HSV-1 and 2 IGG results question - help please

Hi everyone, I have a question about a positive test result.  Several months ago a guy I had been seeing told me he had contracted HSV-2, so I went to Planned Parenthood to get tested.  Both HSV-1 and 2 were negative.  I went back a few months later (3 months after my last contact with him, we aren't together any more) and it was positive for HSV-2 only - 1.05 is the number they gave me over the phone.

I've had no symptoms or outbreaks (that I know of, they tell me they can occur intravaginally).

So I'm wondering if it's worth getting retested, and if so, what test should I get and where can I go?  Our health department doesn't do HSV blood testing (so go figure as to why it continues to spread), the free clinic doesn't do it and I'm reluctant to have my doctor do it because I don't want the diagnosis on my record, although I'm not sure if it will harm me to have it there.  Any insight is greatly appreciated, so thanks in advance.

[serendipiti]

Clarification - it's been 4 months since I last had contact with the guy.  My positive test was a month ago, 3 months after my last contact.

I picked up a hard copy of the results from Labcorp today.

HSV 1 and 2-Specific Ab, IgG
HSV 1 IgG, Type Spec result: <0.91 (no flag, units: index, reference interval 0.00 - 0.90)

HSV 2 IgG, Type Spec result 1.05 (flag: high, units: index, reference interval 0.00 - 0.90)

[gracefromHHP]

1.05 is actually negative.   It's up to you if you want to retest at all - personally I wouldn't even bother but it's your choice.  Obviously his hsv2 infection didn't come from you and it doesn't appear that you contracted it either.

grace

[serendipiti]

Hi grace,

Thanks so much - I feel better about that.  I think I'll get retested because the test results page says:

Negative  1.09

Note: negative indicates no antibodies detected to HSV-2. Equivocal may suggest early infection.* If clinically appropriate, retest at later date. Positive (etc.).

I checked with my doctor and they said they'd do an IgG blood test and if it came back positive, they'd test for antibodies.  Is this reliable?


* My test was exactly 3 months after my possible infection.  He doesn't think he got it from me but instead was worried he gave it to me.  Luckily his outbreak (which shortly occurred after our last time together 4 months ago) was not ON his penis but on the skin over his pubic bone just above, so hopefully that means I'm less susceptible to getting it than if his outbreak were on the head of his penis.

[serendipiti]

CORRECTION to my previous post - I believe the forum software took out the stuff between the "less than" sign and the "greater than" sign.  OOPS!

The test results page ACTUALLY says:

Negative LESS THAN 0.91
Equivocal 0.91 - 1.09
Negative GREATER THAN 1.09

[gracefromHHP]

It doesn't matter where his ob was located actually - you shed from the entire anogenital area along with ob's as well as periodically in between. It's not "safer" because his ob wasn't on his actual penis. That said - it's unlikely that you actually contracted herpes from your test results.

Yes indeed your hsv2 igg is getting close to the + range but the thing is - even if it was 1.1 - I'd still tell you it's unlikely you have hsv2.  Low positives are frequently false - the folks who are that low and are really truly positive are the minority, not the majority. Even if your retest came back as 1. 5 - you'd need additional testing to confirm it because it's still likely to be a false positive. Clear as mud?

" I checked with my doctor and they said they'd do an IgG blood test and if it came back positive, they'd test for antibodies.  Is this reliable? "  Either you misunderstood your provider or they don't understand the herpes blood tests. The igg test is a test for antibodies - since herpes isn't a blood borne virus, we don't have a consistantly useful test that actually tests for it in the blood.  We look for the presence of igg for herpes which means you were infected and your body has had a reaction to you being infected and your immune system was working hard to fight the virus. You either have to get a igg based test to see if you have herpes or get a lesion culture of actual active genital symptoms.  

grace

[serendipiti]

Hey, thanks again.  I probably misunderstood them - they may have said "we do a blood test and if it's positive, then we test for antibodies."  I went ahead and got another test with them - it will be a week and I'll post the results back here.

