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Question Re: HSV 1 & 2 Test Results
I have a questions re: HSV 1 & 2 Test Results. In April 2009, I had unprotected sex with an individual whose HSV status was unknown to me. As a precaution, 30 days later, on May 20th, 2009, I was tested for a wide variety of STD's, including HSV 1 & 2.
The test was the HSV Specific Type 1 & 2 IgG Combo (HerpeSelect) and my results were as follows:
HSV 1 IGG Type Specific AB: 1.22 (out of range)
HSV 2 IGG Type Specific AB: <0.90 (in range)
The diagonisis was that I was at one time exposed to HSV 1 and was Negative for HSV 2.
A follow up test on July 21st, 2009 produced similar results, with a slightly elevated read for HSV 1:
HSV 1 IGG Type Specific AB: 1.54 (out of range)
HSV 2 IGG Type Specific AB: <0.90 (in range)
Again, the diagonisis was that I was at one time exposed to HSV 1 and was Negative for HSV 2.
A follow up set of tests more than a year later (on September 8th, 2010) produced the following results:
HSV 1 IGG Type Specific AB: 3.10 (out of range)
HSV 2 IGG Type Specific AB: 1.16 (out of range)
This time, the diagonisis was that I was at one time exposed to HSV 1 and HSV 2, and therefore, was positive for both, so my questions are as follows:
Given that I have had the same partner since May of 2009, do I need to be concerned about the 1.16 HSV 2 IGG Type Specific AB reading and does that indicate that I do, indeed, have HSV 2 or is it a false positive?
What would account for the increase in the HSV 1 readings over time?
Should I consider the Western Blot test obtain definitive results?
You should also know that I have never had any symptoms of HSV 1 or HSV 2 and this last set of tests was taken only to put my mind at ease more than a year post potential exposure in April 2009. Instead, this most recent set of results has confused me entirely as I was expecting this last set of results to mirror those of May 2009 and July 2009, which indicated that I was Negative for HSV 2. Thank you for your time and insight.
The test was the HSV Specific Type 1 & 2 IgG Combo (HerpeSelect) and my results were as follows:
HSV 1 IGG Type Specific AB: 1.22 (out of range)
HSV 2 IGG Type Specific AB: <0.90 (in range)
The diagonisis was that I was at one time exposed to HSV 1 and was Negative for HSV 2.
A follow up test on July 21st, 2009 produced similar results, with a slightly elevated read for HSV 1:
HSV 1 IGG Type Specific AB: 1.54 (out of range)
HSV 2 IGG Type Specific AB: <0.90 (in range)
Again, the diagonisis was that I was at one time exposed to HSV 1 and was Negative for HSV 2.
A follow up set of tests more than a year later (on September 8th, 2010) produced the following results:
HSV 1 IGG Type Specific AB: 3.10 (out of range)
HSV 2 IGG Type Specific AB: 1.16 (out of range)
This time, the diagonisis was that I was at one time exposed to HSV 1 and HSV 2, and therefore, was positive for both, so my questions are as follows:
Given that I have had the same partner since May of 2009, do I need to be concerned about the 1.16 HSV 2 IGG Type Specific AB reading and does that indicate that I do, indeed, have HSV 2 or is it a false positive?
What would account for the increase in the HSV 1 readings over time?
Should I consider the Western Blot test obtain definitive results?
You should also know that I have never had any symptoms of HSV 1 or HSV 2 and this last set of tests was taken only to put my mind at ease more than a year post potential exposure in April 2009. Instead, this most recent set of results has confused me entirely as I was expecting this last set of results to mirror those of May 2009 and July 2009, which indicated that I was Negative for HSV 2. Thank you for your time and insight.
MEDICAL PROFESSIONAL
Welcome to our Forum. Please do not take this as criticism but your experience in precisely the reason that we do not recommend repeat testing for HSV following possible exposure. While the HerpeSelect (I presume this is what you were tested with) is a superb test, like all tests for antibodies, there are occasional problems with false positive test results. We also know that on a day to day (or month to month) basis, numerical values for test results can tend to "bounce around" and that this is not a reason for concern.
