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HSV-2 False Positive Stats Question
Hello -
First, the facts:
- I'm asymptomatic.
- My HSV-2 IgG score came back with a 3.45
- My last sexual partner was roughly two months ago. We had oral sex and protected vaginal sex. Prior to that, my most recent partner was the same activities, but six months prior. Prior to that, I performed oral sex on a stranger that was, admittedly, skeezy. This occurred in roughly 21 months ago.
- The most my two most recent partners have not been explicitly tested for HSV-2, but are also asymptomatic, if they have it.
When I got the call from the clinic, they said that I would need to re-test in three months to confirm that I do, in fact, have HSV-2. This made me start researching odds about false positives, the range of IgG scores that yield false positives, etc.
I am looking for the following:
1) Scientific literature about the range of "normal" scores vs. the range of scores for asymptomatic people vs. the range of scores for people with symptoms
2) An explanation of why the Western Blot is more accurate and how much more accurate it is
3) Any reference material that discusses a way to definitively say that an asymptomatic person with an IgG score over in the 1.1 to 3.5 range has the virus--I saw one reference to PCR from spinal fluid, for example.
4) Scientific literature about the odds of a false positive occurring by a given IgG score and, ideally, an explanation of why these false positives happen
Anyone have any of that? I mostly seem to be finding links to this site.
Also, I just want to say that I am fairly frustrated that this testing is non-standard when asking for an STD screening. I was under the impression from the blood test prior to this one that I had a clean bill of health, but a new relationship in which I was asked specifically to check for HSV-2 has helped me determine that is not the case.
First, the facts:
- I'm asymptomatic.
- My HSV-2 IgG score came back with a 3.45
- My last sexual partner was roughly two months ago. We had oral sex and protected vaginal sex. Prior to that, my most recent partner was the same activities, but six months prior. Prior to that, I performed oral sex on a stranger that was, admittedly, skeezy. This occurred in roughly 21 months ago.
- The most my two most recent partners have not been explicitly tested for HSV-2, but are also asymptomatic, if they have it.
When I got the call from the clinic, they said that I would need to re-test in three months to confirm that I do, in fact, have HSV-2. This made me start researching odds about false positives, the range of IgG scores that yield false positives, etc.
I am looking for the following:
1) Scientific literature about the range of "normal" scores vs. the range of scores for asymptomatic people vs. the range of scores for people with symptoms
2) An explanation of why the Western Blot is more accurate and how much more accurate it is
3) Any reference material that discusses a way to definitively say that an asymptomatic person with an IgG score over in the 1.1 to 3.5 range has the virus--I saw one reference to PCR from spinal fluid, for example.
4) Scientific literature about the odds of a false positive occurring by a given IgG score and, ideally, an explanation of why these false positives happen
Anyone have any of that? I mostly seem to be finding links to this site.
Also, I just want to say that I am fairly frustrated that this testing is non-standard when asking for an STD screening. I was under the impression from the blood test prior to this one that I had a clean bill of health, but a new relationship in which I was asked specifically to check for HSV-2 has helped me determine that is not the case.
Congrats! I recently also received a neg confirmation result from WB and I tested pos at 2.43 with herpesselect.
I encourage anyone who has any doubts to get WB as confirmation with no history of outbreak.
We all are transformed people after the experience no matter positive or negative. I think it really help me to see what is important vs not.... Good decisions vs bad. The people who really loves you will not care as everyone is flawed in their own ways. I am certainly much more educated and grateful in everything.
God bless, S
I encourage anyone who has any doubts to get WB as confirmation with no history of outbreak.
We all are transformed people after the experience no matter positive or negative. I think it really help me to see what is important vs not.... Good decisions vs bad. The people who really loves you will not care as everyone is flawed in their own ways. I am certainly much more educated and grateful in everything.
God bless, S
Thanks for posting the story, I think it is a very important one on the topic of false positives.
As indicated above, when you have no lesions and a score of around 3.45 then the stats suggest 10% or more chance of being a false positive. The IgG test there had a reasonable doubt. You also know your own sexual history and the possibilities that they may or may not involve.
Your persistence in obtaining a WB test is a role model to many others in the same situation. There is never anything to be lost from taking this test in the face of any doubt. Being negative is not a huge statistical anomaly in your particular circumstances.
The test is as definitive as it gets. It exceeds the accuracy of a commercial IgG test by magnitudes. Whereas a commercial test has just one antigen, the WB uses the full virus protein signature to attract the antibodies from your blood.
I love your attitude around HSV2, because it is quite simply spot on!
As indicated above, when you have no lesions and a score of around 3.45 then the stats suggest 10% or more chance of being a false positive. The IgG test there had a reasonable doubt. You also know your own sexual history and the possibilities that they may or may not involve.
Your persistence in obtaining a WB test is a role model to many others in the same situation. There is never anything to be lost from taking this test in the face of any doubt. Being negative is not a huge statistical anomaly in your particular circumstances.
