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Avatar universal

False Positive HSV-2 Igg test and Western Blot

Hi everyone,
I wanted to share my story in case it's helpful to others. Although I have not posted before, I benefited from many of the other posts. The short version is that I had a low-positive 2.5 Elisa HSV-2 Igg test from Labcorp, and like many other people I later got a negative Western blot HSV-2 test from the U. of Washington, proving that the initial Labcorp result was a false positive. If you keep reading, you'll get details of the story as well as information about how to get the Western Blot test (which was not easy!). :)

In August 2013 during a routine annual exam my obgyn tested me for a variety of STDs. Please note that this was just routine since I had ended my previous relationship 8 months prior and I was starting to date someone new and wanted a "clean slate." I've never had an STD in my life, I am a healthy and responsible woman in my early 30s. As a lesbian, I am less at risk than heterosexual women. I did not have any symptoms of any kind.

It was devastating and shocking to hear from my doctor that my HSV-2 Igg Elisa antibody test performed at Labcorp turned out to be a 2.5, which is positive according to their official range of values (>1.1). For the record, my HSV-1 Igg was negative (and indeed I've never had a cold sore in my life, unlike most people). That's the only herpes test I had ever had, since routine STD screenings don't typically check for herpes, so I had no prior results to compare it to.

I work in academia, I have a Ph.D., and I have access to medical journals and publications, so I began to research everything published on the subject. Here's what I found out:

1) In low-risk populations, any Elisa HSV-2 Igg "positive" value under 3.5 should be considered suspect. According to published studies, it is estimated that 65% of those low positive Igg values (under 3.5) in the Elisa test are in fact false positives. That is why the the CDC does not recommend routine screening for herpes in low-risk populations. What you should realize is that MOST DOCTORS ARE NOT AWARE OF THIS FACT.

2) The reasons for the low-positives are not clear. According to many researchers, a positive HSV-1 (cold sore) might lead to a false positive HSV-2 value because of cross-reactivity among those different strands of the herpes virus. That has been shown in the literature. In my case, however, this is not a relevant explanation since my HSV-1 values were negative. A working hypothesis is that other strands of herpes (chickenpox and shingles) might cause the test to falsely report HSV-2 antibodies, but to date that is speculation based on clinical findings only that has not been proven conclusively. Personally, I believe in the latter theory because I myself had shingles a couple of years ago (when I was 30 years old).

3) The scientific literature on the subject has found 2 tests to be accurate confirmatory tests to ascertain if a low-positive Elisa HSV-2 Igg value is indeed a real positive or not. Those are the Biokit (also marketed under SureVue) and the Western Blot.

The Biokit is a finger prick test done in a doctor's office. It takes about 10 minutes for the result. Articles published in medical journals have found the biokit to be highly accurate. The problem I encountered is that it was virtually impossible to find it. I called the manufacturer (http://www.biokitusa.com/) and they were able to give me the contact information of just 2 clinics in my state that carry it. If you have a supportive doctor, you can convince them to order the kit and administer the test in their office. Most doctors, however, would be unlikely to bother with it because they are not informed enough about the statistics on low-positive HSV-2 Igg results. I gave up on the biokit because it was too difficult to get to it for me. Instead, I went for the Western Blot.

The Western Blot HSV-1 and HSV-2 Igg antibody test is absolutely the gold standard herpes antibody test. The validity and reliability of all other tests are measured against this one. This is the test you want. The catch is that it is only performed at the University of Washington in Seattle. I had found older posts on this forum and on other fora explaining that you could get the Western Blot done and ordered through your local Quest Diagnostics lab. That used to be the case, but it is NO LONGER TRUE. Quest Diagnostics does their own HSV-2 Elisa Igg test, and if the result is a low positive (under 3.5) then they also do an immunoassay test to confirm the result. Their immunoassay is better than nothing (certainly better than Labcorp), but it is not accurate enough. You could have a low positive HSV-2 Elisa Igg and a positive immunoassay at Quest, and you might still be a false positive. The only way to know for sure is a Western Blot.

So, how do you get the Western Blot HSV-2 Igg test nowadays? Here's what you do step by step.

