Herpes Testing Question

[Badluck7]

You've previously mentioned that after 16 weeks Herpes Select is probably 90-95% accurate but that some false negatives persist, perhaps indefinitely.  My question is why do the false negatives persist.  Is it because (1) the strain of HSV-2 acquired is missing the IGg that Herpes Select tests for, (2) some people simply take longer to produce detectable antibodies or never produce them at all, or (3) some other reason?

If a person acquires HSV-2 from someone who is seropositive for HSV-2 by Herpes Select, will the acquiror then definitely also test positive by Herpes Select or is the 90-95% figure still appropriate?

Percentage wise, how much more accurate is a 24-week Herpes Select test than a 16-week test?  If someone has a false negative Herpes Select at 24 weeks, is it probable they will never test positive by Herpes Select?

Sorry for the barrage of questions, but I'm just trying to nail down all apects of the efficacy of Herpes Select testing and you seem to be very knowledgeable on and practical about it.  Thanks for your input.

[H. Hunter Handsfield, M.D.]

You're asking for more detail than is available; there aren't definitive answers.  You provide excellent possible explanations for false negative tests, except that option 1 (missing glycoprotein G in HSV itself) probably doesn't happen; the other two possiblitities are good.  The "some other reason" probably is the most common explanation--and we don't know the reason.  [Terminology note:  glycoprotein G, often abreviated gG, is entirely different than IgG, immunoglobulin G.  The first refers to a protein made by HSV; the second is a class of antibody produced in response to infection.  It is unfortunate, and often confusing, that IgG and gG seem so similar and both are pertinent to HSV diagnosis and testing.]

The antibody response and test results in an infected person are entirely unrelated to the test result in the person from whom the infection was acauired.

I'm not certain about 16 week vs 24 week testing.  The giant majority of people who are negative at either of those times can be confident they do not have HSV-2.  But almost all infected persons eventually develop positive tests, even if it takes 6 months or longer.

Good luck--  HHH, MD

[H. Hunter Handsfield, M.D.]

Don't worry about the confusing terminology.  If you had a HerpeSelect test, you have a reliable result.

HHH, MD

[chrisaf4]

Dr. HHH
Does this mean that if my herpes teat results were in IGG that it is not accurate because HerpeSelect uses gG???? Please answer i need to know if i need to be retested.. Thanks

[Badluck7]

As a follow-up, when does the 16-week period begin to run, when a person acquires the virus or from the first "outbreak"?  In other words, does the body begin producing these detectable anti-bodies when the virus enters the body or only after the virus first surfaces (i.e. an outbreak)?  This makes a huge difference in asymptomatic/subclinical infections.