The test is as definitive as it gets. It exceeds the accuracy of a commercial IgG test by magnitudes. Whereas a commercial test has just one antigen, the WB uses the full virus protein signature to attract the antibodies from your blood.
I love your attitude around HSV2, because it is quite simply spot on!
So, I got my Western Blot results back -- They were negative. I think that this story warrants telling, though, so here it goes:
I live near the University of Washington--After a really lengthy process, I finally got an appointment with the Infectious Disease clinic there. I wanted to go to an expert because the amount of conflicting and/or misleading information I was finding online and hearing from people I knew who were doctors was a little overwhelming. I figured that I should go to the pros to hear exactly what was going on.
I walked in, told the doctor why I was there, and walked through my risk factors and total lack of recognized symptoms. I then said that, while I knew that it was a long shot, I was not going to be able to move forward with my life until I got a Western Blot confirmation of HSV 2. The doctor looked at me and said:
"I'll have to see if we do that test here."
I was shocked. I told her that, based on everything that I had read, the Western Blot was, in fact, only performed at the University of Washington. The doctor had to go and grab the attending physician. They were gone for 30 minutes while they looked up literature on the test and its efficacy at detecting HSV 2 versus the IGG test.
They both came back to the room and the attending physician basically said a version of the following:
"Look, your test says you have it. There's some evidence of false positive IGG scores in the 0.6 to 2.6 range, but you were well above that (3.45), so I think you should not be hopeful and that the test isn't going to tell you anything new."
To which I replied that I would like to go ahead and have the test anyway.
So, they sent me off to have some blood drawn after swabbing a bump on my lip and told me that they would be back in touch with me in a week or so. Sure enough, when the results came back, they were negative.
The thing I am struggling with now is that I have one positive test and one negative test, and I am trying to decide whether to move forward with the negative result or if I need to wait another few months to get tested for a third time to know for sure. The doctor who didn't know what a Western Blot was told me in the initial note that I was good to go, but when I wrote back to ask if another test was recommended, that same doctor told me that I should wait a few months and come back in, just to be sure.
So, I have one question: What are the chances that the WB could have delivered a false negative, and should I go ahead and move forward with my life as though I have a negative result?
And I have a few comments:
1) This experience is proof that a little bit of knowledge can go a long way if things turn out to be definitively good news for me. I had three doctors tell me "Don't bother getting tested--you're screwed."
2) Even though things are looking good for me, I know that I am a statistical anomaly. The fact that the WB didn't confirm the IGG is a total fluke, and is nothing to bet on.
3) Even if I had ended up getting it, I would have been fine. Everyone I told was very supportive and, essentially, said that it would be a non-factor for them in considering whether to date someone. More than that, the number of options available for people who are HSV2+ is pretty wide and encouraging.
4) If anyone reading this has it, know that I would not let it get in the way of dating you.
I live near the University of Washington--After a really lengthy process, I finally got an appointment with the Infectious Disease clinic there. I wanted to go to an expert because the amount of conflicting and/or misleading information I was finding online and hearing from people I knew who were doctors was a little overwhelming. I figured that I should go to the pros to hear exactly what was going on.
I walked in, told the doctor why I was there, and walked through my risk factors and total lack of recognized symptoms. I then said that, while I knew that it was a long shot, I was not going to be able to move forward with my life until I got a Western Blot confirmation of HSV 2. The doctor looked at me and said:
"I'll have to see if we do that test here."
I was shocked. I told her that, based on everything that I had read, the Western Blot was, in fact, only performed at the University of Washington. The doctor had to go and grab the attending physician. They were gone for 30 minutes while they looked up literature on the test and its efficacy at detecting HSV 2 versus the IGG test.
They both came back to the room and the attending physician basically said a version of the following:
"Look, your test says you have it. There's some evidence of false positive IGG scores in the 0.6 to 2.6 range, but you were well above that (3.45), so I think you should not be hopeful and that the test isn't going to tell you anything new."
To which I replied that I would like to go ahead and have the test anyway.
So, they sent me off to have some blood drawn after swabbing a bump on my lip and told me that they would be back in touch with me in a week or so. Sure enough, when the results came back, they were negative.
The thing I am struggling with now is that I have one positive test and one negative test, and I am trying to decide whether to move forward with the negative result or if I need to wait another few months to get tested for a third time to know for sure. The doctor who didn't know what a Western Blot was told me in the initial note that I was good to go, but when I wrote back to ask if another test was recommended, that same doctor told me that I should wait a few months and come back in, just to be sure.
So, I have one question: What are the chances that the WB could have delivered a false negative, and should I go ahead and move forward with my life as though I have a negative result?
And I have a few comments:
1) This experience is proof that a little bit of knowledge can go a long way if things turn out to be definitively good news for me. I had three doctors tell me "Don't bother getting tested--you're screwed."
2) Even though things are looking good for me, I know that I am a statistical anomaly. The fact that the WB didn't confirm the IGG is a total fluke, and is nothing to bet on.
