Need help with test results

[at9999]

Had Herpeselect IGG testing 9 weeks, 14 weeks, and then 17 weeks after some symptoms.  The 9 week & 14 week were negative (less than .90 for both HSV1 & II).  The 17 week test showed negative for type 1 (less than .90 ), but showed 3.82 for IGG HSV2.

I had 2 samples of blood taken at the 17 week mark, one went for the herpesselect testing (results above), the 2nd went to the university of WA for the HSV western blot test.   I received the results for the western blot today.  Positive for antibody for HSV-1, and negative for HSV-2.

Fairly confused at this point, which test should I believe?   My Dr. was not much help, he is not sure what is going on.  My symptoms are fairly mild.  Some Itching, also have had a couple of red spots that look like a pimple, but they disappear in 2-3 days.  Never a cluster of sores, and most of the time they are in the pubic hair region.

[H. Hunter Handsfield, M.D.]

Welcome to the STD forum.  I'll try to help.

You describe an atypical situation.  Almost all HSV-2 antibody tests with ELISA ratio results over 3.5 are truly positive, and so your result of 3.82 normally would be considred definitive.  (Indeed, I don't understand why the Western blot was done.)  On the other hand, the HSV Western blot is the gold standard and the negative for HSV-2 probably is accurate.  However, the additional confusing issue is the discrepant results for HSV-1.  Indeed, I would wonder whether the HSV-1 and HSV-2 results were mixed up on the report of WB results.

In other words, I agree with your doctor: like him, I am confused about these results.  I suggest the following:  First, have your doctor contact the lab and ask for convirmation that the WB results have been accurately reported.  Second, have a repeat Wesrern blot test.

Finally, your symptoms might be consistent with mild or atypical herpes, but I doubt they are due to HSV-2.

Please come back and let me know the results of repeat WB testing, if you decide to do that.  I'll be interested to know the outcome.

Regards--  HHH, MD

[at9999]

I asked my Dr. to call Univ. of Wa. to clarify, He said he would get to it this week.  In the meantime I had the herpeselect IGG test done again on Tuesday since it was a cheap test to do.  The Herpeselect came back today, negative for both type I & II (Less than .90 IGG on each).  The lab is confused and researching why I am now negative, but they don't seem to have any answers.

At this point would you still recommend a repeat Western blot test?    Can you think of why the western blot is showing I am type I positive and Herpeselect is showing type I negative?  

[H. Hunter Handsfield, M.D.]

That's good news.  Most likely the positive HSV-2 IgG test was in error.  You can go forward in confidence you don't have HSV-2.  That's not a guarantee, but if I were in your situation, knowing what I know, that's what I would do.  But if you remain concerned, go ahead with the Western blot.  You can expect it to be negative.