False Positive HSV 2 test results ?

[HSVType1_2]

I got the HerpeSelect for HSV2 twice over a year ago.
One result was 1.25 and the other was just Positive.
In over a year and a half I have never had an outbreak so I decided to take the Western Blot test.

The Western Blot came back negative for HSV2 and positive for HSV1.
I am extremely confused given that I tested positive twice before for HSV2.
Is there a logic explanation for my results?
What is the accuracy of each test?
What are the low positive values?
How do I know if I am really infected?
I was not taking any medications during this period of time.

Thanks a lot!

[Edward W Hook, MD]

Welcome to our Forum.  You do not have herpes.  The Western Blot assay if the "gold standard" test for blood test diagnosis of HSV and it was the standard upon which the other blood tests for HSV have been judged.  The results of the studies to validate other tests (such as the one you had) show that there are no perfect tests and that all tests miss a small proportion of infection and that when tested with the other sorts of test such as the HerpeSelect, there are a small number of persons who have falsely "positive" values. The false positive values typically occur among persons whose test result numbers are numerically lower than the range where false positives are virtually non-existent.  There is a growing body of scientific literature which show that persons with values of less than 3.0 may be falsely positive and when the values are less than 2.0 over 2/3rds of the so-called "positive" results are falsely positive results occurring in person who do not have HSV.   The reasons for these false positive results are highly variable and include cross reactions of the test with antibodies to other viruses such as the ones that cause chicken pox.  

You do not indicate that you have ever had an outbreak.  This, combined with the negative Western Blot result you mention is strong evidence that you do not have HSV. My recommendation is to understand that you are a victim of an overly sensitive test, that you do not have HSV and that you do not need further testing.  EWH

[HSVType1_2]

Thank You for your time.
It is greatly appreciated.

[Edward W Hook, MD]

The post you mention is over 4 years old.  I suspect that were the question repeated again today Dr. Handsfield would seek the information regarding the value to the test, etc.  Either way. this in no way changes my advice to you.  

Is the Western blot perfect, no.  But, in situations such as your in which testing was probably no warranted to begin with (we really do not recommend testing in the absence of some sort of reasonable reason for suspicion such as lesions or an infected partner), if your Western Blot is negative the chance that you actually have HSV-2 in vanishingly low.

You just have to decide what you want to believe.  EWH

[HSVType1_2]

Here is the link for Dr. Hunter's thread.  :)

http://www.medhelp.org/posts/STDs/Western-Blot-Test-Accuracy/show/247910

[HSVType1_2]

Dear Dr. Hook:

Thanks for your response.
While I was doing some more research i found a response from Dr. Hunter that confused me a little. If my understanding is correct he does NOT recommend a WB when there is a positive Herpeselect. Could you please read the thread and share your thought with me?
It raised questions about how accurate the WB really is and what is the possibility of getting a FALSE NEGATIVE WB result.

You mentioned "There is a growing body of scientific literature which show that persons with values of less than 3.0 may be falsely positive and when the values are less than 2.0 over 2/3rds of the so-called "positive" results are falsely positive results occurring in person who do not have HSV." is there a way i can get a hold of this literature. I would love to complete my research and give some information to my doctor, given the fact that he is completely misinformed and might have some other patients in my situation.

Thanks a lot!