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Herpes test positive then negative

Hi Terri,

A few years back I got screened for Herpes and I had a test come back positive with an IgM titer of 0.93 (the doctor explained that above 0.9 is considered positive and I should do another test since the value is low).

I got retested about a month later, and had the following results in this second round:
IgM 1.13: positive
IgG 2.21 (Type II): positive

A test for Lyme disease done as part of the same physical also came back as positive (titer 0.96 with <0.9 being negative). I read that the Lyme test can cross react during a Herpes infection.

The results came as a surprise, so I got retested a little over a week later. This third round came back negative for IgG (doctor received no titer value from the lab, just an indication that it was <0.9). No IgM testing was done.

I had left it at that for a few years, but decided recently to get tested again. The test was a Herpeselect typespecific antibody test with the following results:
IgG Type I at 0.25 (negative)
IgG Type II at 0.26 (negative)

Considering that both IgM and IgG were positive in the second round, I am still worried that something may be wrong. How should I interpret these results?

Thank you!
4 Responses
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55646 tn?1263660809
I've seen false positives with and without HSV 1, but more with HSV 1 infection.

Terri
Helpful - 0
55646 tn?1263660809
I would agree that many times, the person with a false positive for HSV 2 have HSV 1.  However, any test that comes back in the 1.1 to 3.5 range needs confirmation.  But now you have a clear negative, so I would move on.

Terri
Helpful - 0
Avatar universal
Thank you, Terri! I read that most of the problems in the 1.1 to 3.5 range are due to cross-reactivity with HSV-1. Since I tested negative for that, does it still apply to my HSV-2 titer results?
Helpful - 0
55646 tn?1263660809
First, 0.9 is NOT positive, it is equivocal.  Which means it is neither positive nor negative, technically.  The ELISA test that you had done has some problems with false positives in the low positive range (1.1 to 3.5).  Your value was in that range.  Since you have a clear negative now, if you were my patient, I would encourage you to accept that you are negative for HSV 2 and move on.  If you need more reassurance, you could have a western blot done, but really, I think you are good to go.  The IgM is useless - ignore it.

Terri
Helpful - 0

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