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Labwork for viral shedding
An_254401 posted:
I really hope someone can help me here.

I am a seriopositive woman with an asymptomatic HSV-2 infection. Four years ago I was diagnosed after having unprotected sex and developing a vaginal discharge. After that, my sexual partner and I both had our first HSV-2 test and we both tested positive. His doctor mentioned to him that his antibody numbers looked high for a new infection and the man claimed that he had never had an outbreak.

I had also never had an outbreak. However, when looking at Web photographs of lesions, I recognized the blisters as the same I had developed on my inner ankle 25+ years ago. (At that time, I had gone to a dermatologist who didn't know what it was. It eventually healed and then returned a couple of years later in the same spot. Then it went away forever.)

I wrote to Terri Warren and gave her my detailed information and test results and she said that she suspected that I had had HSV-2 for a very long time. She also mentioned that she had had patients before with herpes on their ankles, but that they had all experienced genital outbreaks as well. But I have yet to experience any outbreaks anywhere.

I now want to find out about my viral shedding. I read an NIH research paper recently (Genital Shedding of Herpes Simplex Virus Among Symptomatic and Asymptomatic Persons with HSV-2 Infection) and am interested in mailing PCR swabs to a lab like Westover Heights Clinic (WHC). But I am unclear on many points and I hope that someone can help me answer these questions:

1) In the NIH report, participants were given daily swabs that were collected every two weeks. Each swab was then evaluated individually to determine the duration of the shedding episodes. Is that what a lab like WHC does? My understanding is that they send you a vial of seven swabs, but I wasn't able to find out whether the swabs are individually evaluated (e.g. swabs 1-4 are found to be positive, swabs 5-7 negative) or whether they are batch evaluated (e.g. the swabs are all found to be either positive or negative).

2) In the NIH report, a result was considered positive if greater than 150 copies of HSV DNA per mL of PCR buffer were detected. Would a lab like WHC use the same standard? Also, does this mean that fewer than 150 copies of DNA are not transmissable?

3) In the NIH report, genitial HSV was detected at least once in 68.2% of persons with asymptomatic HSV-2 infection (60 of 88 persons). Does that mean that 28 people may theoretically not have viral shedding indefinitely?

4) What is the minimum-maximum time one should have PCR swabs evaluated to produce information that is meaningful?

5) Does anyone know of similar research using participants that take viral suppressants?

I really tried to keep this post succinct - I apologize for its length. But this condition has been so devastating for me - I really need to understand it better. I appreciate any help - thank you.
abe648 responded:
Terri Warran is a well known leader in the Herpes scene and is very knowledgeable in Herpes. If this is something new that she is looking at at WHC then I would recommend that you talk to her or her office about these questions. I am sure that they would have the answers for your questions.

Once you get answers could you come back and give us more information on what this new testing is Thank you
Abe ...I am not a medical professional. Read the Herpes Handbook, Watch the Video and Terri Warren's book is availible umder the Heading Herpes at
An_254401 replied to abe648's response:
No, this is not a new service - I believe they offered it four years ago when I wrote to her about my infection, but I didn't have the money to consider it.

I called her office recently, but wasn't able to get specific information, nor was I able to find any on the website. I was hoping that someone here had experience or knowledge of this procedure and could answer question 1. I was hoping that someone current with the research could answer questions 2 and 5. Questions 3 and 4 may need to be answered by someone who works in a lab that does this - it's possible that Quest or other labs also provide this service, but I don't know yet.

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