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Interpretation of HSV 2 results
I received today positive IgG test results for HSV 1 (5.46) and HSV 2 (2.99). The test results state "Positive
indicates antibodies detected to HSV−2; coinfection with HSV−1 cannot be excluded without type specific
testing."
I have read on this forum that an HSV2 result less than 3.5 where there is a positive HSV 1 result is considered by infectious disease experts to be a "low positive" and could be indicative of a false positive. I have had no symptoms (other than a couple hours of fleeting stinging sensation while urinating a week ago and a similarly very slight and fleeting testicular pain a few days after). I have had no outbreaks and other than some slight discoloration on the crown of my penis, no tangible skin issues or skin discomfort. My last unprotected genital to genital sexual encounter was in late July. I have never had any cold sores but am fairly certain i was infected with HSV1 as a child.
1. How would you interpret my results?
2. What next steps would you recommend I take? Should I seek to validate the results with other tests and if so which ones?
3. If the result is confirmed to be positive, is there any way to determine whether the one unprotected encounter in late July resulted in a transmission.
4. Is it possible I have been infected for many years and not know it?
Thanks so much for your assessment and advice.
indicates antibodies detected to HSV−2; coinfection with HSV−1 cannot be excluded without type specific
testing."
I have read on this forum that an HSV2 result less than 3.5 where there is a positive HSV 1 result is considered by infectious disease experts to be a "low positive" and could be indicative of a false positive. I have had no symptoms (other than a couple hours of fleeting stinging sensation while urinating a week ago and a similarly very slight and fleeting testicular pain a few days after). I have had no outbreaks and other than some slight discoloration on the crown of my penis, no tangible skin issues or skin discomfort. My last unprotected genital to genital sexual encounter was in late July. I have never had any cold sores but am fairly certain i was infected with HSV1 as a child.
1. How would you interpret my results?
2. What next steps would you recommend I take? Should I seek to validate the results with other tests and if so which ones?
3. If the result is confirmed to be positive, is there any way to determine whether the one unprotected encounter in late July resulted in a transmission.
4. Is it possible I have been infected for many years and not know it?
Thanks so much for your assessment and advice.
MEDICAL PROFESSIONAL
1). Yes, we have certainly seen this. It is a realistic possibility
2) I understand your confusion. Symptoms can be more general, outbreaks are actual breaks in the skin with sores, generally. I would not describe a full feeling in the scrotum as an outbreak, and it is a stretch to call it a symptom of herpes either.
3) you cannot know if this is a first infection of recurrence if you do indeed confirm as positive with the western blot.
Terri
2) I understand your confusion. Symptoms can be more general, outbreaks are actual breaks in the skin with sores, generally. I would not describe a full feeling in the scrotum as an outbreak, and it is a stretch to call it a symptom of herpes either.
3) you cannot know if this is a first infection of recurrence if you do indeed confirm as positive with the western blot.
Terri
Terri: yes, that makes great sense. I will wait until 16 weeks and will seek the WB. Two follow-up questions: 1) have you seen many instances in which positive results on the Elisa test came back negative on the WB and is there any way of knowing from my score of 2.99 whether that is a realistic possibility? 2) I read the Westover handbook and am having trouble distinguishing between "symptoms" and "outbreaks." Other than a fullness feeling in my scrotal area with some slight testicular discomfort, and some slight, fleeting stinging when I urinate which has largely subsided, I have had no discernible changes in my skin of any kind. Is it possible I could show no symptoms or have no outbreaks for a long time or do outbreaks occur relatively soon after infection? How will I know if its a primary initial or non-primary outbreak? I really appreciate your expertise and guidance. Thanks.
MEDICAL PROFESSIONAL
1. You have a low positive HSV 2 result which needs confirmation with another test, preferably a western blot.
3. If the test confirms that you have HSV 2, there is no way to know when the infection occurred, no.
4. Yes, it is certainly possible that you have been infected for years and didn't know it.
Don't get too far ahead of your self, though. First confirm that the HSV 2 result is either real or not. You can get the western blot in two ways: you can send a request of the University of Washington for a test kit. Your health care provider will draw blood and return it to the University of Washington for testing. Also, you can become a phone patient of our clinic and we can order the western blot for you to be drawn at a Quest lab near you and sent to the University of Washington for confirmation.
Which ever way you do it, you need confirmation. Half of the positives in the low positive range (1.1 to 3.5) do NOT confirm as true positives.
Having said all of this, I must say that doing the western blot now is too soon. The western blot takes longer to become positive than the ELISA that you had done. I would wait 16 weeks from the encounter to do the western blot for greatest accuracy. If you do it and now and it is positive, then I would rely on that, but if you do it now and it is negative or indeterminate, you will still need to retest to know more clearly what is really going on. Does that make sense?
Terri
3. If the test confirms that you have HSV 2, there is no way to know when the infection occurred, no.
4. Yes, it is certainly possible that you have been infected for years and didn't know it.
Don't get too far ahead of your self, though. First confirm that the HSV 2 result is either real or not. You can get the western blot in two ways: you can send a request of the University of Washington for a test kit. Your health care provider will draw blood and return it to the University of Washington for testing. Also, you can become a phone patient of our clinic and we can order the western blot for you to be drawn at a Quest lab near you and sent to the University of Washington for confirmation.
Which ever way you do it, you need confirmation. Half of the positives in the low positive range (1.1 to 3.5) do NOT confirm as true positives.
Having said all of this, I must say that doing the western blot now is too soon. The western blot takes longer to become positive than the ELISA that you had done. I would wait 16 weeks from the encounter to do the western blot for greatest accuracy. If you do it and now and it is positive, then I would rely on that, but if you do it now and it is negative or indeterminate, you will still need to retest to know more clearly what is really going on. Does that make sense?
Terri
You are reading content posted in the Herpes Forum
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.
