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Blood Test - need help understanding results
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The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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Blood Test - need help understanding results

Dear Dr. H,

Like the thousands before me, I'd like to thank you for this wonderful site.  It has been like a life preserver in this tidal wave that I feel like I've been clobbered by!

I'd like to get some help in understanding my test results as the NP at my doctor's office basically said "I don't know what the numbers mean, (but I'll try to find out)".  OMG!!  The whole attitude there is so blase' "No one else has ever asked these questions.  Why do you want to know?  Everyone has herpes
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While I agree the provider doing a test should "know what the numbers mean", the test manufacturer does not specifically intend the provider tell the patient the numbers.  What your provider could have done is just say your test is negative for HSV-1 and positive for HSV-2.  Your numbers are a little atpyical, repeat testing would be a good idea but, until/unless repeat testing shows otherwise, you have to assume you have genital herpes due to HSV-2.  (All this assumes the lab did the Focus Techologies HerpeSelect test, which is what the numbers suggest.  If in doubt, you or your provider can call the lab and find out.)

The HSV IgM tests are totally unreliable and meaningless.  Ignore those results.  Search this forum for "herpes diagnosis", "IgM", and "HerpeSelect test" for more information about IgM testing.

1) Most HSV-1 results below 1.0 are negative, not "borderline".  Probably you are not infected with HSV-1.

2) An HSV-2 result over 1.0 is positive.  Sometimes there are false-positive results, though, especially when the result is less than 3.5.  But as I said above, for now you need to assume you have HSV-2.  Your partner does not.

3) Abnormal means the result is not in the normal range.  (I guess I don't know why that confuses you.  It's pretty straightforward terminology, yes?)

4) Non-transmission is quite common.  Many couples in which one has HSV-2 go a lifetime without transmission.

5) No, the scenario you describe does not make sense.

6) Some HSV-2 results between 1.0 and 3.5 are false positive. In your case, I doubt it.  Most false-positive results occur in people who have HSV-1, which you do not.  However, as I said above, you should consider repeat testing.  Or you can have a specimen sent to a reference laboratory for a Western blot test.  It's expensive, but it will sort things out once and for all.

Good luck--  HHH, MD
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Dr. H,

Thanks so much for your response, it was very helpful.  I wonder if you could clarify one point, though.  Your response to my question 5 said that scenario didn't make sense, but so much that I've read tells people to wait up to four months or so to be absolutely sure they are not hsv2+.  My concern in this instance is that I believe my partner had a sexual encounter outside our relationship in late April or early May .... so we are just a month and a half into this, hence my question about developing antibodies at a different rate.  The flip side, of course, is that neither of us had ever been tested for hsv before.... but I asked the question assuming we were both negative all along (which is highly likely).  Thanks again.
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