Herpes Transmission Rate - Page 3

DoctorTan · #31 13-08-2015, 05:12 PM

I agree with Boss. Your problem is psychological.

OK let's talk about HSV testing. You PMed me a question but I thought it would be better to answer it here and share the info with everyone.

There are 2 groups of patients who carry HSV.

Group 1 - symptomatic patients
To make the diagnosis in these patients is really straightforward. It could be purely clinical i.e. you look at the blisters/ulcers and immediately you know it is HSV because it looks exactly like what is shown in textbooks. If you are still not sure or you want to know which type it is, you swab the base of the ulcer/blister and send it to the lab for a HSV PCR test. This has largely replaced viral culture tests we used to do which were highly non-sensitive.

Group 2 - asymptomatic patients
First of all you have to ask yourself and your patient the question "why the hell are you testing in the first place?". Let sleeping dogs lie and let the patient live his life in blissful ignorance.

But you absolutely have to know if you are infected or not if not you will go mad. That's fine.

You then have to rely on serologic tests. In other words, you have to test for HSV antibodies and not HSV virus. The problem with serologic tests is that they are extremely difficult to interpret. There is a lot of cross reaction. For example, most people carry HSV 1 and this may cause the HSV 2 results to become false positive. Even getting a chickenpox vaccine may cause the HSV serologic tests to become false positive.

So you want serologic tests that are as specific as possible. The Gold Standard is the Western Blot test. As far as I know, there is only 1 lab in the world that does this and they only do it for research purposes.

A good alternative is Type Specific Serologic Testing. I have personally called the labs in Singapore that I use for HSV serologic testing and they have told me that the tests that they do are TSST tests. I have my doubts but let's just take that at face value.

The labs use a cut off index value of anywhere from 0.80 to 1.1 to say a test is "positive" for HSV infection. I call bullshit on this. From the studies I have read, it should be > 3.50. So if you HSV IgG index reads > 3.50 you can more or less (99%) say that you have been infected with HSV.

The problem is when your reading comes back as 2.0 or 2.5 or 1.8 and you do not have any symptoms. Are you infected or not? Nobody knows. You can re-test in a few months to look for a SIGNIFICANT INCREASE in titer but most of the time, this does not help either. SIGNIFICANT INCREASE means it must rise above 3.50. If you go from 2.0 to 2.8, you are still none the wiser.

The other problem is the window period. This is the time from infection to when TESTS CAN PICK UP THE INFECTION. This is very different from saying WHEN THE BODY STARTS PRODUCING ANTIBODIES. The body starts to produce IgM antibodies (more on this later) as early as 3 weeks from infection. And IgG antibodies no later than 6 weeks form infection. Very frequently, IgG can be produced much earlier. So the doctor who informed you that the HSV IgG test at 28 days is "90% to 95%" accurate is absolutely correct. From the studies I have read, HSV IgG tests are accurate no later than 16 weeks from infection.

IgM is produced much earlier so some doctors use this test to detect an infection earlier. The problem with IgM is that is disappears very fast also. So it has very limited utility in diagnosis. Furthermore, IgM cannot differentiate between HSV 1 and 2.

Last thing: even if your HSV test came back positive, you don't know when you caught it anyway! Maybe your parents had cold sores and passed HSV 1 to you as a child. So now you test positive for HSV 1 and going to freak out when you have been living with it happily all your life? Maybe you caught HSV 2 from your 1st GF, been symptom free all this while and now you are going to freak out?

After knowing all this you still want to test?
Listen to good advice from everyone here. You have no symptoms. Leave it.
Live your life. Be happy.

PPGirl · #32 13-08-2015, 05:30 PM

Ts .. if really u r tested positive with herpes, what r u goin to do?
Just relax n i knw say is easy.
I think anxiety going to kill u rather than the illness itself.

sammyboyfor · #33 13-08-2015, 06:12 PM

I'd like to add that I'm positive for Herpes Zoster because I had Chickenpox when I was 13 years old.

The virus never goes away. It remains in the system and can surface as a nasty case of Shingles later in life. Shingles can cause blindness if it attacks the eye.

I've improved my odds against Shingles with a Shingles vaccine. You do what you can and don't worry about what is beyond your control.

Life goes on.

Aladeen · #34 13-08-2015, 08:30 PM

drTan, I fell asleep reading half way. I think im gonna let the sleeping dog sleep.

PPGirl · #35 13-08-2015, 08:44 PM

Quote:

Originally Posted by sammyboyfor

I'd like to add that I'm positive for Herpes Zoster because I had Chickenpox when I was 13 years old.

