What causes false positives?

[stupid28]

Hello Doctor thank you in advance for all your help.

HSV1 and 2-Specific Ab, IgG by labcorp

In the above described test what causes false positives?  How does HSV1 (or any other thing) influence the results of HSV2?

and what is the difference betweenn {immunoassay antibody to Gg-2 TO HSV1 and 2-Specific Ab, IgG} whitch is more accurate

Could someone actually be infected with HSV2 for more that 13 years and have three children and never be diagnosed and also not infect their partner.

[H. Hunter Handsfield, M.D.]

Last question first:  Yes, many people are infected for years, without diagnosis, and never transmit to their partners.

False positive results essentially never occur for strongly positive results, i.e. those with ELISA ratios of 3.5 or greater.  For low-positive results with HSV-2, i.e. ELISA ratios 1.0 to 3.5, the most common cause of a false positve result is being postive to HSV-1.  If there are other causes, they are unknown.

The reasons for false positive results for HSV-1 have not been studied, to my knowledge.  Probably there is no such thing, or at least it is rare.

As to terminology, I think you are using different words for the same thing.  Different labs might use different terminology.  Neither one is more accurate than the other.

For more detailed discussions, use the search button to look for threads using search terms "HSV diagnosis", or maybe "herpes diagnosis"; also "HerpeSelect".

Best wishes--  HHH, MD

[stupid28]

In your experience would you rather trust the results from a
HSV1 and 2-Specific Ab, IgG or a Biokit USA after 12 weeks

thanks

[H. Hunter Handsfield, M.D.]

Both of those tests are IgG based and "specific", and they are equally reliable for HSV-2.  BiokitUSA only tests for HSV-2, not HSV-1.

If the lab-based test and Biokit both are positive for HSV-2, you definitely are infected, even if you have a low-positive lab-based IgG test.  If positive on one but not the other, it depends on the ELISA ratio. If there is doubt, the tie-breaker is a Western blot test, done at the University of Washington clinical laboratory in Seattle.

As I suggested, please use the search link to find more detailed information.

[stupid28]

results:
Biokit was Negative
lab-based HSV2 (positive 2.1)

[H. Hunter Handsfield, M.D.]

If your HSV-1 test is positive, probably you don't have HSV-2.  If your HSV-1 is positive, you should have a Western blot to sort things out once and for all.

[stupid28]

So either if I am postive or negative for HSV1 I should get a westernblot
I was HSV1 pos 5.8?

[H. Hunter Handsfield, M.D.]

Sorry, in my last comment I meant "If your HSV-1 is negative [not positive], you should have a Western blot."

The test results show you have HSV-1.  You do not have HSV-2.  You do not need further testing.  

Apologies for the confusion.   But if instead of the roundabout questions you had just posted your HSV-1 and HSV-2 results in your original question, it would have been quicker and for both of us!  Anyway, you're home free with respect to HSV-2.

Best wishes--   HHH, MD

[jp813]

Same thing happened to me.  Had a Herpes Select test done for both 1 and 2.  Came back with 5.2 for 1 and 3.0 for 2.  Took the HSV-2 Inhibition test and it was negative.  Wahoo!  I just wish more doctors knew to double check when you're postive for 1 and lower than a 3.5 with 2. Thanks to this site, I provided a bunch of info to my doctor and was able to get a test done to confirm.  Otherwise, I was just another patient with a Herpes diagnosis.  I bet there's a lot of people who are dumbfounded with the results and assume they're walking around asymptomatic.

thanks Dr HHH for all you do!

[stupid28]

I am so happy your test came back negative.  My gynecologist told me that she only uses labcorp (i do not know if it's the herpes select of some other test) and that when the test return positve at any reaction level higher than 1.0 its positive no matter if it's a low positive and I should start on valtrex.  She really freaked me out, so thanks to this website I was able to determine that is not always correct.  I do now understand how doctors are so uninformed and how they do not know about other test such as the BIOkit USA or the Inhibition.

