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HSV 2 Type Specific Test AB 2.22
For the HSV 1/2 IGG Type Specific Test, how high can a number be in the "in range/out of range"?
I got a result that stated 2.22 on the HSV 2 IGG Type Specific AB test and I am very confused and saddened.
Any help will be greatly appreciated. I just got these results and I am having a hard time really understanding this and coping/dealing.
Thanks.
I got a result that stated 2.22 on the HSV 2 IGG Type Specific AB test and I am very confused and saddened.
Any help will be greatly appreciated. I just got these results and I am having a hard time really understanding this and coping/dealing.
Thanks.
ELISA stands for Enzyme-Linked ImmunoSorbent Assay and is the technology upon which the Herpeselect IgG test is based.
The basic premise is that a plastic dish that has many individual wells (for many samples) is coated with a specific protein (HSV2 gG in the case of Herpeselect) which sticks to the plastic. These coated plates are then exposed to your blood which lets antibodies in your blood (if you have them) stick to the HSV2 gG protein. The plate is then washed, leaving only wells that either have no antibody stuck to them (from a person who has no anti-HSV2 antibodies in their blood) or wells that DO have antibody stuck to them (from someone who does have anti-HSV2 antibodies in their blood). This stuck antibody can then be detected in the well using a reagent that changes colors if antibodies are in the well. This color change is then read by a machine and the degree of color change is what is used to calculate your index score that gets reported on your test results. The technique is very sensitive and can detect very small amounts of antibody. The problem is that it is prone to false positives because things that have nothing to do with HSV could cause the well to turn positive. Some ELISAs will change colors if saliva from the person running the assay falls in a well because of certain enzymes in a persons saliva. Theoretically, the samples are run in duplicate to avoid this sort of random mistake from creating a false positive but there are other circumstances in which you can get a positive result from the serum reacting against non-HSV related proteins without actually having HSV antibodies.
The western blot uses entirely different technology in that it is looking for antibodies against many different pieces of the virus, not just the gG protein used in the ELISA. It is also not dependent on the same reagents that cause color change in the ELISA. As such, it is a good confirmatory test.
Sorry for all the jargon.
The basic premise is that a plastic dish that has many individual wells (for many samples) is coated with a specific protein (HSV2 gG in the case of Herpeselect) which sticks to the plastic. These coated plates are then exposed to your blood which lets antibodies in your blood (if you have them) stick to the HSV2 gG protein. The plate is then washed, leaving only wells that either have no antibody stuck to them (from a person who has no anti-HSV2 antibodies in their blood) or wells that DO have antibody stuck to them (from someone who does have anti-HSV2 antibodies in their blood). This stuck antibody can then be detected in the well using a reagent that changes colors if antibodies are in the well. This color change is then read by a machine and the degree of color change is what is used to calculate your index score that gets reported on your test results. The technique is very sensitive and can detect very small amounts of antibody. The problem is that it is prone to false positives because things that have nothing to do with HSV could cause the well to turn positive. Some ELISAs will change colors if saliva from the person running the assay falls in a well because of certain enzymes in a persons saliva. Theoretically, the samples are run in duplicate to avoid this sort of random mistake from creating a false positive but there are other circumstances in which you can get a positive result from the serum reacting against non-HSV related proteins without actually having HSV antibodies.
The western blot uses entirely different technology in that it is looking for antibodies against many different pieces of the virus, not just the gG protein used in the ELISA. It is also not dependent on the same reagents that cause color change in the ELISA. As such, it is a good confirmatory test.
Sorry for all the jargon.
..thanks..all those terms get too technical for me..im going to ask my doctor today about the tests and im going to ask for the WB, just so i can get a definite answer..is there room for false positives on the wb too?..i havent noticed any outbreaks, but mine would be a bit tricky since it deals with my cervix..and there is little information on that..but i would rather know any how..thanks again..and i will keep on reading so i can understand all those medical terms..rhetorical question, but what is ELISA?..
..super thanks..appreciate it..and i made a call to my doctor yesterday, waiting on him to return my call..i will ask him about the western blot test just so i can get that definite answer and take it from there..apparently mine is a bit tricky if anything, because i dont get genital outbreaks..mine is in regards to my cervix..and there is so little information out there..
I'm not sure there is a difference between the HSV 2 IGG Type Specific AB test and the IGG. All of the papers I've looked at refer to the UW western blot as the "Gold Standard" for HSV serology testing. I'd definitely get the Western. Aside from that, you can re-test your IgG with reflex to HSV2 neutralization which uses the same Herpeselect test, or you can use something completely different like the Biokit (which uses a different method for making the virus protein used in the test as well as being read out differently).
Neutralization is a way to double-check that the number that comes up on the ELISA is really because of antibodies in your blood recognizing HSV2 and not some non-specific cross reactivity of your antibodies for something on the plate (lets say the plastic well itself for example). The idea is that they do the standaed Herpeselect test and get an ELISA value like 2.2 from your blood. Then they expose your blood to virus and let all of the HSV2 antibodies stick to the virus (which means they can't stick to the ELISA test now) then you re-run this neutralized blood on the ELISA. If the score drops by 60% or more and the reading is now 0.88 or lower, they say that your blood had HSV2 antibodies that now can't be seen by the ELISA anymore because they were stuck to the virus. If the score drops 40% or less and your score stays at 1.32 or higher, they say that most of the signal in their test was due to non-HSV2 antibodies (like ones that stick to plastic for example) and they call it a false positive. It's basically just another way to confirm their result while still using the same basic test. For those interested in factual correctness antibodies against plastic wouldn't come up in the test because the ELISA uses a protein to block access to the plastic but the general principle applies, if you have antibodies to any other part of the test which doesn't have to do with HSV2, then they'll see that in a neutralization assay.
