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HSV-2 Diagnosis
Hello,
Two weeks ago my doctor diagnosed me with HSV-2 with an IgG reading of 1.77 (done through Quest Diagnostics, I believe). She mentioned that my HSV-1 was insiginificant, but did not provide the reading. I have been in a monogamous relationship since July 3, 2007. My last sexual experience prior to that was in early 2006. I have never experienced any of the HSV-2 symptoms, nor has my boyfriend. I understand that stress and illness can be triggers for primary and recurrent outbreaks. I have been experienced both and still have not seen any outbreaks.
1. Do you think this is a false positive given the low reading of 1.77 and lack of a primary or recurrent outbreak? What do you think is the reason for the 1.77 reading? Could my doctor have misdiagnosed me? My doctor also mentioned that individuals with a stronger immune system may be less prone to have an outbreak. Is this correct?
2. Would you suggest that I see an STD specialist? Do you believe that his/her diagnosis will be the same?
3. For peace of mind, I'd like to repeat the test each month for another two months. How many times would you advise me to do so?
Two weeks ago my doctor diagnosed me with HSV-2 with an IgG reading of 1.77 (done through Quest Diagnostics, I believe). She mentioned that my HSV-1 was insiginificant, but did not provide the reading. I have been in a monogamous relationship since July 3, 2007. My last sexual experience prior to that was in early 2006. I have never experienced any of the HSV-2 symptoms, nor has my boyfriend. I understand that stress and illness can be triggers for primary and recurrent outbreaks. I have been experienced both and still have not seen any outbreaks.
1. Do you think this is a false positive given the low reading of 1.77 and lack of a primary or recurrent outbreak? What do you think is the reason for the 1.77 reading? Could my doctor have misdiagnosed me? My doctor also mentioned that individuals with a stronger immune system may be less prone to have an outbreak. Is this correct?
2. Would you suggest that I see an STD specialist? Do you believe that his/her diagnosis will be the same?
3. For peace of mind, I'd like to repeat the test each month for another two months. How many times would you advise me to do so?
MEDICAL PROFESSIONAL
Follow-up questions should be asked in the same thread. Only a limited number of new questions can be accepted, and superfluous block other persons with new questions. I deleted your new thread, in which you asked "If my HSV-1 results are 'insiginificant,' as my doctor stated, and I do not have HSV-1, what is the likelihood that the low HSV-2 reading of 1.77 is truly a false positive?"
I based my response on the assumption that your HSV-1 result was positive. If it was totally negative, presumably that is what your doc would have said. But you are right that this should be clarified. If your HSV-1 result in fact was completely negative (e.g., HerpeSelect result under 1.0), then your HSV-2 result is definitely positive.
I based my response on the assumption that your HSV-1 result was positive. If it was totally negative, presumably that is what your doc would have said. But you are right that this should be clarified. If your HSV-1 result in fact was completely negative (e.g., HerpeSelect result under 1.0), then your HSV-2 result is definitely positive.
MEDICAL PROFESSIONAL
Although the clinical situation is different, you are basically asking the same question addressed just 2 questions before yours ("HSV-2 Question" by hemlock). It is true that low-positive HSV-2 results by HerpeSelect test, which is the assay used by Quest Laboratories (and LabCorp), can be false positive, especially in people with positive HSV-1 results.
To your questions:
1) Yes, it might be possible your HSV-2 result is a false positive. The "strong immune system" comment is the sort of things doctors say as a common sense assumption, but there are no data that this has any effect on HSV test results. The biological reasons for increased false positive results in people with HSV-1 are not known; it is not simply cross reaction with HSV-1 antibody.
2) An STD specialist probably will agree with what I have already written here. But it wouldn't hurt.
3) See my reply to hemlock's question, where I describe the kind of repeat testing that would help to sort this out. The options are to be retested by a different test method, such as the BiokitUSA test, or the Trinity Biotech "Captia" brand test (I forgot to mention that one in my reply to hemlock); or have a Western blot test, the gold standard for HSV-2 testing.
I hope this helps. Best wishes-- HHH, MD
Your statement about stress and illness being triggers isn't quite right. Other illnesses clearly trigger oral herpes outbreaks, hence the names cold sore and fever blister. This has not been well documented for HSV-2 genital infection, although it probably occurs. But despite lots of testimony and folklore, stress has never been clearly documented as a trigger of either genital or oral herpes. These comments apply only to recurrent herpes, not primary; primary means the very first infection, and has absolutely nothing to do with stress or other illnesses.
To your questions:
1) Yes, it might be possible your HSV-2 result is a false positive. The "strong immune system" comment is the sort of things doctors say as a common sense assumption, but there are no data that this has any effect on HSV test results. The biological reasons for increased false positive results in people with HSV-1 are not known; it is not simply cross reaction with HSV-1 antibody.
2) An STD specialist probably will agree with what I have already written here. But it wouldn't hurt.
3) See my reply to hemlock's question, where I describe the kind of repeat testing that would help to sort this out. The options are to be retested by a different test method, such as the BiokitUSA test, or the Trinity Biotech "Captia" brand test (I forgot to mention that one in my reply to hemlock); or have a Western blot test, the gold standard for HSV-2 testing.
I hope this helps. Best wishes-- HHH, MD
Your statement about stress and illness being triggers isn't quite right. Other illnesses clearly trigger oral herpes outbreaks, hence the names cold sore and fever blister. This has not been well documented for HSV-2 genital infection, although it probably occurs. But despite lots of testimony and folklore, stress has never been clearly documented as a trigger of either genital or oral herpes. These comments apply only to recurrent herpes, not primary; primary means the very first infection, and has absolutely nothing to do with stress or other illnesses.
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