As far as your positive test for HSV-2, at the value you report, less than 20% of tests are able to be confirmed using the Western blot while the remainder are false positive results. Further, most false positive results are in person who have HSV-1 infection, as you do.
My analysis of your situation is that this test result is very likely to be a false positive result. If you choose to get a Western blot I predict the result will be either negative for HSV-2 or indeterminate and in either circumstance this will be evidence that you do not have HSV-2 infection. Personally, I don't think you have HSV-2 and see no reason for further testing of any sort.
I hope my comment is helpful. EWH
As far as your positive test for HSV-2, at the value you report, less than 20% of tests are able to be confirmed using the Western blot while the remainder are false positive results. Further, most false positive results are in person who have HSV-1 infection, as you do.
My analysis of your situation is that this test result is very likely to be a false positive result. If you choose to get a Western blot I predict the result will be either negative for HSV-2 or indeterminate and in either circumstance this will be evidence that you do not have HSV-2 infection. Personally, I don't think you have HSV-2 and see no reason for further testing of any sort.
I hope my comment is helpful. EWH
MEDICAL PROFESSIONAL
Thanks for your comment. It is a pleasure to help. We do not request donations but if you wish to help the cause of better information for persons with and at risk for STDs, you could donate to the American Social Helath Association who provide excellent, reliable general web site infomration on STDs. (Disclosure, Dr. Handsfield and I are both on the AHSA Board). EWH
WOW! That was fast!
Thanks so much for your time **and** your quick reply!
Although your answers conclude my inquiry, I wanted to take a moment to express my sincere thanks to you, Dr. Handsfield, Terry, Grace and everyone here at the MedHelp STD/Herpes forums for working in concert with each other, responding with insight and compassion and for providing critical and true information when people need it most.
Aside from making a donation to the MedHelp forums so that this resouce will remain available to others in their times of need, is it possible to also make a donation to the work/research that you and Dr. Handsfield are doing on a daily basis?
I understand that I can support Terry's work by making a donation to the Westover Heights Clinic, but am unsure how to support the work that you and Dr. Hansfield are doing, so any information you can provide would be greatly appreciated.
I look forward to your reply and wish you continued success in your research.
Thanks so much for your time **and** your quick reply!
Although your answers conclude my inquiry, I wanted to take a moment to express my sincere thanks to you, Dr. Handsfield, Terry, Grace and everyone here at the MedHelp STD/Herpes forums for working in concert with each other, responding with insight and compassion and for providing critical and true information when people need it most.
Aside from making a donation to the MedHelp forums so that this resouce will remain available to others in their times of need, is it possible to also make a donation to the work/research that you and Dr. Handsfield are doing on a daily basis?
I understand that I can support Terry's work by making a donation to the Westover Heights Clinic, but am unsure how to support the work that you and Dr. Hansfield are doing, so any information you can provide would be greatly appreciated.
I look forward to your reply and wish you continued success in your research.
MEDICAL PROFESSIONAL
The HSV-1 test has problems similar to those describe for the HSV-2 test but, as you know, HSV-1 is far, far more common and for that reason I think there is little value to getting the Western blot for HSV-1. EWH
Thanks so much for your reply, Dr. Hook.
It provided the additional clarity I was seeking and was very helpful.
To follow up, I have two final questions:
For HSV1, is the protocol for interpreting the results the same as HSV 2, meaning that my results for HSV1 may also be a series of false positives as all have been less than 3.5, and to obtain a definitive diagnosis for HSV 1, one would also want to consider the Western Blot given the low positive test results I have had for HSV1 or are those results more reliable than for HSV2.
Realizing that HSV1 is very common and it may not be worth investing in the Western Blot to obtain definitive results, I am still curious if the protocol for HSV1 is the same as it would be for definitively determining the presence of HSV2.
Again, just trying to wrap up any loose ends and sincerely appreciate your time and expertise.
It provided the additional clarity I was seeking and was very helpful.
