Test result help

[Daisy999]

Hello,

I am hoping someone here can help me.  I recently learned that i have possibly been exposed to herpes, so I went to the doctor and had a type-specific blood test (processed by LabCorp).  The results were puzzling and I'm not sure what to think.  According to the doctor's office (with whom I spoke on the phone, I haven't seen the numbers myself), the results were:

HSV1: negative
HSV2:  negative
"reflex to HSV2": positive

The nurse with whom I spoke was puzzled as well, and showed it to 2 doctors on staff who said not to worry, that I don't have HSV1 or HSV2.  So....what's the "reflex" positive for?  

I have never had an outbreak of any kind, either on my mouth/face, or anywhere I've read you can get HSV2.  The only thing even a little suspicious is that I sometimes get small, blemish-like bumps on the back of my neck when under severe stress.  Also, I was once diagnosed with shingles (over 10 years ago).  But shingles is not HSV2, so...???

Adding to this confusion is that the person I was exposed to has also never had an outbreak of any kind in the "usual places."  His HSV blood test was prompted by a doctor who noted some small bumps on his lower back, right where his waistband sits, that flare up in summer when he sweats.  He was floored when the doctor suggested herpes, because he's had these things flare up in that spot for over 25 years, and never anywhere else.  He always figured it was a heat rash.  His resulting non-type-specific HSV test result was positive, with a reading of 46.  We have been in a monogamous relationship for three years.  If he really had HSV1 or HSV2, wouldn't I have it by now as well?

I have suggested to him that he go and have the type-specific version of this test.  But in the meantime, what do *I* actually have?  Is it herpes or not?  Am I contagious?  Is this "reflex positive" a reading you get if you have the virus but haven't had an outbreak yet?  It's hard to believe I have nothing, if a part of the test came up positive.

I am cautiously hopeful at these test results, but kind of waiting for the other shoe to drop, you know?

Thank you in advance to anyone who can help answer these questions.

Daisy999

[auntiejessi]

The IgM should never be done on an adult.  The only thing I can think of with EBV is that if you are having a flare of that, your body's immune response to that might give you a false positive on the IgM.  Grace can correct me on that if I'm wrong.

The IgM is unreliable for an adult, so really, just disregard those results.

AJ

[Daisy999]

Thank you both for responding.  I am expecting the report in the mail in a few days and will post the specifics, maybe that will help.

But I did find a site that has an example of this test.  Part of it lists the name(s) of the test as:



HERPES SIMPLEX VIRUS DETECTION BY SEROLOGY

Recommended Tests:


Test Name:  Herpes Simplex Antibodies type 1 and 2 (IgG), HerpeSelect ®

Test Code:   6447

and/or

Test Name:  Herpes Simplex Virus Antibody (IgM) with Reflex to Titer

Test Code:   7438

- - - - - - - - - - - - - - - - - - -

It sounded to me as if both of these were done in my case.

Further down the page, it shows an example of a result for the "reflex" portion of the test, and then adds some sort of disclaimer:

- - - - - - - - - - - - - - - - - - -

Test Code                        Result-Final              

    7438

    Herpes Simplex Virus IgM Antibody, Reflex to Titer

    HSV IgM Ab Screen      DETECTED


Reference range:          NOT DETECTED

HSV IgM Ab Titer         Has been added.



14554

Herpes Simplex Virus IgM Antibodies

HSV IgM Ab Titer         1:40 H       < 1:10

This test does not distinguish between HSV 1 and HSV 2.  A positive HSV IgM may indicate primary or reactivated infection. IgM antibody can persist 12+ months after primary infection.  Cross reactions occur with Varicella Zoster, CMV and EBV.  Herpes Simplex Virus 1 and 2 IgG, type specific antibody (HerpeSelect), helps confirm and differentiate prior infection with HSV 1 or HSV 2.

- - - - - - - - - - - - - - - -

I don't know if I am reading this right, but the last part leads me to believe that you could possibly get a positive read if you have had shingles (zoster) or Epstein-Barr.  I have had both, with an especially high reading on the EBV (EBV Ab VCA, IgG = 1985).

If you want to read the whole thing, the test info link is

http://www.maclonline.com/website/news2.asp?id=530&issueid=98


I appreciate that you both responded.  Maybe this is a new type of test.  I will wait for my report to come in the mail, and call my doctor and have him explain it.  When and if I get an answer, I will let you know, as it may help someone else.

Thanks again!




    

[waringblender]

Reflex testing simply means that there was further testing done based on a prior result. It's done across a spectrum of lab tests and is not specific to herpes testing.

In this poster's case, my guess is that it could mean that they ran the IgM and then ran the "reflex" IgG post IgM results. But I could be wrong.

[gracefromHHP]

Wish I could help you but even HHH/EWH have no idea what the reflex test part is with the test that labcorp is offering.  sorry.

grace