interpreting HSV-2 test scores...

I recently was tested for HSV-2 with Herpes Select ELISA IGG.  I have taken this test before.  I got a 1.51, .80, .90, 1.13 set of scores four different times in that order.  Odd...anyway, sometimes OK, sometimes positie...I was wondering if these were false positives, etc.  I have never had symptoms.  

This last test though (1.13) had another test called the HSV-2 inhibition which tested positive.  Does that mean I shouldn't bother with a Western Blot?

[Edward W Hook, MD]

Herpes blood test results must be taken in context.  By that I mean that all blood tests have both false positive and false negative results from time to time (the goal is to minimize this and know when it is likely, that is a large part of my job).  Now on to you and your results:

The Herpes Select detects infection in close to 95% of people with infection.    The test results tend to "bounce” around and although the company defines a positive test result as any value of >1.0 as positive, there is increasing evidence that in lower risk persons (i.e.  fewer partners, no history of lesions, etc) that a portion of those with "low positive" test results (values of less than 3.0) the results are actually false positive.  There is an ongoing debate in the expert community about what the cut-off for a positive HerpesSelect antibody test should be in such situations.  Given your consistently low results, it would not surprise me if indeed your results were among those which are false positive, at least when using the company's interpretation of the test values.  

All things being equal, at this stage a Western blot would be most helpful in giving you a somewhat more conclusive answer.  If you get one, please let us know what it shows.  I hope this helps.  EWH

[worriedandrestless]

A related discussion, hsv2 false positive?? was started.