To follow up, I have two final questions:
For HSV1, is the protocol for interpreting the results the same as HSV 2, meaning that my results for HSV1 may also be a series of false positives as all have been less than 3.5, and to obtain a definitive diagnosis for HSV 1, one would also want to consider the Western Blot given the low positive test results I have had for HSV1 or are those results more reliable than for HSV2.
Realizing that HSV1 is very common and it may not be worth investing in the Western Blot to obtain definitive results, I am still curious if the protocol for HSV1 is the same as it would be for definitively determining the presence of HSV2.
Again, just trying to wrap up any loose ends and sincerely appreciate your time and expertise.
MEDICAL PROFESSIONAL
Thanks for the follow-up. I would interpret your results as idnciating that you do not have HSV-2, that you probably have HSV-1. It is impossible to determine the site of your HSV-1 infection but it is most likely an oral infection. Your reuslt on test numer 3 was most likely a false positve.
HSV-2 tests in the range you expereinced can be falsely positive for many reasons including due to cross reaction with antibodies to HSV-1. EWH
HSV-2 tests in the range you expereinced can be falsely positive for many reasons including due to cross reaction with antibodies to HSV-1. EWH
Hope this note finds you well and having a great day!
As requested, I am checking in with you re: my most recent set of test results.
As a reminder, the following is a recap of my situation and test results:
April 2009: Unprotected sex with an individual whose HSV status was unknown to me. As a precaution, 30 days later, on May 20th, 2009, I was tested for a wide variety of STD's, including HSV 1 & 2.
The test was the HSV Specific Type 1 & 2 IgG Combo (HerpeSelect) and my results were as follows:
HSV 1 IGG Type Specific AB: 1.22 (out of range)
HSV 2 IGG Type Specific AB: <0.90 (in range)
Diagnosis: At one time exposed to HSV 1 and Negative for HSV 2.
A follow up test on July 21st, 2009 produced similar results, with a slightly elevated titer for HSV 1:
HSV 1 IGG Type Specific AB: 1.54 (out of range)
HSV 2 IGG Type Specific AB: <0.90 (in range)
Again, the diagnosis was that I was at one time exposed to HSV 1 and was Negative for HSV 2.
A follow up set of tests more than a year later (on September 8th, 2010) produced the following results:
HSV 1 IGG Type Specific AB: 3.10 (out of range)
HSV 2 IGG Type Specific AB: 1.16 (out of range)
This time, the diagnosis was that I was at one time exposed to HSV 1 and HSV 2, and therefore, was positive for both, so I tested one more time on September 28th, 2010 (1 year, 5 months or 75 weeks post potential exposure) to determine the validity of test #3 which indicated a very low positive for HSV2.
The results of that test were:
HSV 1 IGG Type Specific AB: 2.22 (out of range)
HSV 2 IGG Type Specific AB: <0.90 (in range)
So, the diagnosis has returned to a one time exposure to HSV 1 and Negative for HSV 2.
Since the BioKit is not available in my state, I elected to retest with the HSV Specific Type 1 & 2 IgG Combo (HerpeSelect).
Each draw/test was performed at the same facility, by the same RN and processed by the same lab. The subject also remained the same (me) so the only known variable was my time since exposure and the individual who actually performed/processed the test at the lab.
Given the full compliment of my test results, and the fact that I have had the same partner since May of 2009, I have the following questions:
Do I need to be concerned about the 1.16 HSV 2 IGG Type Specific AB reading on test #3 or would you conclude that it was, indeed, a false positive?
If it was a false positive, what would account for the antibodies being there in the first place?
Knowing what you know, if your daughter or your niece were in my situation, would you suggest the Western Blot for definitive results on HSV2, or consider the positive HSV 2 results from test #3 truly a false positive based on the Negative results from tests 1,2 & 4.
Finally, for HSV1, is the protocol the same, meaning that my results may also be a series of false positives as all have been less than 3.5, and to obtain ad definitive result for HSV 1, I would also want to consider the Western Blot.
Just trying to wrap up any loose ends so I can finally put this behind me (whether I am positive or negative for HSV1 and HSV2), move forward and take the appropriate precautions if I am indeed infected with either (or both) strains of HSV and capable of passing it along to others.
