HSV-1 and HSV-2 Test report...confusing

[meowmixM]

Hi, I just returned from my doctor and received both my HSV-1 and HSV-2 test results. I was expecting only HSV-1 to show positive since I had fever blisters in my mouth while young. However, to my surpise my doctor informed me I was HSV-2 positive and
HSV-1 negative.
I have never had sexual contact and never had symptoms of genital warts, this test was a prerequisite for me and my partner. My question is, did the doctor interpret the results correctly? There is not much info on these results and my doctor seems rather conservative about the issue and unwilling to go into detail about the results.

Here are the results:

Herpes I & II IGG

TEST NAME            Result   Reference Range
HERPES I IGG    NEGATIVE     NEGATIVE
HERPES II IGG   POSITIVE       NEGATIVE

TEST METHODOLOGY - ELISA
LESS THAN 0.90 I.V.     NEGATIVE
0.90-1.1o I.V                  EQUIVOCAL
GREATER THAN 1.10 I.V.  POSITIVE

REFERENCE RANGE FOR HERPES SIMPLEX VIRUS IGG IS NEGATIVE IF NOT EXPOSED


Under HSV-2 "Result", it states positive, but under "reference range" it states negative. What exactly does that mean? The final comment on the test report state that reference range is negative if not exposed. What does that mean?

If I am in fact positive for HSV-2, could it be true that the fever blisters caused in my mouth where in fact the cause of HSV-2?

[Edward W Hook, MD]

Although cold sores can sometimes be caused by HSV-2, this is quite unusual.  Most cold sores are due to HSV-1.  I worry that the test you had was not one of the type specific tests such as the HerpeSelect or Captia tests that truly differentiate HSV-1 from HSV-2 infections.  Do you know what brand of test was performed?  Unfortunately, there are a number of tests in use which claim to differentiate HSV-1 from HSV-2 but do so poorly.  In answer to your questions:

1.  A result which is positive is just that.  The so called reference range means that the expected result would be a negative test.  Your test was positive.

2.  See above

What to do.  A couple of suggestions:

1.  Find out what test by brand names was performed.
2.  found out the "Strength" of your positive results.  Usually there is a number associated with it.
3.  Having never had sex, you chances of having HSV-2 are very, very low.  this makes the test results suspect. (BTW, why be tested if you've never had sex?)
4.  The best answer would come from having a viral culture performed the next time you have cold sores and, if the culture is positive, having the virus which is cultured typed.

Hope this helps.  Let me know what you learn about the test you had.  EWH

[meowmixM]

The name of the test was not listed, it just states IGG ABS and ELISA. It was done by Scott and White Reference Laboratory in Temple, TX.

I am unsure of the strength of these results, however I will attempt to obtain them.

I took it to confirm a HSV-1 infection, that is all.

[meowmixM]

I was only able to find out it is manufactured by focus diagnostics and in IGG.

[Edward W Hook, MD]

Thanks for checking. The focus diagnostic tests are type specific so I think you need to presume you have cold sores due to HSV-2.  With this knowledge, you can also know that while there is a theoretical possibility of transmitting your infection through kissing or oral sex without a cold sore present, this is quite unlikely.  EWH

[gracefromHHP]

Have you ever performed oral sex on anyone to even have been at risk for contracting hsv2 orally?

grace

[meowmixM]

I took the BioKit test and it came up HSV-2 negative. I am almost certain that the lab switched my results for hsv-1 and 2.

[Edward W Hook, MD]

Possible although labs don't mess up often. The reason I asked about the "strenght"of your test result is that if the HerpeSelect assay result was in the "low positive" range, there is a possiblity that your HSV-2 IgG test result was false positive.  EWH