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STDs (Expert Forum)
HSV 2 False positive???
Answered by
University of Washington
Seattle - WA
Welcome to the STD Forum, which 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.
HSV 2 False positive???
by P999, Aug 12, 2006 12:00AM
Hi Doctor i recently had the following results from the Diagnostic Lab of Oklahoma:
HSV 1/2 IGG, Herpeselect
Type specific AB.
Herpes Simplex type 1 >5.00 H EIA Value
Herpes Simplex type 2 1.23 H EIA Value
HSV IGM Antibody W/REFL
TITER
HSV IGM ANTIBODIES NOT DETECTED
Now! the Doctor I went to did not really have very much information, and the majority of my education on this subject has been on the internet. I have had very bad cold sores around the mouth area since I was a kid. Oh, I am a 38 year old male in great health. My possible exposure to this Type 2 may have been approx. 12 weeks ago. I have had no symptoms what so ever down below. My significant other is also negative for Type 1 and 2. I know I have Type 1 and dont really care, my concern is the type 2 result. I am in shock! My questions are:
1)I have seen some things on the net talking about false positives with the Herpeselct tests. Is this the test i have had and could it be a false postive?
2)Based on my test results above does it look like my very high Type 1 result may have influenced the Type 2 result?
3) What is my next step? Further testing?
4) if so could you provide a web site or contact that i can give to my Doctor to have blood tests sent to them for further testing? (If required)
5) Since my result was between 1 and 3 is this unusual? it just dosent seem very high to me and looks like a very low positive almost a negative.
6) The rsult for Type 2 shows >5.00 does this value mean greater than 5.00? Off scale high?
The Doctor i went to did not appear to be very sharp on the subject so getting any information was not going to happen. Doctor, please help me i am not taking this very well and my mind is spinning out of control because of all this.
Thank you very much.
P999
HSV 1/2 IGG, Herpeselect
Type specific AB.
Herpes Simplex type 1 >5.00 H EIA Value
Herpes Simplex type 2 1.23 H EIA Value
HSV IGM Antibody W/REFL
TITER
HSV IGM ANTIBODIES NOT DETECTED
Now! the Doctor I went to did not really have very much information, and the majority of my education on this subject has been on the internet. I have had very bad cold sores around the mouth area since I was a kid. Oh, I am a 38 year old male in great health. My possible exposure to this Type 2 may have been approx. 12 weeks ago. I have had no symptoms what so ever down below. My significant other is also negative for Type 1 and 2. I know I have Type 1 and dont really care, my concern is the type 2 result. I am in shock! My questions are:
1)I have seen some things on the net talking about false positives with the Herpeselct tests. Is this the test i have had and could it be a false postive?
2)Based on my test results above does it look like my very high Type 1 result may have influenced the Type 2 result?
3) What is my next step? Further testing?
4) if so could you provide a web site or contact that i can give to my Doctor to have blood tests sent to them for further testing? (If required)
5) Since my result was between 1 and 3 is this unusual? it just dosent seem very high to me and looks like a very low positive almost a negative.
6) The rsult for Type 2 shows >5.00 does this value mean greater than 5.00? Off scale high?
The Doctor i went to did not appear to be very sharp on the subject so getting any information was not going to happen. Doctor, please help me i am not taking this very well and my mind is spinning out of control because of all this.
Thank you very much.
P999
Doctor's Answer
by H. Hunter Handsfield, M.D., Aug 12, 2006 12:00AM
, Aug 12, 2006 12:00AM
Your results show you are infected with HSV-1, as are half of all adults in the US. Most likely you are not infected with HSV-2.
1, 2, 4) The lab report itself, as you quote it, says HerpeSelect, so obviously that's the test that was done. Low-positive HSV-2 results (below 3.0) often are falsely positive, especially when the HSV-1 test is positive. That is the most likely explanation for your results, but it isn't certain.
3) Three choices: a) You could have a repeat standard test (HerpeSelect). If a repeat shows HSV-2 ELISA ratio below 1.0, it will prove you don't have HSV-2. b) Or you could ask your provider to do the BiokitUSA HSV-2 test. Although not yet published, recent research data show that it is a good tie-breaker in cases like yours. Postive Biokit means you have HSV-2, negative will prove you do not. I predict it will be negative. c) Or have an HSV western blot test, which your provider and lab can arrange with the University of Washington, or perhaps anothe reference lab.
5) As I said above, I agree that most likely you are not infected with HSV-2.
6) You mean HSV-1, not -2. The height of your HSV-1 ELISA ratio doesn't mean anything, except that it's positive. There is no difference in meaning between any values above 1.0, even when off scale.
Bottom line: No reason for "spinning out of control". You have HSV-1, like over half the populaton; no big deal, especially if you're not having recurrent oral cold sores. You probably don't have genital herpes or HSV-2, but you can figure it out for sure with additional testing. In the meantime, don't lose a lot of sleep over it.
Good luck-- HHH, MD
1, 2, 4) The lab report itself, as you quote it, says HerpeSelect, so obviously that's the test that was done. Low-positive HSV-2 results (below 3.0) often are falsely positive, especially when the HSV-1 test is positive. That is the most likely explanation for your results, but it isn't certain.
3) Three choices: a) You could have a repeat standard test (HerpeSelect). If a repeat shows HSV-2 ELISA ratio below 1.0, it will prove you don't have HSV-2. b) Or you could ask your provider to do the BiokitUSA HSV-2 test. Although not yet published, recent research data show that it is a good tie-breaker in cases like yours. Postive Biokit means you have HSV-2, negative will prove you do not. I predict it will be negative. c) Or have an HSV western blot test, which your provider and lab can arrange with the University of Washington, or perhaps anothe reference lab.
5) As I said above, I agree that most likely you are not infected with HSV-2.
6) You mean HSV-1, not -2. The height of your HSV-1 ELISA ratio doesn't mean anything, except that it's positive. There is no difference in meaning between any values above 1.0, even when off scale.
Bottom line: No reason for "spinning out of control". You have HSV-1, like over half the populaton; no big deal, especially if you're not having recurrent oral cold sores. You probably don't have genital herpes or HSV-2, but you can figure it out for sure with additional testing. In the meantime, don't lose a lot of sleep over it.
Good luck-- HHH, MD
Thanks again.
P999