HSV2 Detected, then Negative?

[nyctpatterson]

I received lab results as follows:

HSV2 IGG Herpeselect AB 2.05 H (IN BOLD)    (out of range)
  
HSV AB (IGM) W/REFL TITER

HSV AB IgM AB Screen     DETECTED  (IN BOLD)

under this, it states Reference Range: NOT DETECTED

HSV IgM AB Titer <1:10                    Report states tested "Detected" for HSV IgM by the EIA methodology but tested Negative by the confirmatory IFA methodology.

My doctor stated that the detection of antibodies indicated my body's memory of the virus. From what I've read, once the virus enters your body, it remains. He told me that I did not have the virus, had never contracted the virus, could not transmit the virus when asked very specifically. However, I am still concerned and not certain that he is correct. Can you shed some light on this and give me some idea of my next steps? Is this a false positive that upon further testing demonstrates negative? Am I positive? Should I see another doctor/retest/anything? Does the IgM AB Titer reflect active outbreaks or something? Sorry--I will stop with the questions. :) I just want to make sure that I am responsible with my own health, but also that of my partner.

Thank you

[Edward W Hook, MD]

The doctor is incorrect.  If you have the Biokit it isis a very good "tie breaker" and far, far less expensive thatn the Western Blot.  If the Biokit is negative, your earlier test is a false positive.  If it is positive, then you have acquired HSV-2 at some time in the past.

However this works out, as I said before, I urge you not to get HSV blood tests as part of "check ups", as I mentioned above. EWH

[nyctpatterson]

Hello Doctor,

Thank you for your reply. As for reasoning behind testing, I got a routine battery of testing as I'm entering a new relationship. I am a gay male who is sexually active and I wanted to check everything out for this current relationship. I have never had symptoms that gave me cause to worry. I've had no sores or outbreaks. Yesterday I went to take the BioKit rapid test but the new doctor told me that it wouldn't definitively tell me anything, regardless of the result. Is this accurate? I did take the Liaison (sp) test and I'll wait to hear back. He told me that this also will not be conclusive, but I feel better doing something. Is the Western Blot the only test that will tell me for sure?

the doctor yesterday was basically ready to prescribe medication that I would take for the rest of my life even though we're not sure of the positive status. I don't feel comfortable with that, but I want to make sure that I protect my partner.

Should I go ahead and get the WB test--supposedly it's only done by Univ. of Washington in Seattle and costs about $500. For peace of mind either way, I'd be glad to do that.

Thanks again!

[Edward W Hook, MD]

Welcome to our Forum.  Interpretation of herpes antibody tests is sometimes complex and depends in part on why you had the test. Because of the problems and relatively frequent false positive results in persons without good indications for testing (the test is not recommended to see if someone is infected but doesn't have other risk factors), most experts do not recommend herpes antibody testing. Further, almost no expert in herpes infection recommends the IgM tests for infection because the tests are plagued with false positive results.  Thus you should ignore all of the IgM tests- they are worthless.

As for your IgG test with a result of 2.05, at this level about half of such results are also falsely positive if there is further testing performed.  If you could comment on why you got the testing the first place, I might be able to provide a bit more information. EWH