 months.  He originally went to his general practice doctor for STD testing, and received a postive HSVI and HSVII result.    His girlfriend at the time, had all negative results. Based on his positive result, he was tested again at an STD clinic, and had a positive result again (For both HSVI and HSVII.) He decided to go to a specialist that performs the Western Blot Test.  He explained the two past prior positive results, and when the results came back - was told that he had HSVI antibodies, but NO HSVII antibodies. I've also seen the letter this lab sent, corroborating this.
  To make a long story short, after their relationship had ended (6 months later), a few months after that - he and I began an exclusive relationship, we did not use protection -since both of us had been tested in the past, both with negative HSVII results (In my last test, I was negative for both HSVI and HSVII).)  Within 3 weeks, I had symptoms, and was diagnosed both visually as well as by a culture test.  Devastated, we both returned to the specialist where my partner had originally gone for testing.  They compared his old blood work with his new blood work - found that he was positive now - and that yes, in fact, the blood drawn over a year ago - did show early stages of the infection - so he fell into that 1% error category.  My test came back as showing early signs/inconclusive, which obviously meant that I had contracted this from my current partner.  

My question here really is - if the less effective tests were picking up antibodies in his blood over a year ago - but the Western Blot came back as negative - was this truly the test error or USER error in making a diagnosis of the results? In addition, since he had been in this monogamous relationship for 6 months, he would have contracted the virus prior to that, and should have had enough antibodies in his system for detection (as was obviously concluded by the first 2 tests he'd taken).

Any clarification on this would be much appreciated! Thanks!

No HSV antibody test is perfect.  (Indeed no diagnostic test is perfect, although modern HIV antibody tests come close, happily.)  The Western blot is not 100% sensitive, meaning it misses a few infected people; that is, the non-WB diagnostic tests (e.g., HerpeSelect) actually is a little more sensitive.  The main purpose of a WB is to confirm another test that is positive--NOT to diagnose absence of HIV in someone with a positive standard test.  Also, WB tends to become positve more slowly than the type-specific ELISA tests.

Given the positive results of 2 type-specific serological tests, the WB really was not indicated and probably should not have been done.  I would not have ordered the WB; and if I had, when the results returned, I would have informed the patient that s/he probably had herpes, or was in the process of seroconverting--which, in retrospect, probably was exactly what was happening.

As to who was infected when, I can't answer that an won't try.  But at this point, perhaps it doesn't matter.  You and your partner both have HSV-2.  As long as you are together, and there are no other partners, it should be no big deal.  You cannot reinfect each other, and if you have bothersome symptoms, you can be treated. Your infection might be a concern if your current relationship ends and you're out there dating again sometime in the future; but I suggest worrying about that possibility then, not now.

Good luck--  HHH, MD .

就是这个 westernblot也会错

关于怀孕请看terri这篇帖子
大意是伐昔洛韦每天2次每次500mg提前5天吃，没问题。
手淫到容器里在受孕或者套套前弄洞洞爱爱
为不误导原文如下：

Dear Terri ,

i'm 28 years old , male ,Asian ,heterosexual .sorry about my poor english as its not my mother language .

i belive i was infected on Nov 2nd 2013 and got swab tested feedback HSV-2 postive on Apr 4th 2014.i have 3 outbreaks in last 6 months ,

currently i protact my partner by condom but not Suppressive therapy as i dont wants to take too much drugs .

we want have our first baby by 2015 and obviously condom can not protact my partner anymore but i have to use Suppressive therapy . i have read most of your books and advise but below questions seems not mentioned , hence ...

1.my final goal is have a healthy baby without infect my partner ,pls give me all your suggestions and instructison .

2.i know Suppressive therapy by valaciclovir can lower the risk to infect my partner but if it harm my sperm ? i dont want valaciclovir hurt my baby too.

3.if valaciclovir not harmful my sperm ,How long in advance i should start Suppressive therapy befor i will intercourse to have a baby (i mean how long time it takes valaciclovir will effect ? )? what will be the dosage i should take daily ?

awaitting your valuable feedback and thanks in advance !

Best regards ,

Joey


First, suppressive therapy will reduce the risk of transmitting herpes to your partner.  However, I will ask, has your partner actually been tested by antibody test for herpes to determine that she is not infected?  Suppressive therapy will reduce the risk but is not a perfect solution as you likely already know.  It has nothing whatsoever to do with your sperm.  It is a very safe drug and I'm not clear why you don't want to take it regularly, but some people just don't want to take medication, I think.  You should begin suppressive therapy five days before having unprotected intercourse for it to be most effective.  For maximum effect, in this particular situation, I would recommend 500 mg twice a day, 12 hours apart.  

Alternatives to getting her pregnant would be masturbating into a clean container and inserting the semen into her vagina with something like a turkey baster if she is very afraid of herpes.  Also you could try having intercourse with a condom with a hole pierced in the end.  I've heard of people doing this, but just not sure how well it works.  Might be fun trying!    Also, for maximum benefit, be sure to have sex when she is most likely ovulating when you do this condom with a hole in it thing.

Hope this was helpful for you.

Terri .