Confused about IGG Results - False Pos?

Hello Terri.

Approximately 1 year ago I was tested for HSV 1 & 2 through Herpeselect IGG with the following results.  Test was done 9 weeks post possible exposure:  Positive for HSV 1, which I already knew (cold sores about once a year as a kid) and negative for HSV 2 (I didn't get the numbers).

At 13 weeks post possible exposure I tested again.  Results:

HSV 1: >5
HSV 2: 1.18

After learing that this could be false positive, I had a Biokit done at 13.5 - 14 weeks post.  It was Negative.

Then at 5.5 months post I had another Herpeselect IGG test.  Results:

HSV1: >5
HSV 2: .09

Last week (a full year past potential exposure) I had what I suppose could be prodrome symptoms - just very minor itching at the top of my buttock crack/tailbone.  The next day, I noticed a very small red spot in the center of my crack, above the tailbone near the top of the crack..  It did not turn into any kind of sore or blister, wasn't raised, just a tiny splotch/mark about half the size of a pencil erasure.  I don't know if it was there when I had the slight itching, or came up after.  The mark remained for about a week or so.  Didn't change, hurt, or feel like anything at all.  I decided I'd take another test, hoping I could clear this issue once and for all, and put my mind at ease for good, as it has given me quite a bit of anxiety.  Results:

HSV 1: >5
HSV 2: 1.18

What are your thoughts?

[Terri Warren, RN, Adult Nurse Practitioner]

My thoughts are that you are very unlikely to be infected with HSV 2.  However, I think it would be worth your time, trouble and money to get a herpes western bot.  This will be definitive for you at this time.  If you really did have HSV 2, your third value would have gone, up not down, I believe.  My strong feeling is that when you get the western blot, it will be negative for HSV 2, but positive for HSV 1, as this test is.    If you do it through Quest labs, the code you want is 34534.  The symptoms that you describe don't sound consistent with herpes to me.  Will you let me know what you find out?

Terri

[MDiamnot]

Thanks Terri. What about biokit instead of western blot?  Would that be conclusive?

[Terri Warren, RN, Adult Nurse Practitioner]

No, I don't think so.  I think Biokit would help, but not be definitive.

Terri

[Mri41]

Hello Dr. Warren. Last week I had what I guess was my first outbreak. It started as one bump that looked like an in grown hair and then became more bumps and became clusters and painful lesions. I went to the doctor, she took a culture for herpes 2 and it came back postive. I have only had one partner which was my bf of four years and we had broken up two days prior. I contacted him and he did a hsv 2 blood test and his igg came back negative and so he says he didnt give it to me. Is it possible he transmitted it to me and I had an outbreak but he didn't? He had what looked like one small bump almost like a scratch in his genital area but no other sympoms and says he's  had that for a while and goes away. Should he repeat the blood test and do igm testing for present infection. also would it be possible that he had herpes for four yrs without transmitting it to me although his igg is negative? Please help!

[Terri Warren, RN, Adult Nurse Practitioner]

If you've only had one partner and you are positive for HSV 2 by swab test, then you got it from him.  Either he is lying or he had sex with someone else and contracted herpes recently or he is one of the few who don't make detectable antibody.  IgM testing is useless.  If you have more question, you really need to make a new post, that's the board rules around here, sorry!
Terri

[MDiamnot]

Hi again.  OK, I want to take your advice and get a Western blot, but not sure how to go about it.  I am currently uninsured, but OK paying for the test directly.  Also, if at all possible, I would like to maintain anonymity if negative (if positive, of course I would disclose).  Do you know how I can accomplish this?  Do you know of any pay-for-service clinics, etc, in California (preferably Northern, SF Bay Area but could do San Diego too as I have a trip planned there) where one can get a Western Blot?  All of my IGG tests have been through TSTD online(who, by the way, are either not informed about the false positive risk of the test, or choose not to acknowledge it).  I am making myself physically sick with this.... stress, anxiety, shame.... I really want to know one way or the other and figure out how to move on.