1) Call the University of Washington Virology Dept.  at  800.713.5198
(http://depts.washington.edu/rspvirus/documents/hsv_western_blot.pdf
and http://depts.washington.edu/herpes/faq.php).

2) They are very nice and helpful. They will mail you a kit (free of charge) with instructions, a vial, a requisition form, and an appropriate box with ice pack and biohazard sticker that you will need to use to mail your vial back to U of WA.

3) Go to your doctor with the forms. Your doctor has to give you 2 things: the requisition form for the U. of WA, and a lab order for a local lab to draw your blood.

4) Go to a local lab with your doctor's order, have them draw your blood and spin it, and then give you back the vial with serum.
*Here's the problem: most labs will REFUSE to give you back your vial with serum. Labcorp and Quest both turned me down citing their corporate policy. I had to find a small independent laboratory in my city that was willing to do it. So, be prepared to call around. The lab I found charged me $25 for drawing fee*

5) Pack the vial of serum, the requisition form, and a check payable to the Univ. of Washington (currently the cost is approx. $162) and send it fedex overnight in the box provided by U. of WA. You'll have to pay for overnight shipping. Also, U. of WA does not bill insurance for anyone outside of WA state, so you'll have to pay upfront and then you can try later to get your insurance to reimburse you (highly unlikely though!).

6) Not all Fedex offices will accept a "clinical specimen" shipment. Call ahead of time the general fedex national number and ask them which Fedex office in your area is designated to accept dangerous goods and clinical specimens. They will make you place the box inside one of their fedex "clinical paks." I did not have to fill out a dangerous goods form, but be prepared to describe in detail how you packed it. Here's a post I found on another website that helped me a lot with step by step instructions: http://www.racoon.com/herpes/WB_test.htm

7) Your doctor will call you with the result. It takes about 2 weeks. That was the best part: hearing that indeed it was negative!

8) I am going to try to submit receipts (for the drawing fee, the Western blot test, and fedex shipping) to my insurance company, but I am not holding my breath. All in all, it was about $230 for me.

I hope this will help someone. Good luck!
21 Responses
Avatar universal
Cat, your story is so similar to mine, and yours is the first hope i've gotten.  I also am in western washington - can you please tell me what small lab you used; or at least post the city it is in?  

grateful,
s.
Avatar universal
Cat, your story is so similar to mine, and yours is the first hope i've gotten.  I also am in western washington - can you please tell me what small lab you used; or at least post the city it is in?  

grateful,
sandi
Avatar universal
You stated that "According to many researchers, a positive HSV-1 (cold sore) might lead to a false positive HSV-2 value because of cross-reactivity among those different strands of the herpes virus. That has been shown in the literature." I am asking because i was exposed both hsv1 and hsv2 at the same time. Tested at 6 weeks after last involvement and had a igg of over 4 for hsv1 and a 1.17 for hsv2. Previous reading 6 weeks before were both < .90. Can you provide more information both this type of false positive?
Avatar universal
Wanted to let you know that I'm super greatful for this post. I'm in the same situation and have sent out my sample to University of Washington's lab for testing. I'm expecting a negative but still freaking out, not fun. It's really shocking that a doctor would be as ignorant and irresponsible as mine has been. If it wasn't for your post, I might have accepted his diagnosis and gone the rest of my life under the wrong assumption that I was positive. It kills me to think that there has to be some people out there right now like that. So thank you, thank you, thank you for sharing your story.