Here are some of the open-access references. This one shows the odds of testing negative on western blot and biokit for different index ranges on the ELISA:
http://www.biomedcentral.com/1471-2334/5/84
The rest are all subscription required.
Good luck to you too!
Neutralization is a way to double-check that the number that comes up on the ELISA is really because of antibodies in your blood recognizing HSV2 and not some non-specific cross reactivity of your antibodies for something on the plate (lets say the plastic well itself for example). The idea is that they do the standaed Herpeselect test and get an ELISA value like 2.2 from your blood. Then they expose your blood to virus and let all of the HSV2 antibodies stick to the virus (which means they can't stick to the ELISA test now) then you re-run this neutralized blood on the ELISA. If the score drops by 60% or more and the reading is now 0.88 or lower, they say that your blood had HSV2 antibodies that now can't be seen by the ELISA anymore because they were stuck to the virus. If the score drops 40% or less and your score stays at 1.32 or higher, they say that most of the signal in their test was due to non-HSV2 antibodies (like ones that stick to plastic for example) and they call it a false positive. It's basically just another way to confirm their result while still using the same basic test. For those interested in factual correctness antibodies against plastic wouldn't come up in the test because the ELISA uses a protein to block access to the plastic but the general principle applies, if you have antibodies to any other part of the test which doesn't have to do with HSV2, then they'll see that in a neutralization assay.
Here are some of the open-access references. This one shows the odds of testing negative on western blot and biokit for different index ranges on the ELISA:
http://www.biomedcentral.com/1471-2334/5/84
The rest are all subscription required.
Good luck to you too!
yeah, I think the question is asked because there is such a big possiblity of a false positive on the igg test in the under 3.5 range... so it's like - if you got tested because you had a bad genital rash that your doctor thought looked like herpes and you scored a 2.2 - it probably IS herpes and is NOT a false positive. If you got tested as part of a yearly STD screen, never had a symptom and got a 2.2 - there's probably a greater chance it is one of the false positive readings...
When I got the results of my first test, my provider mentioned in sort of a casual way that sometimes a reading under 3.5 can be a false positive, and so I should retest. I think my 2nd test was about a month later, same test, the igg. when that result came back as 2.04, my provider was ready to call that "positive," final answer, and I would have been taking the valtrex and using condoms for the rest of my life. BUT in the meantime, I had done a lot of research - on this site, reading Terri Warren's book (the good news about the bad news) - and learned about the Western blot test and how it is considered the "gold standard" and is the most accurate test. So when I got the 2nd low positive, I wasn't ready to accept that as the final answer, and insisted on having the WB test. My provider had never even heard of it and was reluctant to order it at first, but I was somewhat pushy about it and finally she said ok and ordered the test. IAnd in the end - of course I'm so glad I did because my result was negative.
I'm not a medical person so I can't explain scientifically what the difference is between the 2 tests - the igg and the WB. I just know that igg is the standard test, and with a reading of 3.5 or higher, it's considered accurate and no further testing is required. With a lower score, the WB is considered the way to get a definitive answer in these gray-area, middle of the road cases, like ours.
Personally, I'd say skip the 2nd igg and go right for the WB if your doctor is willing to order it... Hang in there...
When I got the results of my first test, my provider mentioned in sort of a casual way that sometimes a reading under 3.5 can be a false positive, and so I should retest. I think my 2nd test was about a month later, same test, the igg. when that result came back as 2.04, my provider was ready to call that "positive," final answer, and I would have been taking the valtrex and using condoms for the rest of my life. BUT in the meantime, I had done a lot of research - on this site, reading Terri Warren's book (the good news about the bad news) - and learned about the Western blot test and how it is considered the "gold standard" and is the most accurate test. So when I got the 2nd low positive, I wasn't ready to accept that as the final answer, and insisted on having the WB test. My provider had never even heard of it and was reluctant to order it at first, but I was somewhat pushy about it and finally she said ok and ordered the test. IAnd in the end - of course I'm so glad I did because my result was negative.
I'm not a medical person so I can't explain scientifically what the difference is between the 2 tests - the igg and the WB. I just know that igg is the standard test, and with a reading of 3.5 or higher, it's considered accurate and no further testing is required. With a lower score, the WB is considered the way to get a definitive answer in these gray-area, middle of the road cases, like ours.
Personally, I'd say skip the 2nd igg and go right for the WB if your doctor is willing to order it... Hang in there...
..thank you so much for sharing and responding..thanks..i just dont think any of that is relevant to be honest..to my knowledge..my partners have not been positive..but then again..maybe they just didnt know..i wasnt aware it was not part of the so called "full" STD check i would ask my doctor to run..you have to specifically ask for it..crazy..
..wow..thats what i got..sorry for asking so many questions now..but did you retest quickly after your 2.2 test?..how long did you wait?..did you have to ask your doctor for the western blot or did they suggest it?..thank you so much and you are right about that..a definite answer would change everything..and the western blot is more reliable/accurate in regards to getting a definite answer?..
..wow..thats what i got..sorry for asking so many questions now..but did you retest quickly after your 2.2 test?..how long did you wait?..did you have to ask your doctor for the western blot or did they suggest it?..thank you so much and you are right about that..a definite answer would change everything..and the western blot is more reliable/accurate in regards to getting a definite answer?..
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