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HSV-2 question for Dr. Handsfield
Dear Dr. Handsfield,
I just received results from a Labcorp blood test which showed I am positive for HSV-2 but negative for HSV-1 (also negative for HSV by IgM test). My exact results were: HSV-2 IgG=1.17 ; HSV-1 IgG=<0.91 ; HSV IgM=<0.91
I have a few questions:
1) Based on my HSV-2 result of 1.17 and the accuracy of the IgG test, and the fact that I am negative for HSV-1, what are the chances this HSV-2 result is a false positive?
2) I read in a another post that the Western Blot test admistered by the UW Clinical Lab in Seattle is the "gold standard" to determine whether or not one is positive for HSV-2. Can you provide a phone number where I can call to request this test?
3) If, in fact, I am positive for HSV-2, is it safe to assume that I contracted HSV-2 over 6 months ago? This is what the counselor told me.
As a side note, I have never had any sores/rash/etc in my genital region but I do sometimes get a canker sore inside my mouth (especially when I inadvertantly bite the inside of my lip of cheek). Thank you in advance for any information you can provide.
I just received results from a Labcorp blood test which showed I am positive for HSV-2 but negative for HSV-1 (also negative for HSV by IgM test). My exact results were: HSV-2 IgG=1.17 ; HSV-1 IgG=<0.91 ; HSV IgM=<0.91
I have a few questions:
1) Based on my HSV-2 result of 1.17 and the accuracy of the IgG test, and the fact that I am negative for HSV-1, what are the chances this HSV-2 result is a false positive?
2) I read in a another post that the Western Blot test admistered by the UW Clinical Lab in Seattle is the "gold standard" to determine whether or not one is positive for HSV-2. Can you provide a phone number where I can call to request this test?
3) If, in fact, I am positive for HSV-2, is it safe to assume that I contracted HSV-2 over 6 months ago? This is what the counselor told me.
As a side note, I have never had any sores/rash/etc in my genital region but I do sometimes get a canker sore inside my mouth (especially when I inadvertantly bite the inside of my lip of cheek). Thank you in advance for any information you can provide.
A related discussion, Follow up for question Dr. Handsfield was started.
Thank you for your response. It was very helpful. Although I'm trying not to get my hopes up that it was a false positive, I'm obviously seeking a clear confirmation one way or the other. Given that, I'm going to try to get the WB immediately. Thanks again for your response!
MEDICAL PROFESSIONAL
Your HSV-2 result is technically positive but very weakly so. There is a good chance it is falsely positive. Rather than going directly to Western blot, I suggest either of two options. First, retest with the standard test used by LabCorps, i.e. the Focus HerpeSelect. If a second test is negative for HSV-2, that result undoubtedly is the accurate one. If the result is positive at a higher ELISA ratio, it is probable you have HSV-2. If it remains positive but weak, at that point go on to Western blot.
Alternatively, be retested with a different type-specific HSV-2 test. The easiest is the BiokitUSA test, which your doctor can do in the office while you wait. If it agrees with the current test, it confirms HSV-2. If negative, it probably means you aren't infected; and that could also be confirmed by WB.
You could go directly to WB, however. The advantage is that it might be quicker to a final decision, without risking yet another round of testing. The disadvantage is that it's a fairly expensive option.
To the specific questions:
1) My bet is that you don't have HSV-2, but I can't put a numerical estimate on it.
2) Just ask your provider to contact his usual laboratory. All routine/local labs know how to arrange shipment of specimens to reference labs. Just ask your doc to tell the lab that an HSV Western blot is needed by the UW clinical labs; they'll take care of the rest.
3) You were told wrong. It is not possible from your test results to know when you were infected. Your counselor probably believes the negative IgM result suggests a prolonged infection. But IgM testing is unreliable and doesn't in fact give any clue about how long you have been infected.
I hope this helps. Best wishes-- HHH, MD
Alternatively, be retested with a different type-specific HSV-2 test. The easiest is the BiokitUSA test, which your doctor can do in the office while you wait. If it agrees with the current test, it confirms HSV-2. If negative, it probably means you aren't infected; and that could also be confirmed by WB.
You could go directly to WB, however. The advantage is that it might be quicker to a final decision, without risking yet another round of testing. The disadvantage is that it's a fairly expensive option.
To the specific questions:
1) My bet is that you don't have HSV-2, but I can't put a numerical estimate on it.
2) Just ask your provider to contact his usual laboratory. All routine/local labs know how to arrange shipment of specimens to reference labs. Just ask your doc to tell the lab that an HSV Western blot is needed by the UW clinical labs; they'll take care of the rest.
3) You were told wrong. It is not possible from your test results to know when you were infected. Your counselor probably believes the negative IgM result suggests a prolonged infection. But IgM testing is unreliable and doesn't in fact give any clue about how long you have been infected.
I hope this helps. Best wishes-- HHH, MD
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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.