Again, as a reminder, I have never had any symptoms of HSV 1 or HSV 2 and test #3 was taken only to put my mind at ease more than a year post potential exposure in April 2009. Instead, the results of test #3 confused me entirely as I was expecting those results to mirror those of May 2009 and July 2009, which indicated that I was Negative for HSV 2.
Thanks again for you time and insight. It is more than appreciated!
As requested, I am checking in with you re: my most recent set of test results.
As a reminder, the following is a recap of my situation and test results:
April 2009: Unprotected sex with an individual whose HSV status was unknown to me. As a precaution, 30 days later, on May 20th, 2009, I was tested for a wide variety of STD's, including HSV 1 & 2.
The test was the HSV Specific Type 1 & 2 IgG Combo (HerpeSelect) and my results were as follows:
HSV 1 IGG Type Specific AB: 1.22 (out of range)
HSV 2 IGG Type Specific AB: <0.90 (in range)
Diagnosis: At one time exposed to HSV 1 and Negative for HSV 2.
A follow up test on July 21st, 2009 produced similar results, with a slightly elevated titer for HSV 1:
HSV 1 IGG Type Specific AB: 1.54 (out of range)
HSV 2 IGG Type Specific AB: <0.90 (in range)
Again, the diagnosis was that I was at one time exposed to HSV 1 and was Negative for HSV 2.
A follow up set of tests more than a year later (on September 8th, 2010) produced the following results:
HSV 1 IGG Type Specific AB: 3.10 (out of range)
HSV 2 IGG Type Specific AB: 1.16 (out of range)
This time, the diagnosis was that I was at one time exposed to HSV 1 and HSV 2, and therefore, was positive for both, so I tested one more time on September 28th, 2010 (1 year, 5 months or 75 weeks post potential exposure) to determine the validity of test #3 which indicated a very low positive for HSV2.
The results of that test were:
HSV 1 IGG Type Specific AB: 2.22 (out of range)
HSV 2 IGG Type Specific AB: <0.90 (in range)
So, the diagnosis has returned to a one time exposure to HSV 1 and Negative for HSV 2.
Since the BioKit is not available in my state, I elected to retest with the HSV Specific Type 1 & 2 IgG Combo (HerpeSelect).
Each draw/test was performed at the same facility, by the same RN and processed by the same lab. The subject also remained the same (me) so the only known variable was my time since exposure and the individual who actually performed/processed the test at the lab.
Given the full compliment of my test results, and the fact that I have had the same partner since May of 2009, I have the following questions:
Do I need to be concerned about the 1.16 HSV 2 IGG Type Specific AB reading on test #3 or would you conclude that it was, indeed, a false positive?
If it was a false positive, what would account for the antibodies being there in the first place?
Knowing what you know, if your daughter or your niece were in my situation, would you suggest the Western Blot for definitive results on HSV2, or consider the positive HSV 2 results from test #3 truly a false positive based on the Negative results from tests 1,2 & 4.
Finally, for HSV1, is the protocol the same, meaning that my results may also be a series of false positives as all have been less than 3.5, and to obtain ad definitive result for HSV 1, I would also want to consider the Western Blot.
Just trying to wrap up any loose ends so I can finally put this behind me (whether I am positive or negative for HSV1 and HSV2), move forward and take the appropriate precautions if I am indeed infected with either (or both) strains of HSV and capable of passing it along to others.
Again, as a reminder, I have never had any symptoms of HSV 1 or HSV 2 and test #3 was taken only to put my mind at ease more than a year post potential exposure in April 2009. Instead, the results of test #3 confused me entirely as I was expecting those results to mirror those of May 2009 and July 2009, which indicated that I was Negative for HSV 2.
Thanks again for you time and insight. It is more than appreciated!
MEDICAL PROFESSIONAL
Nothing more to say. As I have said before I doubt that you have HSV-2. Please let us know how your testing comes out. EWH
Thanks Dr. Hook.
I'll ck out the HSV Community forum. Appreciate your insight and the referal.