3) Even if I had ended up getting it, I would have been fine. Everyone I told was very supportive and, essentially, said that it would be a non-factor for them in considering whether to date someone. More than that, the number of options available for people who are HSV2+ is pretty wide and encouraging.
4) If anyone reading this has it, know that I would not let it get in the way of dating you.
Please come back and let us know the result of your WB. I seen some situation with positive higher than yours comes back with negative WB. You have nothing to lose at this point and getting a confirmation will lead you to a better decisions in the futures ( protecting others).
I am getting my WB on Friday and I am like you ... Not wanting to get my hopes up but not knowing is killing me for sure. God bless, S
I am getting my WB on Friday and I am like you ... Not wanting to get my hopes up but not knowing is killing me for sure. God bless, S
The research odds would suggest at 3.45 that less than 10% of test results are false positives. Maybe this is a little higher if you have never had symptoms.
I wouldn't wait, there is no need to see a virologist. The Westernblot test is the best thing you can do right now. Print out some information about obtaining the test and take it to your doctor (assuming you are US based). Failing that, become a phone patient of the Westover Heights Clinic and they can get the test underway for you right now.
I wouldn't wait, there is no need to see a virologist. The Westernblot test is the best thing you can do right now. Print out some information about obtaining the test and take it to your doctor (assuming you are US based). Failing that, become a phone patient of the Westover Heights Clinic and they can get the test underway for you right now.
I know that this is a bit of a silly question to ask, but I have to try: What are my chances of getting some good news at my confirmation test? The girl I am currently seeing has made it clear that, if this comes back confirmed, she and I will break up. I don't find any real fault in her for this--she was very upfront about her stance on herpes before we even made out the first time.
I'm struggling with having a sense of how doomed I should feel this relationship is. Some of the things I read give me great hope, but they are mostly anecdotes. Some of the things I read make me think that a confirmation test is just a formality and that I am, in all likelihood, a carrier. Oddly, I'm not particularly concerned about the virus--it amounts to an intermittent and inconvenient rash--but I am torn up over what it would cost me in the short- and, potentially, long-term.
If I have a real fighting chance that my 3.45 is a false positive, I will hang on to that. If not, I'd like to know sooner than later so I can start bringing my head around to this new reality.
I already have requested a referral to a virologist. I'm hoping that he/she can shed (ha!) some light on the topic....but there is likely a long way between now and that appointment.
I'm struggling with having a sense of how doomed I should feel this relationship is. Some of the things I read give me great hope, but they are mostly anecdotes. Some of the things I read make me think that a confirmation test is just a formality and that I am, in all likelihood, a carrier. Oddly, I'm not particularly concerned about the virus--it amounts to an intermittent and inconvenient rash--but I am torn up over what it would cost me in the short- and, potentially, long-term.
If I have a real fighting chance that my 3.45 is a false positive, I will hang on to that. If not, I'd like to know sooner than later so I can start bringing my head around to this new reality.
I already have requested a referral to a virologist. I'm hoping that he/she can shed (ha!) some light on the topic....but there is likely a long way between now and that appointment.
Answering your questions:
1. There is no correlation between the values and outbreak frequency. I am not aware of a paper to this effect but have seen it stated I believe by the likes of Terri Warren.
2. The University of Washington website has details on the Westernblot test and why it is accurate. As I understand it, it looks for a greater range of antibodies in four different size bands. The detail in the reports on their website is very good.
3. A good paper is by Golden, Morrow, Swenson, Hogrefe, Hansfield and Wald. They conclude that be comparison to Westernblot that Herpselect has a number of false positives and the cutoff should be greater than 3 in certain circumstances.
4. No one really knows why they happen, but it is believed that proteins unrelated to proteins stick to the testing wells. I have seen the doctors quote some figures suggesting it decreases from 70% false positives at 1.1 to 5% at 3.5.
There are reasons why the medical profession and organizations such as CDC do not recommend blood tests. It pertains to the anguish caused by false positives or actually knowing outweighs the actual impact of the virus. Further, what can you do anyway if you are infected? Not my arguments, but not sure I have a great rebuttal either.
1. There is no correlation between the values and outbreak frequency. I am not aware of a paper to this effect but have seen it stated I believe by the likes of Terri Warren.
2. The University of Washington website has details on the Westernblot test and why it is accurate. As I understand it, it looks for a greater range of antibodies in four different size bands. The detail in the reports on their website is very good.
3. A good paper is by Golden, Morrow, Swenson, Hogrefe, Hansfield and Wald. They conclude that be comparison to Westernblot that Herpselect has a number of false positives and the cutoff should be greater than 3 in certain circumstances.
4. No one really knows why they happen, but it is believed that proteins unrelated to proteins stick to the testing wells. I have seen the doctors quote some figures suggesting it decreases from 70% false positives at 1.1 to 5% at 3.5.
There are reasons why the medical profession and organizations such as CDC do not recommend blood tests. It pertains to the anguish caused by false positives or actually knowing outweighs the actual impact of the virus. Further, what can you do anyway if you are infected? Not my arguments, but not sure I have a great rebuttal either.
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Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