Thanks Terri.

[Terri Warren, RN, Adult Nurse Practitioner]

You need to find a testing service that uses Quest labs and ask for code 34534.  So first ask if they send their samples to Quest and then ask for this test code, specifically.  I doubt that you are going to be able to do this anonymously.  If you are going to be in the San Jose area, you make an appointment with Dr. Kuljeet Rai and tell him I sent you.  Before you do that, ask if they could send labs to Quest.

Providers can send samples directly to UW, but most prefer to go through a lab due to shipping issues, etc.

Terri

[allyp209]

I was hoping you could answer a question for me. My boyfriend and I are both 19 and have been together for 2 1/2 years, last week he went for a checkup and got a blood test. He got back a positive hsv 2 igg test with a result of 1.50, he was negative for type 1.  He has only been with my in the past 2 years (I'm positive he did not cheat).  He had 2 partners before me (1 he frequently had sex with without a condom).  My test results came back negative for both hsv 1 & 2.  He has never had any symptoms of hsv 2 and was not aware of either of his other partners having it either.  He got retested today using the same test I believe.  I have recommended getting a western blot, but his doctor continues to say that is only used for hiv.  What is the chance of this being a false positive?  

[Terri Warren, RN, Adult Nurse Practitioner]

His doctor is uninformed. This has a very reasonable chance of being a false positive.  I would recommend that you go to the UW western blot site, print out the info and give it to his doctor.

Terri

[allyp209]

Terri, I got back his second test result today, he went from 1.5 to 1.2.  What does this mean?

[Terri Warren, RN, Adult Nurse Practitioner]

It has no meaning, no

[MDiamnot]

Hello again Terri.

I had blood drawn Wed of last week for a Western Blot.  The Dr. sent it through Quest (SF Bay Area).  How long does it typically take to get results?

[Terri Warren, RN, Adult Nurse Practitioner]

About two weeks.
Let me know the results, OK?
Terri

[MDiamnot]

Hi Terri.

After 2 weeks of biting my nails I just got my results.  

HSV 1 positive - which I knew
HSV 2 NEGATIVE!!!!  :-)  :-)  :-)

One note for the community here.  If you get a Western Blot through Quest, be proactive about getting your results.  Each time I called the Dr.'s office, they told me that Quest still had not sent them the results. Today - 2 weeks plus one day after having the blood drawn - I got the same response.  Frustrated, I called the UW Virology Lab myself.  They looked up my test using my name and birthdate and told me that the test resulted on the 3rd!!!  That meant that Quest had them for 8 or 9 days....  The UW told me that the Dr. has to call Quest to get them.  Finally, I have them... And finally, I can put this to rest.

And, one final question for you Terri.  Do you know why, or have a theory as to why the folks at tstd.com either are uninformed about the false positive potential with the Herpeselect test, or are aware but refuse to counsel on it?  Both low positives I received came with counseling from tstd that assured me that I was absolutely positive and there was no such thing in a low positive from that test resulting in false positive.  They were adamant both times...  We know better.

Finally, thank you, thank you, thank you for your knowledge and counselling.  And most of all, thank you for "pushing" me to get the Westernblot.  Had I settled for the Biokit, I would probably still have a ? lingering in my head (which I suppose is a measure of my neurosis).  :-)

[Terri Warren, RN, Adult Nurse Practitioner]

I'm so glad you finally got clear results, that is so great.  Good for you for pushing this through understand seemingly great pressure!

I actually called the 800 number at tstd.org this past week and asked about availability of the western blot and had a discussion of false positives in the low positive range.  The person I spoke with on the phone was absolutely insistent that anything over 1.1 was positive.  I even quoted to them the article by Matt Golden discussion false positives in the low positive range.  They were not at all interested.  But I have say, many providers offices who offer the ELISA tests are also not informed about this issue.  Very frustrating.

But at least for you, this issue is behind you.  I'm happy for you!

Terri