So, in the absence of the availibility of the Biokit, I am thinking that I will go ahead as planned:
Test one more time for HSV1 & 2 HerpeSelect (same draw facility, lab and test as before) and then based on that result, do the following:
If the HerpeSelect results for HSV2 are still positive (even if a low positive) then I will move directly to the Western Blot for definitive confirmation.
If the HerpeSelect results for HSV2 are again negative (as the first two were) then I am thinking that I would test one final time with the HerpesSelect to perhaps confirm (in my mind, at least) that the positive HSV2 test results from Sept 2010 were a false positive and indeed an erroneous red hearring.
I know this may all seem like over kill to you from a testing standpoint, but it is important that I obtain as definitive an asnwer as I possibly can (given current testing options/accuracy of tests) so that I can put this behind me once and for all and move forward with my life.
This last sent of results really threw me for a loop (I was fully expecting the HSV2 result to be negative as the first two tests were) and am tying to make sense of all of this and put my mind at ease.
I welcome any additional thoughts/comments you or Dr Handsfield may have, otherwise, I will be sure to update this thread with my results once I have them in hand.
Thanks again for your time and expertise and have a great rest of the day!
I'll ck out the HSV Community forum. Appreciate your insight and the referal.
So, in the absence of the availibility of the Biokit, I am thinking that I will go ahead as planned:
Test one more time for HSV1 & 2 HerpeSelect (same draw facility, lab and test as before) and then based on that result, do the following:
If the HerpeSelect results for HSV2 are still positive (even if a low positive) then I will move directly to the Western Blot for definitive confirmation.
If the HerpeSelect results for HSV2 are again negative (as the first two were) then I am thinking that I would test one final time with the HerpesSelect to perhaps confirm (in my mind, at least) that the positive HSV2 test results from Sept 2010 were a false positive and indeed an erroneous red hearring.
I know this may all seem like over kill to you from a testing standpoint, but it is important that I obtain as definitive an asnwer as I possibly can (given current testing options/accuracy of tests) so that I can put this behind me once and for all and move forward with my life.
This last sent of results really threw me for a loop (I was fully expecting the HSV2 result to be negative as the first two tests were) and am tying to make sense of all of this and put my mind at ease.
I welcome any additional thoughts/comments you or Dr Handsfield may have, otherwise, I will be sure to update this thread with my results once I have them in hand.
Thanks again for your time and expertise and have a great rest of the day!
MEDICAL PROFESSIONAL
In general there is good agreement between the results of the HerpeSelect and the Biokit result. If you are tested with the Biokit and the result is negative, this is further storng evidence that you do not have HSV-2 and do not need to get a Western Blot. As to the availability, it is not as widespread as the HerpeSelect. You might ask on the HSV Community site. To be honest, for questions such as these, they are a better resource for this sort of information than me. EWH
Again, Dr. Hook, thank you for your quick reply and for confirming thet the test I took was the ELISA.
I will be sure to advise of my results as soon as I have them, and I am hopeful that they will be, as you predict, negative for HSV-2, however, upon reading additional info on this sites, I have a few final follow up questions:
Understanding that the UofW Western Blot is the gold standard (I understand how to obtain this test should I need to take it) I am wondering if it might be more beneficial for me to take the BiokitUSA HSV-2 rapid test to clarify/confirm the results of my low positive HSV-2 Specific Type 2 IgG Combo (HerpeSelect) as opposed to simply taking the same test again.
I have looked into the Biokit's availability locally and do not see that it is available in my state. I also called the manfacturer to verify and I am wondering if you are aware whether this test is available, but in limited availability, or not at all, in certain states.
Any insight/guidance you can provide is most appreciated. I am also working with the clinic in which I have been tested all three times as well as my obgyn's office for a follow up visit and will advise not only on my results, but also the plan going forward.
That said, any insight you mayhave on the availability of the BiokitUSA HSV-2 Rapid Test would be very helpful.
Thanks again for your time and reply.
I will be sure to advise of my results as soon as I have them, and I am hopeful that they will be, as you predict, negative for HSV-2, however, upon reading additional info on this sites, I have a few final follow up questions:
Understanding that the UofW Western Blot is the gold standard (I understand how to obtain this test should I need to take it) I am wondering if it might be more beneficial for me to take the BiokitUSA HSV-2 rapid test to clarify/confirm the results of my low positive HSV-2 Specific Type 2 IgG Combo (HerpeSelect) as opposed to simply taking the same test again.
