Interpreting Your Results

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All About STI Testing
Interpreting Your Results
Vaginal Discharge - When to Test
The Herpes Virus - When to Test
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Rectal and Pharyngeal Swabs
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Interpreting Your Results
Teletest allows you to view your results directly from our public laboratories and Ontario Public Health.  Our physicians are available to talk with you about any questions regarding your results.  The following page outlines some commonly used terms in your report, and what each term means.  Our physicians will contact you directly if you are positive for Syphillis, HIV, Chlamydia, Gonorrhea or Trichomonas.  
We are available to discuss your results if you are positive for the herpes virus, but do not contact you unless you have specific questions about the virus.  If you are positive for the herpes virus, you will recieve a secondary email inviting you to a conversation with a physician if you would like.   
Common terms on your results page
“Not Detected” = no evidence of current infection 
“PND” = Pending Lab Result, our labs take a few days to process results
“Detected” = presence of an infection
“Non-Reactive” = you haven’t had a detectable infection - this means you have a negative test result; we recommend repeat testing at the 3 month point to guarantee a negative result.  
“Reactive” = you have been exposed to the virus
I saw this when I viewed my results on the Teletest Portal.  What does this mean?
The image below means we have partial results from the lab, and are awaiting public health to release bloodwork.  You will be notified when the full results are released with a new email and this information will be replaced with public health blood results.  The N does not mean normal or abnormal - it's just a placeholder public health uses.
Commonly asked questions
(A) I tested 'reactive' for HSV 1 or HSV 2.  Does this mean I have genital herpes or cold sores?
HSV 1 or HSV 2 antibodies are produced when you are exposed to the herpes virus.  This can occur through sexual and non-sexual contact.  HSV virus can be acquired through non-sexual contact - sharing a drink with someone (even a relative) with an active or recent cold sore.  Most people don't know that cold sores are actually caused by the herpes virus, and are quite common.  You can also contract HSV through kissing.  Over 90% of the world is positive for one or both viruses. (Reference 1)
HSV can also be transmitted through sexual contact.  Performing or receiving oral/anal/vaginal intercourse can result in exposure to the Herpes Virus.  If you’ve experienced blisters in the genital region, you have likely had a herpes outbreak.   Most infections are common and often do not have symptoms.  
If you are experiencing an outbreak, a physician at a local walk in clinic or urgent care centre can swab the area and give you a definite answer if it is a herpes outbreak, and the strain (HSV 1 or HSV 2).
(B) What’s the difference between HSV 1 and HSV 2?
Both HSV 1 and 2 are nearly identical viruses - HSV 1 can cause cold sores but also genital herpes.  HSV 2 can cause cold sores but also genital outbreaks.  Scientists make the distinction between HSV 1 and HSV 2 based on the frequency we find each virus in the oral and genital regions.  HSV 1 is more likely to be found in the oral region and HSV 2 is more likely to be found in the genital region.  This does not mean if you test positive for HSV 2 that you have had a genital exposure, as the exposure may have been oral (cold sore).  This is why doctors rely on whether you’ve had symptoms of an outbreak in the past to determine why you’re positive.  
(C) I tested positive for herpes, but I don’t recall ever having genital sores or cold sores.  
Having a positive test means you were exposed to the virus at some point in your life.  Many people never have symptoms and never experience an outbreak.  In general, you are more likely to transmit the herpes virus to a partner if you have an active outbreak or are experiencing prodromal symptoms (i.e. burning, tingling or pain before an eruption is about to occur).  Asymptomatic transmission (having neither prodromal symptoms or an outbreak) can occur, but risk can be reduced by avoiding intercourse around the time of a recent outbreak.  
(D) I have had cold sores, but I have never had a genital outbreak.  Can I still get genital herpes?
Yes.  Contracting genital herpes requires exposure to the virus through bodily fluids.  If someone has cold sores and performs oral sex on you, even if you are positive for the virus, they can transmit the virus to you in the genital area even though you have antibodies to the virus.  As such, we advise against sexual contact of any nature (oral or genital) if there are any ongoing outbreaks in any partner.  
(E) Can herpes can be cured?
The herpes virus cannot be cured, but we have very effective antiviral medication to treat an outbreak or prevent transmission.  Some people never experience an outbreak in their lifetime, and others may only experience an outbreak once every few years.  Others may have an outbreak more frequently.  If you would like a prescription of Valtrex (valacyclovir), a commonly used oral antiviral medication to treat cold sores or genital herpes, please email us at [email protected] and our physicians will be in contact with you to send in a prescription to a local pharmacy of your preference. 
Cold sores are treated with Valtrex (valacyclovir) tablets for a single day; genital outbreaks are treated for a total of three days.  For some individuals with multiple outbreak a year, they can be on once daily dosing supressive therapy that prevents outbreaks.  
(F) I tested positive for HSV 1 or HSV 2.  Should I start medication now?
Medication for the herpes virus is only suggested if you are experiencing an oral outbreak or a genital outbreak.  For oral outbreaks, we typically prescribe 4 pills of valacyclovir in the morning and evening for one day when a cold sore is about to erupt or has erupted.  For a genital outbreak, we give you a tablet twice daily for three days.  These medications do not 'cure' herpes but treat an active flare.  If you have no flares (i.e. no cold sores or genital outbreaks) and only a positive result, we don't routinly recommend supressive (daily valtrex).  If you tested positive and have more questions, email us at [email protected] and we will be in touch.
(G) Could my result be an error?
Our Ontario public health laboratories use the Liaison HSV 1 and Liaison HSV Type 2 Specific IgG Assay - it has a sensitivity of 96.9-98.9% (misses 1.1-3.1% of infections) and a specificity of 91.3%-96.8% (false positive rate of 3.2% - 9.7%).  The test result can be negative early in the course of an infection, which is why we encourage repeat testing if you are symptomatic at the 3 month point. There is a change of a false positive result, which is why we encourage you to get checked for the HSV antibody only if you have had cold sores or a suspected genital outbreak in the past.
(F) My Herpes test says 'indeterminate'.  What does this mean?
If you have an indeterminate Herpes Antibody Test, and have had symptoms of cold sores or a genital outbreak recently, it may represent an 'early' antibody response that will become positive with a repeat test in 12 weeks.  A repeat test is encouraged for certainity if you have had symptpms.  If you have not had any outbreaks in the past, or any known exposures it can also represent a false positive and we don't recommend a repeat test at this time.  
Reference: 
(1) https://www.ncbi.nlm.nih.gov/books/NBK47447/ 
All About STI Testing
Vaginal Discharge - When to Test
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