If anyone is wondering, the current cost of the test is $206.85. They are, btw, readily available, super nice, and helpful at the university.
Avatar universal
Great article. Thanks for the info, this is really a helpful post. BTW, if anyone needs to fill out Dangerous Goods form, I found a blank form in this link http://pdf.ac/6LCVG. This site PDFfiller also has several related forms that you might find useful.
Avatar universal
Thanks for this deep explanation. My results then might be a false positive as well (LabCorp):
28.5 HSV1
3.02 HSV2
I'll try this new test and will post here.
Thanks again
Avatar universal
This gives me hope. I got a hsv1-negative,hsv 2-1.31. I don't have any symptoms. I called yesterday and had a kit sent out. I'm going to go to one of those fastmed/urgent care places and tell them I want to get an hsv test but that I have a specific lab I want it sent to and see if I can do it that way. I hope I'm false positive because All I can think about is how I'm going to be single the rest of my life.
Avatar universal
Thank you for your informative post. I too had a routine screening because I was about to start a new (heterosexual) relationship and wanted to provide him with a clean slate and ask him to do the same for me. To my shock, the Herpeselect Igg test came back as negative for HSV1 and positive for HSV 2 with a 1.73. I asked my provider if this could be a false positive because I have not had sex in 10 years and have been completely asymptomatic. She did not know the false positive rate but explained most people are asymtomatic but that when it is dormant people shed virus. She offered me a Valtrex prescription to reduce shedding, so I might protect future partners. In 1996 I had a boyfriend who requested we both get HIV tests; both were negative and then we proceeded to have monogamous sex without condoms (I was on the pill) for 3 months until one day he came to my house crying and told me he had herpes from his previous girlfriend and he should have told me sooner but he's been asymptomatic until that weekend. Fortunately, I had been traveling the week before his outbreak. As it turned out, he broke up with me because he felt he had ruined the trust and we'd never be the same. I was very sad and confused. Really crushed, actually. As months went by and I never had any symptoms, I forgot about it over the years and assumed I had dodged a bullet. So, in 2015 to hear that I might be an asymptomatic carrier for 19 years was rather devastating. It was especially devastating because my new boyfriend and I are very much looking forward to a sexual relationship. After being abstinent for so long, I have taken things slow, but was looking forward to things progressing. I do believe that if you love someone or care for someone, that love is a verb and your actions must be such that you protect them. By protecting them, you should not conceal such a diagnosis - you must tell them and treat them as you would want to be treated. I realized with medication and condoms we could get the risk down to around 2% per year. In other words, if having sex 2x a week, out of 100 couples, 98 will avoid transmission if medication, condoms and awareness are all in place. Still 2 couples will transmit. I spent 2 weeks thoroughly joyless and depressed going over the script in my mind of how I would break it to my new guy, whether I would be rejected, and contemplating getting on the medication and wondering about how difficult it might be to date if I had to disclose this every time a relationship became serious. After reading this story and other online information, I decided to become a phone patient of the Westover Heights clinic with Terri Warren. She ordered the Western Blot from the University of Washington, and I had my blood drawn at Quest labs. While this was in progress I began having a lot of anxiety and I became convinced that the test would confirm my worst fears. I recently received my results. They were negative for hsv 1 and NEGATIVE for hsv 2 by Western Blot. I'm so relieved and even though this month has been very, very difficult, I feel I have been given an incredible gift….the gift of education. I will never have unprotected sex without blood work from a partner again (this includes HIV, Hep B & C, chlamydia, syphilis/gonorrhea, and HSV 1 and 2). It may seem unromantic to present a new partner with a list of things he must test for before sex, but it is much worse to have regrets due to health problems. Besides, once you each do that for the other, you should share the paperwork, not just "talk" as I found out that the previous 1996 boyfriend had been intentionally deceptive to me. So, I encourage everyone to learn from my experience: 1) Get tested, know your status on things. 2) If you have a low positive hsv under 3.5 gig, seek confirmatory testing using the Western blot. Repeating the same Herpeselect test likely would have continued to get me low false positives. There may be a cellular protein similar to hsv that creates false positive for some people, and a different test, such as the Western blot can sort it out more effectively (it is the gold standard) 3) Have partners get tested before sex. This includes before oral sex because many hsv 1 infections (cold sores) can be spread to the genitals and should you have that genitally, it requires a lifetime of disclosure to new partners, and 4) if you have hsv 1 or 2, check out Terri Warren's books. She is truly an expert and very helpful. Be honest with your partners, and take care of your health and mental well being. Get counseling to help you if you need it, and remember that you are still the same lovable and valuable person - you just need to be thoughtful, and forthcoming before sexual activity so you can protect others.
1 Comments
Hey Alittlewisernow , I had a evisit with Terry Warren just now. Unfortunately, the connection got lost just about when she was going to ask me her last question. I remember her saying that she would send me the completed virology form which I need to submit when they draw my blood. Did she sends yours on your email and how long did it take for you to receive it? I am a little frustrated as I got charged for the evisit and the test but havent received any documents yet.
Avatar universal
What was the cost of going through the westover clinic?
Avatar universal
It was 250.00 flat rate. That included the phone consultation and the Western Blot. When I was at Quest labs, I gave my insurance card. I am not 100% sure if insurance will cover the blood draw, so there could be an extra blood draw charge if my insurance bills me. You can also order a kit free of charge from UofW, take it to your doctor or a med-stop and have them fill out the order and then go to a blood draw place. When the result is sent in, you'd need to include a check for approximately 206. I found it easier to just go through Westover Heights. The 250 included a 10 minute appointment phone call with Terri Warren. I found it was better to do the blood draw on a monday than a friday because it gets overnight shipped on dry ice. Quest labs handled all of this. You don't want your sample sitting around on a weekend.
Avatar universal
I just got my results back and It was negative for both. I would of went the rest of my life thinking i had hsv2 if i hadn't come across all the info Terri Warren has out there. When my doctor called with the results they were just going to give me a valtrex prescription and send me on my way. Luckily I already knew my result and had done research. It was until I BROUGHT UP the high false positive rates for someone with a  number low as mine that they said yes there is a high rate and that confirmation testing is a good way to go. I'm just glad Terrie Warren has made the western blot available to more people. If you can spare the $250 and youre between 1.1-3.5 i suggest getting the WB. If you're over 3.5 and have never had symptoms and can spare the $250 i would suggest getting it done just for the peace of mind.
3 Comments
I am in the same boat as you were right now. I just got tested in 09/2016 and the test came back positive for hsv1. I'm single and not sexually active. I'm so devastated by this and I cry almost every day. I want to get the western blot test. When my Dr called to give me the news they wanted to give me antivirals and send me on my way. I was so devastated that I didn't ask what my numbers were. I'm so stressed right now.
This is an old thread. Please start a new thread if you need help.
Thank you
Please tell me how to get this test
Avatar universal
Good news! Your advice is very wise indeed, thank you for reporting back.
Avatar universal
Current partner tested over 5.00 for HSVI and 3.66 for HSV II. I don't know what are my chances for contracting this.
Avatar universal
Dear Cat,

