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STDs (Expert Forum)
HSV-2 Test Positive then Negative by ELISA test, why?
Answered by
University of Washington
Seattle - WA
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This forum is limited to questions about STDs other than HIV/AIDS. For questions about HIV prevention, or if you have general questions about safe sex (e.g., condoms, how to protect yourself from HIV and STDs), please visit the HIV Prevention and Safe Sex Forum
Some of the most common types of questions concern the risk of HIV or STD after a particular sexual exposure, and about symptoms that might or might not be due to HIV. If your question is along these lines, please visit the HIV Prevention and Safe Sex Forum.
HSV-2 Test Positive then Negative by ELISA test, why?
by v.confused, Oct 24, 2005 12:00AM
Did a complete physical so I had a herpes blood test. Didn't get test because of any sign i had it.
HERPESELECT. HSV-1 was neg, which they said was unusal, why? Positive for HSV 2. Then with same sample it was automatically retested (ELISA). Result was HSV 2 Negative, saying prior test was falsy positive. Doctor said to get first positive result i had been exposed to the disease but due to the negative result i don't have herpes. Can you please explain this better?
Can you be exposed and not get it and the test pick up you have been exposed?
Is the test picking up on a raise in anti bodies or immunity that fought it off?
How and why did i get a positive then a negative?
Does this mean i am a carrier?
I think i am just asking the same questions! Sorry. I don't understand and i have been searching internet with no luck.
On result sheet of HERPESELECT Positive result it says "A single positive result only indicates previous immunolgic exposure and the level of antibody response may not be used to determine active infection or disease stage. Test to be repeated 4-6 wks when neg or equival results are obtained"
At end of sheet of ELISA Neg result it says "A POSITIVE inhibition study interpretation indicates true HSV-2 specific reactivity, whereas a NEGATIVE inhibition study nterpretation indicates that the positive screening index was falsely positive"
I don't understand what they mean. I do have it but it has not fully developed yet? Or i don't have it but the disease is present in me? How can it be present in me but not have it?
I don't have HSV-1 and no signs of HSV-2
I am female, mid twenties, sexual active that uses protection.
HERPESELECT. HSV-1 was neg, which they said was unusal, why? Positive for HSV 2. Then with same sample it was automatically retested (ELISA). Result was HSV 2 Negative, saying prior test was falsy positive. Doctor said to get first positive result i had been exposed to the disease but due to the negative result i don't have herpes. Can you please explain this better?
Can you be exposed and not get it and the test pick up you have been exposed?
Is the test picking up on a raise in anti bodies or immunity that fought it off?
How and why did i get a positive then a negative?
Does this mean i am a carrier?
I think i am just asking the same questions! Sorry. I don't understand and i have been searching internet with no luck.
On result sheet of HERPESELECT Positive result it says "A single positive result only indicates previous immunolgic exposure and the level of antibody response may not be used to determine active infection or disease stage. Test to be repeated 4-6 wks when neg or equival results are obtained"
At end of sheet of ELISA Neg result it says "A POSITIVE inhibition study interpretation indicates true HSV-2 specific reactivity, whereas a NEGATIVE inhibition study nterpretation indicates that the positive screening index was falsely positive"
I don't understand what they mean. I do have it but it has not fully developed yet? Or i don't have it but the disease is present in me? How can it be present in me but not have it?
I don't have HSV-1 and no signs of HSV-2
I am female, mid twenties, sexual active that uses protection.
Doctor's Answer
by H. Hunter Handsfield, M.D., Oct 24, 2005 12:00AM
, Oct 24, 2005 12:00AM
Focus Technologies recently reformulated the HerpeSelect test, and I'm not yet 100% certain of their procedures and reporting standards. The new approach includes a screening test with their standard ELISA, then for some specimens--those that are weakly positive--they do an "inhibition" assay as a confirmatory test. Assuming that is what was done in your case, you can be 100% confident you have not been infected with either HSV-1 or HSV-2. In other words, with a negative inhibition assay, the previous HSV-2 positive (screening) result doesn't count. This is the meaning of "A POSITIVE inhibition study interpretation indicates true HSV-2 specific reactivity, whereas a NEGATIVE inhibition study nterpretation indicates that the positive screening index was falsely positive".
I can't say why someone said it is unusual to have a negative HSV-1 result. About 50-70% of the population is HSV-1 positive, so a negative result occurs 30-50% of the time, not at all unusual. To answer some of your specific questions:
1) There is no test for "exposure" that did not result in infection. A positive HSV result (either type 1 or 2) means infection; someone exposed to the virus but not infected does not develop a positive test.
2) The test picks up antibodies. Everybody with antibodies to HSV-1 or -2 has infection with the virus. Nobody "fights it off"; every infection with HSV is lifelong.
3) Positive then negative: See above.
4) Your results are negative. You are not infected, therefore not a carrier of either virus.
All the descriptive statements that come with the test are intended for the provider, not the patient. The problem is that most providers don't know enough about herpes and how to interpret the test results, so they cop out: they provide the descriptive statemetns to the patient, instead of explaining things the way I just did. What your provider should have done is said "Good news! Your test results are negative. You aren't infected with HSV-1 or HSV-2."
Best wishes-- HHH, MD
I can't say why someone said it is unusual to have a negative HSV-1 result. About 50-70% of the population is HSV-1 positive, so a negative result occurs 30-50% of the time, not at all unusual. To answer some of your specific questions:
1) There is no test for "exposure" that did not result in infection. A positive HSV result (either type 1 or 2) means infection; someone exposed to the virus but not infected does not develop a positive test.
2) The test picks up antibodies. Everybody with antibodies to HSV-1 or -2 has infection with the virus. Nobody "fights it off"; every infection with HSV is lifelong.
3) Positive then negative: See above.
4) Your results are negative. You are not infected, therefore not a carrier of either virus.
All the descriptive statements that come with the test are intended for the provider, not the patient. The problem is that most providers don't know enough about herpes and how to interpret the test results, so they cop out: they provide the descriptive statemetns to the patient, instead of explaining things the way I just did. What your provider should have done is said "Good news! Your test results are negative. You aren't infected with HSV-1 or HSV-2."
Best wishes-- HHH, MD
One of the most consistent features of herpes is that symptoms come and go, typically 2-6 times per year (i.e., every 2 to 6 months--pretty infrequently). Each episode lasts up to 2 weeks, but mild sypmtoms without blisters or overt sores (like slight pain, itching, redness) last only 2-5 days. So if someone has a red spot, or a few red spots in a cluster (not all over the genitals) that itch and go away in a few days and then come back (in pretty much the same spot) every few weeks or months, herpes is a good bet. But most of the people who ask about redness, itching, or other nonspecific symptoms ("wrinkled skin", tingling, urinary discomfort, and so on) describe a problem going on for weeks or months, or one that involves the genitals diffusely ("my scrotum itches", "my penis is red"), and their symptoms are continuous or come and go on a daily or weekly basis. Such symptoms are not consistent with herpes.
In other words, the vast majority of genital "itching and redness" are not herpes, even though herpes can cause those symptoms, if the problem is localized and intermittent.
HHH, MD