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Avatar universal

HSV2 Herepeselect test false positive? (GRACE HELP!)

I recently tested positive for HSV2 (herpes) with a score of 1.19. I was told by my doctor that this was a high score and that there was no doubt in his mind that I was exposed to herpes at some point in time. I was shocked and couldn't believe it. I had had unprotected sex about 5 weeks earlier but it was with a person I knew and who is very careful and smart (not saying that makes it less likely exactly but Im just saying.) The test that I took was the HSV 2 IGG Type specific AB Herpeselect test from quest diagnostics. I went home after receiving these results and couldn't believe how many stories I had found about people being given false positives especially with the amount of scores as low as mine. Some of these posts however seemed to be a bit out dated and I was wondering if they have fixed they test by now or is there still a high probability that I have a false positive? I just ordered my Western Blot test and its on its way from the University of Washington (have to wait 3 months after possible exposure for testing correct?) I have done a lot of research on this but Im still unaware of what the chances are that I have a false positive, If anyone has that percentage that would be great as well. Thank You

PS-I understand that Grace is very knowledgable when it comes to these questions so if you could answer Grace that would be much appreciated. Please and Thank you.
11 Responses
Avatar universal
You should wait 4 months with the Western Blot for 93% accuracy.  For 99% it's 6 months.  That's specific to the Western Blot and those figures were given to my by the U of Washington lab.

Regarding your test.  I agree that you should retest with a score that low.  Doesn't meant that the MD is wrong, but typically the HSV2 score would be higher with a SURE-THING positive diagnosis.  Could be a new infection.  Could be a false positive altogether.

No symptoms?  Whats your HSV1 status?
Avatar universal
I had a small pimple like thing on the neck of my penis that kinda freaked me out, i kinda scratched it off in the shower and it healed within 4 days, it didn't hurt or itch. Other than that I have no symptoms except for the fact that my legs sometimes feel weak but I think that is related to nerves and anxiety over this whole ordeal. The symptoms such as the flu like symptoms, back pain and muscle aches would all come before an outbreak correct? Or is that something that consistently happens when you have HSV 2 whether you have an outbreak or not? I was unaware that it is only recommend to take this test if you are high risk of the virus otherwise i never would have taken the damn thing, I didn't it to just simple be precocious. The doctor didn't test me for HSV 1 because he said "everybody has that" but I have had canker sores my whole life so It wouldn't surprise me if I did have HSV 1.

Do the Herepeselect test still have a high probability of being false positive?
Avatar universal
You're gonna need to know whether or not you already have HSV1 because a pre-existing HSV1 infection (which 65% of Americans have ...a far cry from "everybody") actually makes it more likely that a false positive could occur.

yes and no.  compared to other, better tests - like the HIV antibody test for example - the Herpeselect does yield a high percentage of false positives.  But, it's not so much so that "positive" scores should be neglected.  For the most part, it's a very good test, which is why it is FDA approved when many other tests are not.
101028 tn?1419603004
yes, there are still high false positive issues with the test unfortunately.

honestly at this point I'd just repeat the herpeselect test at the 3 month mark and go from there. if that returns with a low positive again, then I'd spend the money for the WB.  

canker sores and cold sores are two completely different things. You can have one without having the other too. It's well worth knowing your hsv1 status too.
Avatar universal
Grace,I would really just prefer to go ahead and do the WB instead of doing another herepeselect test. If my test score was 1.19 at 5 weeks do you think a WB test would be reliable at 12 weeks? I already have the WB on its way in the mail and would like to just go right to the reliable source. I would take the biokit test or POCkit test if i could find it but know body in Florida seems to offer it. What do you think the chances are that this is merely a false positive? Ive been trying to find percentages of it being false positive online but cant seem to find anything but I have seen were other people have talked about there percentages of it being false positive.

Also, The symptoms such as the flu like symptoms, back pain, muscle aches, etc. would all come before an outbreak correct? Or is that something that consistently happens when you have HSV 2 whether you have an outbreak or not?
Avatar universal
If you had a Herpeselect test, the a 1.19 score, if you have never had lesions, has about a 70% chance of being a false positive.

Symptoms for HSV2 at an initial outbreak can include the flu like symptoms that are related to the body making antibodies for the first time to fight the virus. They are often not experienced later. In fact regular flu can be a trigger for a herpes outbreak rather than a result of the herpes outbreak.

I agree with Grace, I think there is more value in asking your partner to test and follow up at 16 weeks with another IgG test before Westernblot.
Avatar universal
Okay thank you very much! Out of curiosity where did you come across that 70 percent? So Just so I make sure I understand this, the flu like symptoms come at the same time as the "outbreak" not before or after or in the middle of? When you say later do you mean later outbreaks? Also, what exactly is considered the outbreak, when you first get lesions or when they break open and become ulcers? Sorry about asking so many questions, Im just wondering so I know what to keep and eye out for if something is to come up before my test. Again thank you very much, I have been so stressed out about this since I got these results back that I think Im literally making myself sick, I cant think about anything but this.
Avatar universal
I recall the figure from answers by Terri Warren. I believe that the figures are intuitive based on the work of Golden that identified that using a cut off of 3 for Herpeselect was required to increase the certainty that an infection exists.

The chance of a false positive falls from about 75% at the 1.1 level to 5% at 3.5 for those without outbreaks.

Don't bother waiting for a herpes lesion, they just appear in their own sweet irregular way. The fact that you've never had an outbreak would suggest that you are not about to have one soon, infected or not.

The flu symptoms would accompany the outbreak, present at the same time. This is related to your preliminary immune system response that kicks in within a couple of days of infection, about the same time lesions appear.

Once your body's immune system is fully addressing the virus, flu symptoms, such as aches and lymph node expansion will not typically occur.

An outbreak is an outbreak, from the time that the skin area shows signs of an emerging lesion until they heal.
101028 tn?1419603004
you have to wait the full 16 weeks for the WB.  No sense in wasting money testing early.

whether or not you have flu like symptoms has a lot to do with your prior hsv1 status which for you at this point in unfortunately unknown thanks to your doctor's wrongful attitude about hsv1.
Avatar universal
So what your saying is that if I had hsv1, I probably wouldn't have the flu like symptoms? Also, I have questions about the leg pain/ achyness, is that like the flu like symptoms where it only presents during the outbreak or can you have it afterwards? And what does it feel like? My legs have been feeling strange lately and Im concerned that I might have maybe had an outbreak and missed it or something.
Avatar universal
I think you are just retrofitting some feelings into a herpes infection based on the HSV2 result. Chances are that if you have HSV2 not all the symptoms you are describing would be related.

I feel confident your follow up testing will be negative from 16 weeks.
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