I came across your post probably on one of my most challenging times of my life recently finding out out my husband had cheated on me and subsequently my STD panel coming back positive for HSV-2.  It gave me hope.  Thank you!!!  For other folks researching data below

1) Tested 1-18-16
a) HSV-1 IgG Antibody negative (Value=0.11)
b) HSV-2 IgG Antibody positive (Value=3.27)

2) Same Sample follow up testing via HSV-2 IGG Inhibition Study result was positive on 1-19-16. Report notes: “This assay is intended only for samples giving a positive index in the HerpesSelect HSV-2 type-specific IgG screening ELISA. A POSITIVE inhibition study interpretation indicates true HSV-2 specific reactivity.”

3) From this forum it said get Western Blot which I did 2-3-16. Great news, results were Negative!!

IF others are in the have low value and also in my case no symptoms, please go get the Westerns blot! As vitrual365, noted, the test is $206.85 is what I just paid and approximately $95 for FEDEX overnight priority delivery.  I agree with Cat, it is hard to find a place to get your blood drawn, but be persistent!  It is worth it.Good luck and best wished to others who are going through the mind **##$$# mess that I have gone through the last several week.
3 Comments
I just got my igg test results from labcorp they were a 2.12... is there a possibility this is a false positive ?! Should I consider the western blot test?
Edit: for HSV-2
Yes, there is a good possibility - at least 50/50, depending on your exposures. Please start your own thread to ask specific questions so your responses don't get lost in this long and old thread.

If you're on a phone, at the bottom of the screen, there is a red bar with an Ask a Question button. Tap on that, and you can fill in the details.

