Herpes and Confused at test results

I had an encounter in February 16 at a strip club where I received protected oral sex from her.  I completed a full battery of tests on March 22nd where I came back positive for Herpes 1 at 4.16 and positive for herpes 2 at 1.39.  I went to my primary doctor and had the test re-done on March 29 (6 weeks to the day post the encounter) and the herpes 1 test again came back positive but the herpes 2 test came back negative at 0.8.

Questions:

1.  If this was a new infection for herpes 2 would the numbers keep increasing instead of a decrease?
2.  Can either test be relied upon based on the timing?
3.  Could there have been a cross-contaimination raising the score for herpes 2?  I am not suprised I had herpes 1 as I have had cold sores during my childhood.

Thanks.

[gracefromHHP]

protected oral sex is about as safe as it gets.  wasn't any reason for any testing. had you ever been tested for herpes prior to this?

your hsv2 igg of 1.39 was a low positive and needed confirmed with further testing. your repeat test that was negative was good enough for confirming a negative hsv2 status and no reason for any more testing.

grace

[worriedandconcerned591]

Thanks for the quick response.  No I have never been tested before.  

Is it possible that the second test that resulted in an igg of 0.8 for herpes 2 is just the start of the formation of antibodies and that number will keep increasing?  I have read that the only sure test is after 12 weeks and I am at six weeks time?

Or as you said I am negative and no need for further testing?  Does that mean that the first low positive of 1.39 was just a false positive?

Thanks.

[gracefromHHP]

why would I change my advice? lol

[worriedandconcerned591]

I know, i guess I just didnt phrase my question correctly, I would not expect you to change your answer.

i guess my question is what could have led to two different test results for the same igg tests that were taken within 7 days of each other?  the first that resulting in a positive was done with an online testing site and the second as i said at my primary physicians office.

I am happy that you think no additional testing is necessary, but I am just confused as other posts have mentioned waiting until the 12 week time period for a definitive igg test.

Thanks again.

[Mistakeguy789]

When dealing with testing their is a lot of various things that go into what the results are.  Our testing does have a false positive rate (which is why one would need confirmatory results).  Your test going back to a negative after a positive is usually the case of a false positive.  Hence why the advice no need for further testing.

The values of the test are based on a comparision of a control side to the strip.  Sometimes a false positive does happen.  This happens in every test out there they all have false negative and false positive issues out there.  When dealing with telling someone to confirm their results this is where we take into account the encounter, symptoms, and the testing performed at the times.  When someone who is trained in understanding the testing (such as Grace is) she can point out when the result is in that false positive range and not a low true positive.  

I guess the best way to point this out is this test is a chemical test.  Sometimes there is an issue in the way the test will respond at times among other factors.  The fact you went from that low positive to a negative is an indication you are not infected with HSV-2.  If someone has HSV the numbers go up or stay the same.  

The biggest part here is what grace first told you.  Protected oral sex is as safe as it gets.  This comes into how is herpes transmitted.  Herpes isn't transmitted through the air.  Herpes needs direct skin to skin contact in order to be transmitted to a person.  You had no real danger of skin to skin contact as you had a condom in place which prevents the virus from being massaged into your skin.  Since you have read our previous posts you would see that our advice for protected oral sex (and only that having protected oral sex) is the same as she said... No risk and no need for testing.  To further prove our advice you have to consider HSV-2 stats for oral location.  HSV-2 orally is rare.  Without spending a lot of time as to explain why it doesn't like the oral region.  So the risk would have been HSV-1 for the most part.

You tested postive for HSV-1 which you wouldn't have gotten from the protected oral sex for the reasons I listed above with the use of the condom.  So you have HSV-1 and chances are it is oral in the form of coldsores which if she did have HSV-1 and you had unprotected oral sex we wouldn't have advised testing to be done unless you had a lesion at which point a lesion culture could be done.  But it is rare to get an HSV infection in another site of the same type that you have.  Having HSV-1 already means your body has an antibody response to fight the infection in a new location.  So you are either immune or highly resistant to getting it in a new location.  

With all that being said something we have seen on the testing is when a person has an established HSV-1 infection they can sometimes show up falsely positive on HSV-2.  Which we would say get the confirmatory testing if you tested positive again on the IGG test.  Which we would say get the WB but there is no need for additional testing.  You had a low positive that was in the range in which a high number of people are truly negative.