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How reliable are positive HSV2 supplemental test results?

I was tested for HSV2 in February just to make a partner feel better. I usually test for everything, including this, in June each year and had last tested negative in June 2019. In February, my test came back with a low positive for antibodies (1.95) and a negative specific test. Since then, I haven't been with anyone except my new partner, who tested negative in November and hasn't been with anyone but me in a year. I went in for my annual exam in June and had slightly elevated HSV2 antibody levels (1.08) but a positive specific test. The doctor said that the February negative could indicate a recent exposure then. I've since talked to every man I was with (safely too!) in the 4 months before February's test, and all have tested negative so far. The one woman I was with isn't able to convince her doctor to test her without any symptoms. I too have had no symptoms. So my question is, could this recent HSV-2 IgG Supplemental Test be a false negative given my lack of symptoms or obvious source? Or was the February specific test a false negative? Note that neither test result gave me more information about what test was run than the fact that it's supposed to be HSV-2 specific.

I did request a kit for a Western blot test today. I'd rather pay for that and get the question of positive or negative answered definitively. This positive test seems likely to end my relationship with my new guy. Sigh. This question is really just to help me set my expectations until that test result comes back.
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The Western Blot test results finally came back yesterday after 4 weeks (I think they're busy with covid-19 testing at the moment). Negative for HSV2, as we suspected given the drop in antibody levels February to June, the negative supplemental test results in February, the lack of symptoms, and having no obvious source. Yay!

That false positive result though probably ruined a really great budding relationship, and the whole ordeal was emotionally painful and expensive. I really do now understand the CDC guidance on not testing without symptoms. This has been a mess. :(

All that said, many thanks, auntiejessi, for pointing out the facts that made that positive seem less likely and keeping me calm. That was much appreciated! I was going to be ok with being positive for HSV2 after reading more on these pages, but it was helpful to know that I was likely actually negative.
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I'm really happy to hear you finally got the results, and that they were negative, as we suspected.

I am sorry that it ruined your relationship. I'd like to think it wasn't meant to be, and you found out early on, but that's easy for me to say, as someone not involved. I know it sucks. It is a mess - a painful, expensive one. Sending you hugs!

You're quite welcome, and I'm glad I could help! We're here if you ever have questions or need anything. Take care of you. :)
207091 tn?1337709493
Hi -

Can you tell me what you mean by this:

"had slightly elevated HSV2 antibody levels (1.08) but a positive specific test"

What is the positive specific test? Is that an IgM test? If that's the case, ignore the IgM because it's terribly unreliable, and the CDC and every single expert in the field says that test should never be done for herpes. It's designed to look for new infections, but it's wrong at least as often as it's right.

A test result of 1.95 has probably an 80-85% chance of being a false positive. The supplemental tests are new, and from what I've seen so far, the negative results seem good. I've seen positive ones that end up negative on the Western Blot, though.

I'm glad you're getting the WB. That will resolve this. I'm sorry your relationship is ending over this, but that just means he's not your guy, and to be honest, he scares way too easy lol. You deserve better. I always say that herpes isn't ever a good enough reason to leave a good relationship, or to stay in a bad one. Whatever happens, you'll be okay. :)

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Thanks, Jessie! Much appreciated. That's good to know about the supplemental negative results being more reliable than the positives. That's what I had gathered from reading up on all HSV2 tests lately. The supplemental test in February came back negative, and I'm pretty sure there was no exposure between then and the positive June test. The 1.95 result but negative supplemental test in February made my doctor think in June that perhaps I'd had some exposure recently when the February test was done. At this point, everyone I've been with since last September has been or is getting tested, and so far everyone has come back with negative results.

I don't know exactly what the supplemental test was. They did it because the screening test in June showed that 1.08 that's in the equivocal range. It's not IgM though, since it's listed on the test report from LabCorp as "labgenerated HSV-2 IgG Supplemental Test."

I'm polyamorous, and most of my partners have shrugged this off. It's only one relationship (which is why I had the extra test in February) that is strained by this. That particular partner is definitely scared. He's the only new person in my life in the past year though, and I do trust that my other partners are honest and open about their test results and how they are taking this.
Has the partner that is scared been tested? Is he scared that you may have transmitted it to him, or he may have transmitted it to you? Is he the partner you tested for?

I've seen a lot of false positive HSV2 IgGs - way too many to count. Since your result went down - not up - and you had the negative supplemental test, I'd be really surprised if you ended up positive on the WB. Obviously, I can't say with certainty that you don't have it, but I'd be really surprised.
Thanks, Jessi. That makes me feel better.

