HSV-2 western blot confirmation

Hello,

I was tested for all STDs about 3 weeks ago and came back negative for everything except HSV-2.  I took two IGG tests and they came back 1.31 and 1.38 (positive), even though I never had any outbreaks.  I then followed up with Terri Warren and took the western blot test, which came back negative for hsv2 and hsv1.  My sexual history is having sex with three virgins, with the first one using condoms 50% of the time, and the others 100% of the time.

The problem is, my current girlfriend is still hesitant to have sex with me.  I haven't had sex in over a year, and haven't even kissed anyone in the past 8 months (except her, who also got tested for STDs and came back negative for everything), so it seems impossible to have acquired hsv2 recently.  I'm hoping you could clear this up for her by answering:

1.  What is the false negative rate of the western blot?
2.  Chances of acquiring hsv2 recently (given the information above)?
3.  Do I have hsv2 (given the information above)?
4.  Is it safe to have unprotected sex with her (given the information above)?
5.  Your qualifications to give such information about hsv2?

She seems suspicious since most doctors don't seem to know about the high false-positive rates of IGG testing (including the original doctor I went to).

Thanks,
the_randomer

[H. Hunter Handsfield, M.D.]

Welcome to the forum.  Thanks for your question.

You can rely on the Western blot result:  you are not infected with either HSV-1 or HSV-2.  That was in fact predictable based on your HSV-2 IgG test results.  As Terri probably told you, even though an ELISA ratio of 1.38 is technically positive (the official cut-off is 0.9 or below for definite negative and 1.1 or more for positive), the large majority of persons with results in your range are not infected.  Only ratios of 3.5 or higher are unequivocally positive.  Here is a link to a thread that discusses this in detail:

http://www.medhelp.org/posts/STDs/IGG-Test-Result-Confusion/show/593272

Beyond your test results, your sexual lifestyle has been essentially zero risk for HSV-2.  All things considred, I hope your new girlfriend can understand and accept that you don't have it.  To your specific questions:

1) In the circumstances described -- low risk for infection, minimally positive IgG test, and negative WB -- there is no chance the WB is falsely negative and no chance you have either HSV-1 or HSV-2.

2) No chance.

3) Nope.

4) Yes indeed.

5) I'm not going to cite my personal qualifications.  Feel free to google me for evidence of my expertise.

Unfortunately, your experience is common.  Most doctors will simply rely on the information provided by the laboratory, without necessarily having understanding about how these tests actually perform.  See the thread linked above.

I hope this has helped.  Best wishes to you, and warmest wishes to both you and your partner for a fulfulling, rewarding, romantic relationship.

HHH, MD

[H. Hunter Handsfield, M.D.]

Also in regard to my expertise:  ask my good friend Terri!  And ask her as well about your test results and my response.

[the_randomer]

I have no doubt on your expertise (I've googled you and Terri countless times when I was freaking out over the positive IgG result).  Just wanted to ask questions that might convince my girlfriend that I don't have hsv2.  I sent her this link, and your qualifications and she said, "That's reassuring."  I guess I would by lying if I said I wouldn't be skeptical if the situation was reversed.  I just hope this whole process is updated soon, so people don't have to go through the same horrible times as I did.

Thanks again,
the_randomer