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Odds of False Positive with HerpeSelect ELISA, and alternatives?
An answer from a medical professional would be greatly appreciated:
I was recently (April 24, 2013) tested for HSV-1 and -2 with a HerpeSelect ELISA. I was told that my results were negative for HSV-1, but positive for HSV-2, with an index value of 1.53 (may have been 1.54). A HerpeSelect inhibition assay was then run which came back positive (as in, saying it was not a false positive).
Two weeks from the initial blood test (May 8, 2013), I went back to my doctor who ordered the a type-specific HSV-2 ELISA by HerpeSelect and the WB. The ELISA test came back at 1.4(something), and I was told that the corresponding inhibition assay again came back positive. My doctor also told me that Quest (who serves my university health center) no longer does the WB, and I should come back in 2 months to get the ELISA again to see if the number changed.
I had intercourse with two partners immediately before the initial test, so I understand this may reflect early seroconversion, but I also had a test in November 2012 at the same health center that came back as negative for HSV-2, and I haven't had any primary outbreaks (or any outbreaks at all) to my knowledge in the interim.
What should I make of the 1.53 and 1.4(something results?) What are the odds that this is a false positive? I know the 1.1-3.5 threshold has a lot of false positives, but what about at my end of the spectrum, specifically?
The likelihood of a false positive at 1.53 and 1.4 is fairly high, especially if you have had no symptoms, but you correctly note that you had your test done too soon to be truly accurate.
Repeat the testing at four months after your last exposure. If the number remains the same or drops, it's likely a false positive, but you can confirm with a Western Blot for peace of mind at that point.
how to obtain a WB for herpes in the US is listed in our read before posting post on the forum. if you get the kit went to your house or your doctor's office, your doctor can then order the WB performed and sent from your local lab. really no point in continuing to get herpeselect testing done with the low positives you've been having and there are some issues with the inhibition testing so well worth getting the WB anytime after 4 months after you last had sex.
This is not the experts forum -- you won't find any trained medical professionals here. If you're looking for something "more concrete" then you need to pay to post in the experts forum. We can only give you guidance based on our own experience and reading.
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