symptoms of gential(genital) herpes

i was wondering if dr. h could answer my question. about 8 years ago i had a vaginal rash that lasted for about a week the doctors gave me steriods and it went away. then four years later i had a vaginal lesion that looked like a canker sore went to the doctor about a week later and they did a culture came back neg. then i requested some blood work results as follows: 1st hsv 2 pos. not sure what kind of of test this was. 2nd test hsv 1/2 igg 1.1 hsv 1 igg spec. <.91 hsv 2 type spec. <0.91. what does this mean?

[H. Hunter Handsfield, M.D.]

It sounds like your blood was sent to a laboratory that does an initial screening test, which suggested the presence of HSV-2 antibody; but that the more accurate follow-up test, using more accurate methods, was negative.  This is a cost-saving approach by the lab:  if the initial screening test had been negative, they would have stopped there and reported the negative result, saving the cost of the additional tests.  The result that is important is the second round, showing negative results (ELISA ratio values under 0.91) for both HSV-1 and HSV-2.

Bottom line:  You have never been infected with either virus, which in turn means that your past vaginal rash and genital ulcer were not due to herpes.

I hope this helps.  Best wishes--  HHH, MD

[scaredsick382]

so what does the the hsv1/2  pos. mean. also so the hsv 2 pos. is not accurate?

[H. Hunter Handsfield, M.D.]

Is is a screening test that commonly gives false positive results.  That result means nothing in the presence of the negative type specific ELISA ratios (under 0.91).  You don't have HSV, period.  Move on and don't worry about it.

[scaredsick382]

okay my dr. did another herpeselect blood tests: and the results are hsv1/2 igg 1.3 h,
hsv1 igg spec. 0.91,hsv2 igg spec  0.91 why does hsv1/2 levels keep jumping around?

[H. Hunter Handsfield, M.D.]

The additional test was not necessary, and the result is still negative.  The HSV1/2 test naturally varies widely; the different values don't mean anything.  You don't have either HSV-1 or 2.  Further testing will be a waste of money, time and energy.  Time to accept the good news and move on.

This thread is closed.  No more comments, please.

[scaredsick382]

one last question could the pos. hsv1/2 ran together the is pos. be from when i had mono and chicken pox?

[H. Hunter Handsfield, M.D.]

No.  Cross reaction between HSV and other herpes group viruses is often assumed by some physicians and even some laboratory experts to explain false- positive HSV antibody test results, but it isn't true.  The reasons are not known but probably have more to do with the chemistry of the test.  It means nothing in terms of your health.  Let it go, secure in the knowledge you aren't infected with HSV of either type.

That really is now the end of this thread.  

[scaredsick382]

sorry i miss typed a test result the hsv2 igg spec only was a 1.5 still not sure what kind of test it was does this make a difference. so does this still mean that i don't have gh?

[H. Hunter Handsfield, M.D.]

If the result was 1.5, and not 0.91, there is a slight chance you have HSV-2.  Although 1.5 is technically positive, most results in that range turn out to be false.  Search the forum for multiple discussions about the sorts of follow-up confirmatory tests that can be done to sort it out.  That's all for this thread.

[scaredsick382]

now iam really confused my herpeselect tests are 0.91 and the unknown hsv-2 pos igg 1.5 is the only pos. so is that accurate? no herpes

[H. Hunter Handsfield, M.D.]

There obviously is a terminology problem here. I assumed the 1.5 result was HerpeSelect.  "HerpeSelect" and "hsv2 igg spec" presumably are the same test.  (HerpeSelect is the brand name of the most commonly used IgG test for HSV-2.)

Let's start over.  Post a comment that shows the exact dates and exact results of every test you have had.

[scaredsick382]

1st test hsv 1/2 1.5h pos. igg  oct. 05
hsv 1 igg neg.
hsv 2 igg type spec. neg.

2nd test hsv  2 igg  spec. pos. 1.5    feb. 06

3rd test hsv 1 pos.   may 06
hsv 2 pos.

4th test (herpeselect)  aug 08
hsv 1/2  igg spec . 1.5h pos
hsv1  igg spec.0.91
hsv-2 igg type spec. 0.91

5th test (herpeselect) nov. 08
hsv1/2 igg spec. 1.3h pos.
hsv1 igg spec. 0.91
hsv-2 igg type spec. 0.91

also had vaginal rash and vaginal ulcer what does all this mean?

[H. Hunter Handsfield, M.D.]

Unfortunately, those results remain a little confusing.  Looking at the last two sets of results, I cannot tell whether the 0.91 results (for both HSV-1 and -2) are the numerical results in your blood, or maybe the lab's statement of the cut-off between positive and negative.

Still, considering all the results, I believe it is most likely that you are not infected with HSV-2.  However, because several of the results apparently are borderline, you now need to have a confirmatory test using an entirely different technology.  There are two options for that.  First is a BiokitUSA test, which is done in the doctor's office in 20 minutes.  Even if your doc doesn't routinely provide that test, a single test kit can be ordered from the Biokit company.  If a Biokit result is negative for HSV-2, it will prove you don't have it.  Alternatively, ask your doc to send a specimen to the University of WAshington laboratory in Seattle for an HSV Western blot test.  WB is the ultimate, final gold standard for HSV blood testing.  It is expensive and likely not covered by insurance (since it's not a test formally approved by the US Food and Drug Administration), but it will tell for certain whether you are infected with HSV-1, HSV-2, both, or neither.

As I said above, my bet is you don't have HSV-2.  But it looks like the results so far are not going to be able to answer the question.  Feel free to return to the forum one more time when you have either a Biokit or Western blot result to report.

[scaredsick382]

are the pcr test accurate this is the next test that my dr is wanting to run?

[H. Hunter Handsfield, M.D.]

That's not the way to go in cases like yours.  If PCR is positive for HSV, it proves the person is infected.  But people with herpes have negative PCR tests more than 90% of the time.  You can expect the result to be negative, in which case it will be meaningless.

That is the last comment that will be permitted until and unless you return to post the results of a BiokitUSA or Western blot test.  (Or if your PCR test comes back positive.)  Other than that, I will delete any further comments, and if you persist I will delete the entire thread.

[scaredsick382]

i ask the dr. and the .<.91 is my actual results so does this mean that iam neg. regardless of the hsv2 igg pos 1.5?

[scaredsick382]

okay i asked my dr.to explains these to me and she said the hsv-2 igg was pos@ 1.5 and the other test that she ran was hsv1/2 igg 1.1 hsv1 igg spec <.91 hsv-2 type spec igg was <.91 these are my actual results. so am i neg?

[H. Hunter Handsfield, M.D.]

Sigh.  I told you I would help interpret the results of a BiokitUSA test or a Western blot.  You are reporting the result of another HerpeSelect test, the same one you had before.  The results remain uncertain; you may or may not have HSV-2.  I cannot help you if you don't get one of the specific tests I recommended.  DO NOT POST ANYTHING ELSE ON THIS THREAD UNTIL YOU HAVE THE RESULTS OF BIOKIT OR WESTERN BLOT.

[scaredsick382]

A related discussion, still scared and confused was started.