I have looked into the Biokit's availability locally and do not see that it is available in my state. I also called the manfacturer to verify and I am wondering if you are aware whether this test is available, but in limited availability, or not at all, in certain states.
Any insight/guidance you can provide is most appreciated. I am also working with the clinic in which I have been tested all three times as well as my obgyn's office for a follow up visit and will advise not only on my results, but also the plan going forward.
That said, any insight you mayhave on the availability of the BiokitUSA HSV-2 Rapid Test would be very helpful.
Thanks again for your time and reply.
MEDICAL PROFESSIONAL
It souns as though you have decided what you plan to do. Please let us know your results as things progress. I predict you will find that you do not have HSV-2. EWH
p.s. Your test results are from the HerpeSelect ELISA, the immunoblot does not provide numerical results. EWH
p.s. Your test results are from the HerpeSelect ELISA, the immunoblot does not provide numerical results. EWH
Thanks so much for your quick reply. It is most appreciated and has provided some very valuable insight, however, I do have a few follow up comments/questions:
Yes, the test that was administered on all three occasions was the HerpeSelect HSV Specific Type 1 & 2 IgG Combo, although I am unsure as to whether it was the Immunoblot version or the ELISA version as I understand Focus Diagnostics markets both versions under the HerpeSelect name and the test indicated on all three reports indicated HSV Specific Type 1 & 2 IgG Combo (HerpeSelect) and nothing more.
That said, I understand and appreciate your comments around my HSV-2 results and am planning on taking the HSV Specific Type 1 & 2 IgG Combo (HerpeSelect) test once again, and based on those results, will decide whether or not to take the Western Blot thru the Univ. of Washington to obtain/confirm a definitive diagnosis if the results of the next HSV Specific Type 1 & 2 IgG Combo (HerpeSelect) are positive
In the event that the results of the next HSV Specific Type 1 & 2 IgG Combo (HerpeSelect) test are Negative, then I may take the test one final time to determine (at least in my mind) whether or not the test results for September 8th, 2010 were indeed falsely positive.
And finally, once my status is confirmed (either positive or negative for HSV-2) I will either put this all behind me or move forward with the appropriate prevention/treatment options.
Any additional guidance you could provide would be most appreciated and thank you again for your time and consideration.
Yes, the test that was administered on all three occasions was the HerpeSelect HSV Specific Type 1 & 2 IgG Combo, although I am unsure as to whether it was the Immunoblot version or the ELISA version as I understand Focus Diagnostics markets both versions under the HerpeSelect name and the test indicated on all three reports indicated HSV Specific Type 1 & 2 IgG Combo (HerpeSelect) and nothing more.
That said, I understand and appreciate your comments around my HSV-2 results and am planning on taking the HSV Specific Type 1 & 2 IgG Combo (HerpeSelect) test once again, and based on those results, will decide whether or not to take the Western Blot thru the Univ. of Washington to obtain/confirm a definitive diagnosis if the results of the next HSV Specific Type 1 & 2 IgG Combo (HerpeSelect) are positive
In the event that the results of the next HSV Specific Type 1 & 2 IgG Combo (HerpeSelect) test are Negative, then I may take the test one final time to determine (at least in my mind) whether or not the test results for September 8th, 2010 were indeed falsely positive.
And finally, once my status is confirmed (either positive or negative for HSV-2) I will either put this all behind me or move forward with the appropriate prevention/treatment options.
Any additional guidance you could provide would be most appreciated and thank you again for your time and consideration.
Appreciate the info, Dr. Hook, and I will be following up with the AHSA directly.
Once again, thank you for your time, wisdom and insight. It has been tremendously helpful and I will remember it and you always!
Very kind regards,
Sara
Once again, thank you for your time, wisdom and insight. It has been tremendously helpful and I will remember it and you always!
Very kind regards,
Sara
Congrats!!!! I told you that you were negative =P
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
