The Helper

  • Increase font size
  • Default font size
  • Decrease font size
Home


Confused about testing and misdiagnosis

Print PDF

I read on your website, as well as many others, that if one tested positive for herpes through a viral culture, one could be sure they had herpes. I wanted to share my experience where I tested positive for herpes through a culture, but turned out not to have herpes.

I went to see a doctor about a bad bout of hemorrhoids as well as a small area of rash on my buttocks that the doctor guessed was shingles. I pointed out another sore spot on my rectum to the doctor which he said was herpes, and suggested I have it tested. He took a swab and sent it to the lab and the results came back positive (it was not a type specific test.) I later had type-specific blood tests for HSV-1 and HSV-2, four weeks after the date of my last, possible exposure, but these came back negative. The infectious disease specialist advised me that, since the viral culture was positive, I could be sure I had herpes. He said that there probably had not been enough time for the antibodies to form. I was retested after 12 weeks from the date of my last possible exposure. Again, I tested negative for both HSV 1 & 2 (with HerpeSelect®).

I spoke to my doctor the following week. He told me that the blood test was accurate and type-specific, and if I had herpes, the antibodies would have formed by the time I was tested. I reminded him of the original doctor’s belief I had shingles, and asked if that would have affected the test. He said that yes, herpes zoster could have caused the viral culture to be positive. So, it would seem that the viral culture test for herpes is not infallible.

Thanks for sharing your story with us. Culture test have long been considered the “gold” standard when diagnosing the herpes simplex virus, though certainly the move now is to use PCR (polymerase chain reaction), a far more sensitive swab test. After reading your story, we decided to speak with one of our Scientific Advisory Committee members for insight. Terri Warren, RN, nurse practitoner, and owner of Westover Heights Clinic in Portland, Oregon, is considered by many a herpes simplex expert. She shed some light on cultures versus blood antibody testing. A positive culture taken from a lesion (sore) is still considered the more believable result in comparison to a blood antibody test, according to Ms Warren. She explained that the cytopathic effect–the changes that occur in the laboratory when a virus infects culture cells–looks different for varicella zoster virus (the herpes virus associated with chicken pox and shingles) than the cytopathic effect for herpes simplex. After a cytopathic effect is noted in the culture media, the affected cells are then treated with a specific stain. Cells from varicella zoster stain differently from those infected with herpes simplex. Therefore, because of this two step process involved in culture identification, cross reaction is very unlikely to occur.

Additionally, Ms. Warren noted if the genital HSV infection is caused by HSV-1, an IgG blood test like the one you mentioned is only 91% sensitive, i.e. it misses almost 1 out of every 10 cases. Situations where this happens are not all that uncommon and often are due to HSV-1 infection. The Western Blot is slightly more sensitive for detecting HSV-1 antibody (93%) and sometimes adding the HSV western blot to the serologic testing regimen can pick up HSV 1 antibody when the ELISA has missed it. In addition, a few people take longer than 12 weeks to become antibody positive. You may want to discuss our response with your doctor and see if further testing is advised.

 

Warning: Illegal string offset 'active' in /var/www/html/www.thehelpernewsletter.org/templates/ja_purity/html/pagination.php on line 129

Warning: Illegal string offset 'active' in /var/www/html/www.thehelpernewsletter.org/templates/ja_purity/html/pagination.php on line 135

Warning: Illegal string offset 'active' in /var/www/html/www.thehelpernewsletter.org/templates/ja_purity/html/pagination.php on line 129

Warning: Illegal string offset 'active' in /var/www/html/www.thehelpernewsletter.org/templates/ja_purity/html/pagination.php on line 135

Warning: Illegal string offset 'active' in /var/www/html/www.thehelpernewsletter.org/templates/ja_purity/html/pagination.php on line 129

Warning: Illegal string offset 'active' in /var/www/html/www.thehelpernewsletter.org/templates/ja_purity/html/pagination.php on line 135

Warning: Illegal string offset 'active' in /var/www/html/www.thehelpernewsletter.org/templates/ja_purity/html/pagination.php on line 129

Warning: Illegal string offset 'active' in /var/www/html/www.thehelpernewsletter.org/templates/ja_purity/html/pagination.php on line 135

Warning: Illegal string offset 'active' in /var/www/html/www.thehelpernewsletter.org/templates/ja_purity/html/pagination.php on line 129

Warning: Illegal string offset 'active' in /var/www/html/www.thehelpernewsletter.org/templates/ja_purity/html/pagination.php on line 135


Page 5 of 5

Get Managing Herpes on Kindle today! ASHA's award winning book Managing Herpes: Living & Loving with HSV, by Charles Ebel and Anna Wald, M.D., M.P.H., is an essential resource for anyone looking for more information on herpes.


Only $7.95 for the Kindle edition.