Conflicting HSV Test Results

[HSVType1_2]

I was hoping you can help me understand my conflicting test results.

03/31/2009 HSV 2 IGG HERPESELECT           1.48 H

10/20/2009 HSV 2 IGG INHIBITION, ELISA      POSITIVE

10/12/2010 HSV WESTERN BLOT (HSWB)      
POSITIVE FOR ANTIBODY TO HSV-1 BY WESTERN BLOT. NEGATIVE FOR ANTIBODY TO HSV-2.

03/15/2011
HSV 1 IGG TYPE SPECIFIC AB 0.00
HSV 2 IGG TYPE SPECIFIC AB 1.37 H

03/31/2011 HSV WESTERN BLOT (HSWB)
POSITIVE FOR ANTIBODY TO HSV-1 BY WESTERN BLOT. NEGATIVE FOR ANTIBODY TO HSV-2.

Why am I showing positive in 3 of the tests and negative for the two western blots for HSV2?
Why are the Igg tests not picking up the HSV1?

I realized that in my panel of April 06 2009 for other STDs I had the following:
HEPATITIS B SURFACE REACTIVE
On a later check up my HEPATITIS B SURFACE WAS NON REACTIVE (MARCH 15 2011)

Could Hepatitis B cause cross reaction? If not, why are my HSV tests conflicting.
I have never had an outbreak of any kind, and my boyfriend for the last year hasn't either. His test results are as follows:
09/03/2010 HSV 1 and 2-Specific Ab, IgG     HSV 1 IgG, Type Spec 1.74 High
02/18/2011 HSV WESTERN BLOT (HSWB)
POSITIVE FOR ANTIBODY TO HSV-1 BY WESTERN BLOT. NEGATIVE FOR ANTIBODY TO HSV-2.

In your opinion, do I have HSV-2 or not?
Why the different results? What test is the most reliable?

Thanks so much for your time :)

[Terri Warren, RN, Adult Nurse Practitioner]

Can you tell me who Dr. Sean Cummings is? I've not heard of him in the herpes world.  Where did you find him to get this explanation?  Would you like me to further investigate your western blot situation further?  If yes, we could do a phone consult through my clinic.
You could certainly do a full Hepatitis B panel, I was assuming that you had more than just surface antibody testing done.  No?

Terri

[HSVType1_2]

Could you please read this response and give me some insight. I am extremely confused. Thanks

by Dr Sean Cummings, MBBS; T(GP); DRCOG; MRCGP; DFSRH; LLM, 4 hours ago
To: HSVType1_2
Hello

Western Blots are variable - they used to be the gold standard for many types of tests but in reality they have been overtaken by much more reliable IgG tests.

From these results - and without the benefit of actually seeing you and the results and taking our own tests at our own laboratory - I would say that you do have herpes 2 and you did have a brief infection with hepatitis B. I would go and discuss with a doctor your results and ask him or her to help you sort them out. I would also suggest a full hepatitis B profile to include surface antigen; surface antibodies; core IgG/IgM; core specific IgM; "e" antigen and "e" antibodies. The combination will determine where you are with hepatitis B.

best regards, Sean

[Terri Warren, RN, Adult Nurse Practitioner]

My oh my, you do have conflicting results, but I believe I can help you sort them out.  
Both of your HSV 2 results are low positives.  The western blot is picking up the HSV 1, and the ELISA is not.  The western blot is more sensitive for HSV 1, by quite a bit, than the ELISA, so that is not a surprise.  You HSV 1 antibody is making your HSV 2 test look artificially positive, there is some cross reaction going on there.  We don't know much more about what causes false positives.

It looks like you've been vaccinated in the past for hepatitis B, but the immunity is no longer present in the test.  The guidance from the CDC suggests that you don't need revaccination, but some people chose to do it anyway.  

My opinion is that you don't have HSV 2.

Terri