I'm kind of worried that Planned Parenthood is giving incorrect information/advice.  Not only are they apparently giving positive test results without the caution that people might want to get retested, I asked them how safe it was to have oral sex, etc. and they said that until I get an outbreak it's hard to tell, because if it's in my mouth I could spread it that way.

I do not want to be responsible for a guy getting it, so I won't be having sex until this matter is put to rest.  I guess that means waiting and having tests every month until it ends up being higher than 1.6 or it's been a year (?).

PS another correction to my last post - the last line of the test result should have read "Positive greater than 1.09."

[gracefromHHP]

Oh no reason to wait a year!!!  I'd just just a confirmatory test and if it's negative I'd be done with it and move on. Only a very small minority of people take longer than 4 months to test + from a new infection and you are very close to that time now.  Get a Wb if you can get it or a biokit hsv2 igg test.

grace

[serendipiti]

Test results at 4 months:

HSV, IgM I/II combination  less than 0.91 ratio   0.00 - 0.91
negative less than 0.91
equivocal 0.91 - 1.09
positive greater than 1.09

HSV Type-2 Spec [H] 1.03 index 0.00 - 0.90
same stuff as above

SO the result is lower than a month ago, I guess that's good, but I need something to *prove* it's definitely negative.  What kind of doctor would I see to get a WB or Biokit test?  I don't see how I can justify putting someone else at risk just because the number is low and web consensus is "you're safe," you know what I mean?   If the test said "definitively negative," no problem.

Thanks again.

[serendipiti]

Dr. just called - they're going to do a WB.

[gracefromHHP]

You are going to test negative for hsv2 on the WB but if you feel the need to waste your money on it - so be it.

Your doctor needs to get out of the habit of ordering igm tests for herpes. They are very inaccurate and shouldn't be used. I am hoping that your hsv2 was an igg and not an igm.

grace

[serendipiti]

Thanks Grace.  The other test was an IgG.
HSV Type 2-specific Ab, IgG
HSV 2 IgG, Type Spec [H]

What I can't wrap my head around is - why an equivocal test if it's negative?  The doctor had said she'd do a WB but then her assistant called and said they can't and suggested I wait four more months and get another test.  

She mentioned that it's possible that I could be positive and capable of passing it on but my body isn't creating the antibodies the way most people's do so the result is in the equivocal range...this seems feasible...is it not?  This is the stupidest of questions but If I am truly positive, I'm expecting the WB to be positive.  It couldn't be equivocal or negative if I was positive, right?

I called an infectious disease doctor and they said they'd order a test but couldn't be sure it would be covered by insurance.  I see them on Monday.  Any specific questions I should ask them?

Sorry, my head is spinning and I'm tired.  I really appreciate your help.

[waringblender]

Wow, it doesn't sound you're willing to take "negative" for an answer. I'd be curious to know what's driving that attitude psychologically.  But knock yourself out on more testing.

[gracefromHHP]

equivocal is negative. What it means is to alert the provider that if not enough time has passed they might want to consider repeating the test at a later date.  this has been more than 3 months now since last possible exposure.  You are negative. There is no reason to repeat the test. do not let the equivocal label mess you up.

grace

[serendipiti]

I'm definitely glad to hear you guys say it's negative and I appreciate your support.  The problem is - there's a guy.  Doesn't every story here start like that? :)  When we were getting close to getting intimate, I told him about the test and that I was positive.  He was concerned (I'd be concerned about him if he wasn't) and didn't want to put himself at risk.

I'd love to go to him now and say "Guess what, I was wrong."  How can I do that?  How would you feel if you were him?  I really like him but our relationship was budding and I didn't expect him to say "I love you and I'll do anything for you" - I'm a bit more realistic than that, and if I were him, I'd really want some kind of proof.