[jp813]

Didn't this incident make you all the more aware that Doctors really are "practicing" and not necessarily "a master"?  Before, I would tend to take the doctor's word and do as I was told.  After all, they the ones that went to med school, so what do I know?  But for me there were too many other factors.  Like why hasn't my husband had an outbreak after 13 years (it's possible, but in my mind unlikely since we had had sex when I had cuts MANY times), and my cuts were lasting way too long and appearing while on Valtrex.  Not to mention, HHH feels strongly that outbreaks are fewer the longer you have it.  So if I've had it this long, why was I getting these cuts more often and worse?? It just didn't make sense.  So glad for this site. There was a lot of stress in my life there for awhile simply b/c my doctor wasn't up on the latest info.  Love her, but...

[stupid28]

How long ago were you told that your test were positve for HSV2?  I also have been with my husband for 13 years and he tested negative, however I started thinking maybe I am asymptomatic and never transmitted it to and also maybe my gynocologist never detected it not even with my three pregnancies.

However, my situation is a little different than yours I would not be panicked after my husbands results came back negative but I had an affair 13 weeks prior to my test results so I am still panicked that I cought it from this time even though the guy was not showing any signs of herpes.  This guy tested 13 weeks after our encounter because I told him that I had received a positive test for HSV2.  he told me that the results for him were negative, however I did not see his results and we have stopped talking.

I wonder how high the risk is after a one time unprotected sex or how often does viral shedding occur?

[jp813]

I really don't like typing your screen name!  I feel like I'm calling names!  :(

Anyway, I think my positive test was done in March or April and the last one (that was negative) was done in June.  We never tested my husband because I wanted to figure me out first.  If mine had come back positive again, we would've tested him.   But, after rereading your post to the Dr, I really think you're in the clear based on the fact that you are positive for one and had a low positive for 2.  Plus, the BioKit (which only tests for 2) was negative.  May I ask if you had symptoms of herpes that prompted the testing? Or were you just checking after the affair.  My thoughts on whether you can get Herpes from one encounter based on what I've read is: Yes, you can.  It would be really unlucky catch especially if there were no visible symptoms since asymptomatic shedding only occurs roughly 4% of the year.

So relax...I think you're good.

[stupid28]

I know, I should of probably used another name but at the time I chose it that's how i felt: ) I STILL DO!!

At 12 weeks I noticed a pimple on the lip of my vagina.  So I freaked out and called an internet based clinic to schedule me a herpes test since i was embarrased to call my regular gyno. However I do not know what kind of test they scheduled with labcorp, if it was the herpes select or something else. I just know it was some type of IGG test. I was told by the doctors that did the biokits that it did not look like herpes to them.  (I dont know if I got this pimple as a reaction to an laser hair removal treament down there that I had received about 6 days prior to getting the pimple)

Does the 4% mean 14 days out of 365 of the year?

Till this day I am still freaked out and would like to visit the doctor in his Seattle Office:(

[H. Hunter Handsfield, M.D.]

Please email each other, or take the personal conversation over to the STD support forum.  Thanks!

[stupid28]

We will, sorry doctor:)

[stupid28]

I am sorry doctor to keep on asking but you are the only one that I know trust regarding these issues.  I promise this will be my last question.

Today I received my negative biokit at 4 months (124 days after assumed exposure). This ID doctor did my 12.6 weeks biokit (negative) and offered to give me a free biokit at 4 months from my assumed exposure when he saw how paranoid and anxious I still was because of the positive HSV2 2.1 result I had recieved from Labcorp at 12.3 weeks.

He offered to have a sample of blood sent to the University of Washington if I wanted for a western blot because he said that he could not explain to me the reason why the lab based test was positive at 12.3 weeks and both his biokits at 12.6 weeks and 4months were negative. However I just want to ask for your valuable opinion.  Should I have the western blot done or should I just drop everything and accept my 4 month negative result for HSV 2 and go on with my life.  

Your opinion will be greatly appreciated.  It has been a long 4 months of stressing over HIV (negative via oraquick at 13.2 weeks) and herpes and I just want to go on with my life.

Thank you so much

[H. Hunter Handsfield, M.D.]

I can't explain it either.  But it looks like you can be confident you don't have HSV-2.  Feel free to "go on with your life".  If you remain nervous, then follow the ID doc's offer of a Western blot at University of Washington.  

[H. Hunter Handsfield, M.D.]

New questions are not allowed in existing threads.  You have to start your own thread, using the Post a Question link.

[sammy640]

A related discussion, false positive range was started.