false positive on HSV I IGG test?

[hellewise]

Hi doctors, my story is rather long so pls bear with me and i’ll try to make it as clear as possible.
Nov 2008 had unprotected oral sex with guy A. Received. Never noticed any symptoms after that.
18 March 2009 gave unprotected oral sex to guy B. Had unprotected intercourse for a short while.
After this there was some itching in my vagina and yellowish discharge. I went to see a gynae about 10 days later (i had also taken the morning after pill). At this point the discharge was watery and colourless. The ob gyn took one look and said it was a bacterial infection and gave me a suppository to use in my vagina. The itching cont and inserting the suppository really irritated my vagina. At one point i think there was a pus like discharge. The test results came back positive for yeast and negative for trich. They gave me a suppository again. i was extremely freaked out because i have read that a herpes infection is often misdiagnosed as a yeast infection. I kept checking for sores and went to a 2nd doctor. The 2nd doc i went to tested me for other STD and it all came back negative. He said that the area looked really red and raw but he didn’t see any sores.
16th april 2009 3rd doctor for a elisa herpes select test. IGG and IGM test and it all came back low negatives.I had a little bump around my vagina which doesn’t itch. the doctor took a look and said it was folliculitis.
20th sep 2009 red little bumps outside my vagina which didn’t itch. The gyn said that it was folliculitis (i just went for a bikini wax) and i asked for blood test again.
HSVI  IGG 1.11 positive
HSVII IGG 0.13 negative
I have no idea which test they ran but I’m devastated and i cannot stop crying now. I also have no idea where the infection is . genital or oral . I have never had colds sores before in my life. And i don’t live in America so HSV I is actually pretty uncommon.
At this point do you suggest additional testing like the WB?

[Edward W Hook, MD]

Welcome to the Forum.  Your test result is in a range where there is substantial likelihood that the result if false positive.  Here in the U.S., if a client felt the she/he HAD to know if they had HSV-1 with a result like this, I would suggest a Western blot but I would first try to get them to not retest or worry.  

Your history of exposures is not high risk and the symptoms you describe do not suggest HSV although, as you point out, clinical diagnosis can be difficult.  

If you have HSV-1, unless you have a definite, culture positive outbreak, I doubt that you will know your infection (if you have one) is oral or genital.  In addition, I would dispute your statement that because you do not live in the U.S. HSV-1 infections are uncommon- that is not the case. Worldwide the figure for HSV-1 infections is about 60%.  

Hope these comments help. To summarize, your history suggests you are rather low risk for having HSV or any sort and your test is at least as likely to be false positive as to indicate a real infection.  My advice would be not to worry about it.  EWH

[hellewise]

Hi Doc~ thanks so much for your comments. Can i just add on some stuff:

Why would my series of exposures not be considered high risk? I read that oral to genital (which makes up 30-40% of genital herpes these days)and genital to genital transmission of HSV I are all very likely. And i did all of that . UNPROTECTED. and had weird symptoms.

I forgot to add that on 16th august 2009, I kissed someone and drank from his glass. 2 days later I fell extremely ill with a very high fever of 39.3 degrees Celsius. However i did not have other flu like symptoms except for 3 white ulcers at the back of my throat. I couldn't swallow. My family doctor took a blood test 2 days in a row and mentioned that the figures suggested a bacterial infection (i.e strep throat) instead of a viral infection. But i had no idea what he tested for. Is this relevant? was this a cold sore attack? and maybe my positive is such a low value because i'm still seroconverting.

I'm sorry for sounding like a paranoid hysteria but knowing if i have HSV I is really important to me . I don't want to pass anything to my bf. He's still a virgin.

[hellewise]

sorry something else to add on. I have rash on my veneris mons and labia majora every once in a while( the area where there is hair). just redness and rash ..although there are no sores...

[Edward W Hook, MD]

With HSV "high risk" is certasinly a relative tern however it generally means direct leion contact.  Lower on the risk level is contact with someone known to have HSV.  In your case you do not know that the persons you were in contact were had HSV.  Remember, particualry with respect to HSV-2, as common as it is, most peole do not have the infection.  Further. for both infections, far less than 1% of contacts lead to transmission and the true fugre, while still imprecise (difficult to study) is somewhere between1 in 1000 and 1 in 10,000.  

I fear that you are really worrying far too much about HSV. While I'm not sihing it on you, every fever, rash and itch is not going to be HSV.   It is far more likely to have another cause.

Two final comments.
1.  You suggest you might get HSV from ddrinking fro another's glass.  Not the case.  HSV is not transmitted this way and the idea that it is is an urban myth,

2.  that your BF is a virgin does not mean that he doesn't have HSV-1.  His risk is largely independent of sexual activity.
EWH

[hellewise]

Hi doctor~ thank you so much for the comments so far. It's much appreciated. Could I just ask a last few questions?

1.I just consulted a infectious disease specialist who told me that false positives don't happen very often and false negatives are more likely to happen. is that true?

2. assuming that both partners have HSV I , what are the odds of me contracting HSV I from that when there are no apparent sores?

3.lastly just out of curiosity, if there was in fact a sore present and there was direct contact with the lesion, what is the % that such a contact will result in transmission of HSV I.?

your answers are greatly appreciated.

[Edward W Hook, MD]

1.  Read my comment. This is incorrect, particularly with persons whose test results ae in the low positve range as yours are
2.  Very, very low
3.  Hard to say, certianly less than 10%and perhaps lower  EWH

[hellewise]

Hi doctor~ thank you so much for your replies so far. All this information has been of great help to me but I'm still extremely worried about genital herpes.

The reason for my concern is that when I tested for herpes in April 2009 and it came back negative for everything and this recent development of testing positive for HSV I is very distressing to me. I've done abit of research online and I noticed that elsewhere on this website other administrators seem to hold the opinion that false positives usually occur for HSV II testing and false positives for HSV I are less likely to occur. What do you think?

And I would also like to add to my account that I just remembered that part of symptoms was that there were 2 painful cuts/abrasions like things near the outer labia. I'm not sure if this happened already or was due to my checking myself frantically frequently by using a cotton bud to seperate the folds of my skin. Could these painful cuts/abrasions be herpes?

why would i test negative for both HSV in April but test positive for it now?

Could the low positives indicate a recent infection and that I am in the process of seroconverting right now?

I'm sorry for extending this thread and I'm sure that you are a busy man with lots of questions from others to answer but this has been an extremely traumatic experience for me and the only way i can sleep every night is by telling myself that this might be a false positive result. I have tried asking for the WB recently but the doctor i consulted tells me that they wouldn't do it for me. =(

[hellewise]

Should I start a new thread?

My results of
HSVI  IGG 1.11 positive
HSVII IGG 0.13 negative

what are the odds that my hsv 2 results are a false negative?

[Edward W Hook, MD]

There is little, if any, chance that you have HSV-2.  

This ends this thread.  EWH

[hellewise]

hi i've recently retested and both HSV 1 and 2 came back negative. I feel so relieved . Just want to say a big thank you to all the good work you doctors are doing on this forum . Now i can go on with my life.... thanks again!