If you're on a computer, at the top of every page, there is an Ask A Question button, either at the top center under the forum description, or at the top right.
15249123 tn?1478652475
COMMUNITY LEADER
Congrats on your good news.
Avatar universal
Hey everyone just wanted to share my story as well.

on 5/26/16

i tested positive for HSV 2 Igg antibody test.
During the test I've gotten a yeast infection from my previous high dose of antibiotics.
the test came back positive:

HSV type 2 Ab, IgG (index): 3.30

After freaking out for many hours and crying, i stumbled upon this post and learned about the western blot test. I asked my doctor for a retest but she even reassured me that the test they did on me is usually 100% accurate. But I just had to make sure.

the test came back from western blot says I was NEGATIVE for herpes! Anyone who tested positive for HSV 2 should take western blot test as well just to make sure. My insurance covered everything and I paid zero dollars, just have to go ask your doctor for the test and depending if your clinic have a blood lab then they'll draw it there and send it out for testing.

I hope this helps for anyone who is doubting their test as well!!!
3 Comments
Hello, was just wondering how you got your insurance to cover the western blot test? Are you located in Washington?
Hey! I need some help. Should I get this testdone?
Hey, I had yest infection also when I too the test ad was on antibiotic because of sinus infection so do you think I  should do this test?
15249123 tn?1478652475
COMMUNITY LEADER
Most insurance company's won't.
4 Comments
Gey! I have tested postive for 1 and 2. My range is like 4 for 1 and 5 for 2. What do yall think?
Pretty high numbers for a possibility for a false positive. Have you tested again ton verify?
I went into LabCorp last Friday and it came back the next day strange. It was even higher. I payed online cite called std and they found  labCorp in my city and I went in had it done.
The values will change a little between tests. Think of the result value number as a confidence number. The higher the number the more confident the test is it saw the antibodies it's looking for
Avatar universal
So do you think I should get tested again?
1 Comments
With numbers in the fives. I wouldn't usually anything over 3.5 is considered a clear positive
Avatar universal
I don't no what to do? I never had outbreak
5 Comments
So don't take another test?
You absolutely can. I would try to get the western blot test. It's a hassle but it will be definitive. I understand your stress over this and I feel for the position you are in.
Should I get on medication for this
Most people start antivirals because of an outbreak or frequent recurring outbreaks. You can if your worried about viral shedding.
Get tested again using the Western Blot test from University of Washington.It's the most accurate test
Avatar universal
Hi. So back on nov 2nd i got tested and my test came back equivocal at .97 for hsv2 and 40 for hsv1. (I got tested back in July and my hsv1 was also at 40 but hsv2 was negative). On dec 6th i got tested again and the hsv2 was 1.38 (from labcorp) at about 11 weeks. I personally had another test done on dec 12 from quest and I‎t came back at 1.62 at 12 weeks. Can the difference be due to different labs or do you think it’s be cause I’m still building antibodies to the virus? Should i check the IGg numbers at 16 weeks or is I‎t worth getting the western blot test now? Just looking for you opinion. Thanks
Avatar universal
I'm confused. I was under the impression that Quest no longer will do this blood draw, but others are saying it will. What exactly do I ask them to do? I thought from the initial post that I would have to ship the blood myself to W. of Washington and that getting a lab to draw and "spin" the blood for me and then give me the vial to send was what the biggest problem was. Can anyone tell me what specifically I am asking the lab to do that's different than what it normally does?
3 Comments
I haven't heard that Quest isn't doing this blood draw, but you have to have an order from a doctor to do it.

Why do you want to get it done?

If your doctor won't order one, you can go through Terri Warren at Westover Heights to get one - https://westoverheights.com/getting-a-herpes-western-blot/

It might be helpful if you start your own thread.  If you go here - https://www.medhelp.org/forums/Herpes/show/195 and then click the red and white "Ask A Question" button at the top of the page, or if you're on a phone, go to that link and start scrolling down, and the Ask A Question will appear at the bottom of your screen.
Thanks. It was Terri Warren who said Quest doesn't do it anymore.
I'm getting it as confirmatory testing for an equivocal first result and then a very low-positive 2nd result.
Oh well, she'd know more than I would since she does them.

Will your doctor order it? If your doctor orders it, then they will work with the Univ of Washington, who is the only place that does these tests, to get your blood handled by the lab.

If your doctor won't do it, then Terri will work with you to do that. Unfortunately, these are your only 2 options.
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