Grace - earlier, you suggested getting a WB or biokit if possible, but now you're not?   Why the change?  Also, why is it coming up equivocal?  No one has been able to answer that yet.

I hope that explains my predicament a bit better.  If I can't find a test that says "DEFINITELY NEGATIVE BY MOST ACCURATE TEST POSSIBLE", I'd like to try to find a doctor who can write a report saying "we've done all the tests and she's showing equivocal for these possible reasons ______ but she definitely doesn't have HSV2."  

Again - thanks so much for your help - you guys mean a lot to people like me.

[waringblender]

I still don't understand what your concern  is here. You have a negative herpes 2 blood test. Why can't you accept that? Who cares that "there's a guy?" So what? Tell him you are negative, and take it from there. It's not rocket science, honey.

I have to ask again - what psychological payoff do you get from believing you are positive? Only your therapist can help you with that one.

[serendipiti]

I'm probably overanalyzing this but it seems that virology is a great bit more complicated than aerospace engineering.  There's a lot of guessing going on and not a lot of tangibles in virology, where in AE everything is known.  Please bear with me when I tell you I don't BELIEVE I'm positive.  I don't know what I am, although I'm hoping you are correct.

1. The test says equivocal, which is definitely NOT negative but not positively positive.
2. You and Grace say it's negative, end of story.
3. Planned Parenthood maintains it's 100% positive even after our discussion today about how they deliver news of equivocal test results.
4. No one has been able to offer a reasonable explanation of why my test went from less than 0.91 four months ago to 1.03 last week.

I tell this guy I'm positive, confess my feelings about him (we have been acquaintances/friends for a few years so yes I had some), then a month later tell him oops, it's really negative, trust me.  Sure.  

I think what I'm hearing that the WB or biokit really won't put a + or - stamp on this issue.  I guess I'll just have to tell him what I know and let him decide.  If he doesn't accept it, move on.

Also, it's not helpful to belittle, use sarcastic endearments or be indignant to people asking for help just because they question your response.

[gracefromHHP]

You will never, ever, EVER find a test that guarantees you that it's 100% accurate. We just don't have them.  Your expectations are unrealistic for what you will get out of testing. You also will never get a medical provider to write you that sort of note either.  It's a legal issue and they aren't going to do that for you.  

I originally suggested the biokit or WB for peace of mind for you but then you went and had another negative test done so why bother getting further testing at this point? It's 2 negative tests.  And yes equivocal is negative even though it doesn't say negative.  Don't allow this to be something you obsess over and spend lots of time and money retesting over and over and over again about.  

And dahlin - any man that hears you have herpes and runs for the hills is one you don't want to be trying to get a 2nd chance with by going to him now and saying "oh I was wrong I don't have herpes".  If herpes was enough to scare him off - what happens with the BIG things in life happen?

grace

[serendipiti]

I might be concentrating on this pretty hard right now, but it will be behind me soon enough.  I just need all my questions answered and you guys are helping this obstinate person.

As regards your last paragraph - that's not the way it is, but I know you hear from a lot of young and scared girls so I can see where your perspective comes from.

Thanks, I appreciate your help!

[doniniqe15]

Hi Grace,
I'm hoping u can help me. I went 2 my doctor 4 my annual pep. I asked 4 her 2 test me 4 everything. I went friday 2 ask them 4 my results since I heard nothing from them in over a month.
It was told 2 me by the receptionist tht everything was negative except I tested positive 4 Hsv2.
It says:
Negative 1.09
I had the same numbers for Hsv1. I've been wth my husband over 20 yrs. I hve regular check ups. I've never been told anythng accept I was a anemic and my blood count was low. I've been told tht since I was 16.
I've never had a break out or any symptoms.My husband and I hve used condoms 4 the past 7 yrs 2 keep from having anymore kids.Is it posible tht ths could be a false positive. I'm so scared. What should I do Pleses,Please help me.