Yes, this is the partner that I tested for in January when I normally just test at my annual each June. He tested negative in November as our relationship was starting and hasn't been with anyone else since well before then from what I understand, so he's worried about getting it from me and not having given it to me. Neither of us had a fluid bonded partner and both of us had been thoroughly tested, so we've been having unprotected sex. I haven't had sex with anyone except him since February. I stayed with him March-May until he went to Germany to spend some time with his family, and we were quite active, thinking that both of us were negative. He hasn't tested since November since he's out of the country and his job and health insurance are here in the US. He plans to when he comes back, probably in September.
Tested for in February, not January. Whoops!

For clarity:
Tested June 2019:
  IgG screening test: < 0.9 - negative

Tested in February 2020:
  IgG screening test: 1.95
  confirmatory test: negative

Tested in June 2020:
  IgG screening test: 1.08
  confirmatory test: positive
Thank you for clarifying that. I think I was confusing your supplemental test dates.

In any case, your IgG results went down from Feb to June, which indicates you aren't positive, even though your supplemental test went from neg to pos.

When are you getting your WB?

I went back and re-read the entire thread, and I think I missed where you said your female partner was having a hard time getting tested. If she feels the need to, she can go to STDcheck.com and get it done, but she will have to self pay. They have packages - you can get a 10 panel that has a bunch of tests most people don't need, but it's cheaper to do it that way than to break it down and just pay for the tests you do need. If she just wants herpes testing, that's cheaper, but if she wants chlamydia and gonorrhea as well, she might as well pay for the rest.

Their cost of an HIV test is insane when in most places, you can find low cost or free HIV testing. If her sex partners are only women, she is at very low risk for HIV.

Your partner in Germany would likely have a hard time finding herpes blood testing there. Europe, in general, is not a fan of the blood tests.

I'm sorry this is so hard. It shouldn't be, but it often is. :(

Thanks. Actually, my female partner will be tested on Monday. I talked to her and her husband the other night (he tested negative in May - I was last with him in February and her New Year's Eve when we were all together), and with the new information about my test, she thinks her doctor will do it. She's generally with men, but we sometimes play together with her husband. We're really just concerned about that positive supplemental HSV2 test I had in June. No one has tested positive for HIV, and we all check regularly.

I think my WB package should arrive today or early next week, so I plan to ask my doctor about the blood draw on Monday.
There's another post here from KayVee20, who in February, had similar test results, and got a WB, and she just posted that her WB came back negative. :)


I hope your female partner doesn't run into any trouble testing. It's ridiculous that people have to all but beg for STD testing. Yes, there is an issue with false positives, but obviously, she knows that going in.

Good luck with your blood draw, and keep me posted. :)
Thanks! I'd noticed that one too. This is all making me feel better. :)

Yes, my female partner was tested yesterday. I expect all will go well there.

My WB kit came in today and I left a message with my doctor about setting up the order and blood draw. Hopefully I can get that done this week. Prices for the test have gone up based on other posts I've seen here, by the way. UW asks $253.31 for the test! It's worthwhile to me for peace of mind, but that's more than I expected.
Yeah, it's expensive as crap. Is your insurance (if you have it) paying for any of that?

Keep me posted. :)
I didn't try to charge my insurance, since it seemed unlikely that they would cover it. Perhaps they'll handle the blood draw, which I just went to my doctor for this afternoon. With $253 for the test and $82 for the overnight shipping, this is not a cheap test. Mine should arrive there by 10:30 am tomorrow though, and I should have a result in 3 weeks.
No, it isn't cheap. I'm sorry you have to go through this. It's an awful process - not physically as it's just a blood draw, but emotionally, financially, time, etc.

Try and submit it to your insurance. The worst they can do is say no.

Good luck!
Still waiting on the WB results of course (blood sample arrived there last Friday morning), but there is some news from my female partner. She has basically the same results I had in February: 2.76 on the IgG screen and a negative on the supplemental test. She'll wait to see what my WB results are and follow her doctor's recommendation to test again in a few months.

I am really understanding at this point the CDC recommendation to not screen for this with these unreliable and confusing tests! It's just stressful on everyone in our circles, and all with no symptoms in any of us. :(
Ugh I'm sorry. I wish it were easier. It's 2020, and we need better testing, but I'll spare you that rant.

Thanks for the update. I really hope the WB helps clear this all up.
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