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HSV2 lab question help
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HSV2 lab question help

Hi there, thank you for answering my question.
As part of a routine well women exam, I requested complete STD testing. I have never had symptoms nor been treated for any prior STDs. I was shocked when the Dr.s nurse called and revealed that I tested postive for HSV2. I asked if she was certain, as I have had cold sores since childhood, but never a genital outbreak. After I settled from the initial phone call, I called back and asked for the specifics of the results. She stated that my IgG level indicated that I had been in contact with the HSV2 virus at some point. I asked for the specific level and she stated ".92" I understand that you can be a carrier without demonstrating symptoms, but with my history of +HSV1, I am not convinced that I "am postive for HSV2".  Can you please help me? I can't describe the sense of anxiety I am feeling.
Thanks!
SG
55646_tn?1263664409
.92 is not a positive test result.  It falls into the category of equivocal.  I have no idea why they told you it was positive, but that's an error.  This number does not necessarily mean that "you have been in contact with the virus at some point".  As you correctly suspect, it can be a could be some antibody crossover from your HSV 1 infection.

When was the last time you had a sexual contact?  You should allow about 4 months from your last sexual contact for greatest accuracy.

I would not assume with a .92 result that you are infected with HSV 2.

Terri
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HI Terri,
Thank you for your response. My last encounter was in October, which is another reason I was confident that I was not  "positive".  I have also been retested in the meantime, and it came back negative.

Now my frustration is mainly with my doctor, who refused to entertain any of my questions regarding HSV 1 crossover, why she claimed .92 was positive when it's not, and her lack of knowledge of the rate of false positives under 3.5.

Do you have any professional articles or literature that I could offer her? As frustrated as I am about how I was treated, if I can do anything to educate her so this doesn't happen to others, I certainly want to help.
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55646_tn?1263664409
Well, the lab report, I am certain, described .92 as equivocal.  As for articles about low positive being sometimes false positives:

Here is on reference:

Herpes simplex virus type 2 (HSV-2) Western blot confirmatory testing among men testing positive for HSV-2 using the focus enzyme-linked immunosorbent assay in a sexually transmitted disease clinic.

Golden MR, Ashley-Morrow R, Swenson P, Hogrefe WR, Handsfield HH, Wald A.

Sex Transm Dis. 2005 Dec;32(12):771-7.
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55646_tn?1263664409
And here is one I actually use all the times.

BMC Infect Dis. 2005 Oct 14;5:84.
Use of "biokit HSV-2 Rapid Assay" to improve the positive predictive value of Focus HerpeSelect HSV-2 ELISA.

Morrow RA, Friedrich D, Meier A, Corey L.
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Avatar_f_tn
You're right, the lab report absolutely stated that .92 was "equivocal", that's part of the frustration. I spoke to my dr. specifically about the difference between what the lab stated and what she stated, and she just said "it's her office policy, anything above .91 is positive". I question if that is even ethical....

Thank you again for your help. Thank goodness there are experts with correct info out there!
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55646_tn?1263664409
oh boy.  I just don't know what to say, honestly.  

Terri
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Terri Warren, RN, Adult Nurse Pr...Blank
Westover Heights Clinic
Portland, OR
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