The virus never goes away. It remains in the system and can surface as a nasty case of Shingles later in life. Shingles can cause blindness if it attacks the eye.

I've improved my odds against Shingles with a Shingles vaccine.

Damn i didnt knw there is shingles vaccine. Anyway i got both chickenpox n shingles. Got shingles recently.. didnt know until after 21 days lolz.

BoringLife88 · #36 14-08-2015, 02:41 AM

Seriously guys after reading everything you guys said. It clears all my doubt and I felt so my better. I definitely feel that I am under psychological issue and a doctor did told me before that I have symptoms of post trauma or something along that line.

But right now I feel so much better. Thanks guys

Especially the so call "boss" I don't know who you are and why they call you "boss" but I appreciate it.

Also DrTan thanks for the clarification. It felt so much better to get the answer like this.

Cheers!

sammyboyfor · #37 14-08-2015, 07:07 AM

Quote:

Originally Posted by BoringLife88

But right now I feel so much better. Thanks guys

Especially the so call "boss" I don't know who you are and why they call you "boss" but I appreciate it.

Also DrTan thanks for the clarification. It felt so much better to get the answer like this.

Cheers!

That's good to hear. If you have a relapse and end up being depressed again, just pop back in and I'll do my best to cheer you up once more.

sammyboyfor · #38 14-08-2015, 07:10 AM

Quote:

Originally Posted by PPGirl

Damn i didnt knw there is shingles vaccine. Anyway i got both chickenpox n shingles. Got shingles recently.. didnt know until after 21 days lolz.

http://www.cdc.gov/shingles/vaccination.html

Shingles vaccine (Zostavax®) reduces the risk of developing shingles and the long-term pain from post-herpetic neuralgia (PHN) caused shingles. The Advisory Committee on Immunization Practices (ACIP) recommends shingles vaccine for people aged 60 years and older. Even people who have had shingles can receive the vaccine to help prevent future occurrences of the disease.

Your risk for developing shingles increases as you get older. The Shingles Prevention Study found that shingles vaccine significantly reduced disease people aged in 60 years and older.

Shingles vaccine is available by prescription from a healthcare professional. It can be given in doctor's office and pharmacies. Talk with your healthcare professional if you have questions about shingles vaccine.

Shingles vaccine is approved by FDA for people aged 50 years and older. However, CDC does not have a recommendation for routine use of shingles vaccine in people aged 50 through 59 years old. Adults aged 50 through 59 years who have questions about the shingles vaccine should discuss the risks and benefits with a health care provider. There are no long-term studies showing how long the vaccine is effective in 50 to 59 year olds. In adults vaccinated at age 60 years or older, protection from the vaccine decreases within the first 5 years after vaccination. Protection beyond 5 years is uncertain; therefore, adults receiving the vaccine before age 60 years might not be protected when their risks for shingles and its complications are greatest.

PPGirl · #39 14-08-2015, 11:23 AM

Quote:

Originally Posted by sammyboyfor

http://www.cdc.gov/shingles/vaccination.html

Shingles vaccine (Zostavax®) reduces the risk of developing shingles and the long-term pain from post-herpetic neuralgia (PHN) caused shingles. The Advisory Committee on Immunization Practices (ACIP) recommends shingles vaccine for people aged 60 years and older. Even people who have had shingles can receive the vaccine to help prevent future occurrences of the disease.

Thx boss for the nice info.
Hmm the vaccine recommended more for ppl aged 60 n above. Maybe i check with my doctor.

sammyboyfor · #40 14-08-2015, 12:02 PM

Quote:

Originally Posted by PPGirl

Thx boss for the nice info.
Hmm the vaccine recommended more for ppl aged 60 n above. Maybe i check with my doctor.

That's only because Shingles usually occurs in the older folk. I'm sure it can be administered at any age.

DoctorTan · #41 14-08-2015, 02:59 PM

Quote:

Originally Posted by sammyboyfor

That's only because Shingles usually occurs in the older folk. I'm sure it can be administered at any age.

The vaccine is indicated for patients above the age of 50.

However, most patients I see with Shingles are a lot younger than that.

To me, it makes sense to vaccinate younger than 50.

PPGirl · #42 14-08-2015, 05:41 PM

Quote:

Originally Posted by DoctorTan

The vaccine is indicated for patients above the age of 50.

However, most patients I see with Shingles are a lot younger than that.

To me, it makes sense to vaccinate younger than 50.

I am below 40 yrs old.
Anyway will check with my company doctor on the vaccine. Thx doctor tan!