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Confusing Herpes Test Results

Where to start!  This is a rather long story so please bear with me.  

On the 11 February 2010 - I went for a full STD test. All STD results were negative apart from my Herpes Type 2 PCR Test.  This was orginally communicated by the Lab (in London) as negative as well as the other tests, but then on 26 February I was contacted by my private doctor to let me know that my result was actually positive, the lab apparently had some problems with their machines, re-ran their tests and mine subsequently was now deemed as positive.

As you can imagine, I was very anxious to get to the bottom of whether I was positive/negative for Type 2 and a further urine and swab test was conducted by the lab a month later and reported as negative.  Also, the lab as they had made a mistake with the reporting of the earlier test, agreed to run igm and igg blood tests for me.  This came out positive for HSV1 - no surprises there, have had many cold sores, and negative for HSV2. The IGM test came out negative for both IGG and IGM.  

So the lab then suggested that I re-run the PCR test in May - but I decided with my Doctor that this was not a good idea, as unless I was shedding the virus (so far never had any symptoms of HSV2 - so could be asymptomatic) it would come out negative again as it did in March 2010.  So we agreed to run the antibody test, which I did on the 10 May. It came out as positive for HSV1 (no surprises again) and negative for HSV2.

I am very happy to accept that the intitial PCR test taken in February 2010 was a false positive, and that the subsequent PCR and antibody tests are indeed confirmation that I do not have HSV2.  However, what has perplexed me is the change in the antibody titre from the two blood tests conducted in February and May respectively.  

I have printed the results below:

Current Result 10 May 2010
IMMUNOLOGY
HERPES SIMPLEX ANTIBODIES
H.S.V. I (IgG) Positive 3.478 Index (Pos = > 1.0)
H.S.V. II (IgG) Negative 0.490 Index (Pos = > 1.0)
COMMENT : The significance of this result depends on
the clinical context.
Rising antibody level is more significant
Suggest testing a second sample in 1-2 weeks.

Result from 26 February 2010

IMMUNOLOGY
HERPES SIMPLEX ANTIBODIES
H.S.V. I (IgG) Positive 4.671 Index (Pos = > 1.0)
H.S.V. II (IgG) Negative 0.022 Index (Pos = > 1.0)
COMMENT : The significance of this result depends on
the clinical context.
Rising antibody level is more significant

Even though both results are within the negative range, there has been an increase (sizeable) from the result in February to May, does this signify my result is positive.  Even with the most conservative of estimates I have not had any physical contact for at least six months, could it have taken 6 months to show an increase in antibody level?  Or could it be the start to me turning positive for HSV 2

Any help would be much appreciated.




11 Responses
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Avatar universal
Thanks for the response.  I agree with you Grace. One thing I have realised from my research here on the forum and the internet generally is that herpes testing is very hit and miss, and Doctors expertise in this area is also hit and miss, especially in the UK. In the US it seems doctors are more experienced. I am confident that the intial pcr was a false positive, due to the lab error, but can see that unless I am willing to expend an inordinate amount of time and stress on this to get the lab to admit this, then they are going to stick by their theory.  Im going to try and put this whole affair behind me!
Helpful - 0
101028 tn?1419603004
I disagree with what they've told you. You had the results in your igg that you did because that's the way the test is run - you will never get a zero as a result on it. I'm still betting with an error and false positive pcr on the urine.

Helpful - 0
Avatar universal
I haven't had a response from you, your help would be much appreciated.
Helpful - 0
Avatar universal
Thanks Grace. Well I have had an update from the Doctors Clinic on their interpretation of events, which I would appreciate your views on. I asked them what conclusion to take from the confusing Herpes results and this is what they have come back with:

"I apologize for the delay in getting back to you but I was confirming a
couple things with the Medical director.

The negative HSV 2 means that you do not have genital herpes. ie. you
will not suffer from this physically and will not have recurrent attacks.

The rising antibody titre, at that increase, indicates that you have
most like been exposed at some point to the virus and have developed
antibodies to it. The initial positive urine was possibly indicative of
exposure to the herpes virus but the viral load was likely small and so
your body was able to develop antibodies to it and hence a level of
immunity.

So I think in the end, you were exposed to Herpes, developed antibodies
(indicated by the rising level) but did not get the disease. ie. you do
not have herpes.

Hopefully this settles things for you now"

Rather than settle things for me as you can imagine it has confused me even more!  I guess the lab and the clinic believe that the original PCR was indeed a positive as opposed to a false positive. So have used that premise to explain the rising antibody titre level as indicative of being exposed but never developing the virus.  I am really very confused and don't know what to think anymore.  The time I had the first PCR test back in February ( I was not in physical contact with anyone - i.e. no sexual exposure for it to be the initial infection).

Sorry to bombard you with all of this, but I don't know what to make of this...
Helpful - 0
101028 tn?1419603004
your igg results changing are meaningless.  levels will vary somewhat from test to test.  

your hsv1 igg's aren't "quite high". they absolutely are not cross reacting with a negative hsv2 result.

grace
Helpful - 0
Avatar universal
Thanks Grace, thats what I think as well. A bit of advice on the test results.

Do you think the Titre change could be due to another viral std in my system. Having said that my tests were negative for all other STDs when taken in February.

Have you any experience of seeing this? Its just I have read other posts from the Drs and Terri Warren and they say sometimes antibody levels cross-react with other antigens.  Or could my quite high positive HSV1 antibody levels be cross-reacting with the negative HSV2 levels?



Helpful - 0
101028 tn?1419603004
honestly I wouldn't bother with any further urine testing for herpes. not worth the money.    it is going to be negative the majority of the time.  so are swabs of the genital area when you don't have actual symptoms present.  

honestly it's likely you don't have hsv2. I'd be very distrustful of the lab mix up originally and having a negative hsv2 igg this far into things would be unusual if you really are infected.

Helpful - 0
Avatar universal
Well thats half the problem, the lab aren't really ready to confirm what happened that day so on the off chance I am tested again by PCR on the day I am shedding the virus then I only have the blood tests to go by.

When I redid the PCR on urine and on swab of the vulva it came out negative again.  

So what I really wanted to understand was whether the change in the antibody titre was anything to be concerned about?  Would this in your opinion show a chance that after a couple of months this result could become positive? I have read on previous posts by you and Dr HH that the antibody result can fluctuate depending on the sample and that blood will give different values and that as long as it is in the threshold it doesn't matter?

I don't have a partner at the moment and haven't had any physical contact for over 6 months.
Helpful - 0
101028 tn?1419603004
well pcr looks for actual herpes DNA so if it was detected in urine, that would be because the virus was actively shedding at that time.

Because of the lab errors though, following up on this more is in your best interest.

do you have a regular partner?
Helpful - 0
Avatar universal
The PCR Tests was done on Urine, as a part of an routine set of STD tests, it was what the doctor called site specific.  There was no active lesion in February or in March. I have never had an active Herpes lesion on my genital area.

So as I was deemed to be asymptomatic the IGG blood tests were conducted.

Helpful - 0
101028 tn?1419603004
what did you have pcr done in february on - blood or an active herpes lesion?

did you have any active herpes lesions when you were retested a month later?
Helpful - 0
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