Herpes 2 Blood Test Confusion

I was tested for Genital Herpes at my Doctor's office and they used the western blot test. It came
back positive. I wanted to make sure that it wasn't a false positive so I took another test using the
biokit test about 2 weeks later. I tested negative with that one. Then about a year later I noticed a red bump on my penis and I was afraid it was herpes so I went to another clinic. The doctor told me that it was an
ingrown hair cause she could see the hair follicle. She tested me again though with the biokit test and it was negative. Is it more probable that the western blot test was a false positive and the two biokit tests were accurate? Or is it more probable that the western blot was accurate and the two biokit tests were false negatives??
Also, I haven't had any symptoms of genital herpes so I wonder if that would make the first scenario more probable.
And what should I tell a potential partner? That it appears that I don't have genital herpes but that I can't be totally for sure?

Confused,

Joe

[H. Hunter Handsfield, M.D.]

This is a confusing situation.  It is rare that a Western blot is the only test done; the usual sequence is to use another test and then WB only if the first result is confusing or uncertain.  So I have to wonder whether that's really what your first test was.  WB is only done commercially at a very few labs, most commonly the University of Washington clinical laboratory in Seattle, where the test was developed.  Also, it is not a highly standardized test -- and although I would trust it from the UW lab, the result might be questionable if done elsewhere.  Also, you don't say positve by WB for which virus.  Are you sure it was positive for HSV-2 and not HSV-1?

Had you not had the WB test, I would say for sure you do not have HSV-2, based on the other test results -- and therefore you are unlikley to have genital herpes.  Some GH is caused by HSV-1, but most positive HSV-1 tests come from oral infection, most commonly acquired in childhood and mostly without symptoms of recurrent oral herpes.

We probably can sort this out if you can provide more details about the Western blot, i.e. what lab did it and the specific results for HSV-1 and HSV-2.  If that information isn't available, I suggest you have a repeat WB at the UW lab.  (Any commercial lab will know how to refer specimens to Seattle for the test.)  Either way, provide the results and we'll figure it out.

Regards--  HHH, MD