Avatar universal

Is this a reasonable reading after 7 years? False pos?

Thank you first of all for your time.
I have what I have come to believe is a herpetic whitlow on my right thumb. The first issue with it was back in 2009, though I did not begin to suspect Herpes as the cause until 2012.
I am married and my husband and I are both monogamous, so by the time I suspected Herpes, it was rather pointless to worry about it. Either we both had it, or we don't.
I'm now 17 weeks pregnant with our first child (my second, first from a previous marriage long before 2009).
My OBGYN requested a type specific IgG test last week which was done at Alfa Labs in Egypt.
The results are as follows:
HSV-1 IgG  2 Eu/mL (Reference range Negative less than 20)
HSV-2 IgG 24 EU/mL (reference range negative less than 20)

I assume this correlates to a 0.2HSV1 and 2.4HSV2 for the US tests as the range is under 20 not under 2.

My question is this... the initial outbreak is now almost 7 years ago... with zero chance of a new infection. The infection would definitely be 7 years or longer ago.
I know that anything lower than 3.5 is questionable and possible to be false positive, and the closer to 2 you are the more likely you are that it is a false positive.

Does this result look reasonable for a false positive? I'd assume that antibody levels after 7 years would be significantly higher than 2.4, but I/m having difficulty finding anything to say if antibody levels rise, or remain steady.

As for the finger... symptoms are as follows...
I typically get an even number of "dots" on my thumb, always the right thumb. Five years ago my arm muscles would tense up and be extremely sore for a day or two in advance, then I'd get an itchy area, then the dots would appear very tiny, they would merge into one larger clear fluid filled bump which would open, and the instant it opened all pain disappeared. It would take a week or more for the area to heal, and then I'd not have another issue for a month.

As time has gone on, the muscle tension/soreness no longer occurs. Occasionally I get a pain in my joint which is lessened by cracking my knuckle (so I know a spot will appear in a day or two when I have the urge to crack my thumb). I know it's bad, but I have found 100% relief if when I see the first "dot" if I use a thin sterilized pin to prick it and remove a bit of the clear liquid. I clean my hands and the area thoroughly and keep it bandaged for a week afterward. If I let it go until several dots show and then "collect" into one, it can be quite a bit more painful, and take much longer to heal.
I have dot every month right before menstruation, so I expect it's triggered by something hormonal.

I do NOT have genital outbreaks that I'm aware of, though I have been known to get an infected hair folicle on occasion, but it's not side or area specific, and it does not at all appear like pictures of genital herpes online.

*Complication* I'm in Egypt. It is not possible here to get additional testing or the Washington Lab tests. Doctors here are exceedingly resistant to any outside advice/suggestion. Nor will they do a swab.

I do plan to go back and get a second test in a few weeks to see how the results come out, but based on the length of time since my first lesion on my finger (7 years) and now, and the low result 2.4 ... what is your opinion?

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3149845 tn?1506627771
Hi, not much is known about whitlow but its estimated that about 60% of the cases are from hsv1 not 2. What we do know is that its most often acquired with someone with a recent infection as with an older one antibodies would be there to prevent contracting.
So this is the issue of a recent infection. Since your hsv1 was negative we can rule that out as the cause. Your hsv2 does fall into a false positive range. Low positives most often mean either a false positive or a recent infection. So the only way to know is another blood test. 8 weeks is a good indicator and the Western Blot is the best test to take. Since we dont believe youve recently contracted hsv2 because of your faithful relationship, its very most likely a false positive.
It would be good to have a new sore swabbed with in 48 hours after appearing.
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3149845 tn?1506627771
continued, its i important to have your male friend tested as this would eliminate him as the cause.
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Avatar universal
The test seems like a Euroimmun test. I believe 20-25 is equivocal. Most people with the infection will test 70 plus. The test experiences false positives just like Herpeselect. I'd suggest your reading is more like 1.05 Herpeselect although there isn't really a comparison.

Given your circumstances, I'd suggest this was very likely a false positive.

HSV2 is very rare outside of genital or oral areas and would be most unlikely to cause regular symptoms outside of the genital area. I doubt what you describe with your thumb is HSV2, possibly you are reverse engineering an explanation for the HSV2 result, which is unlikely to be positive.

I think for now the best you can do is retest in at least a few weeks.
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Avatar universal
Thank you both so much for the help.
I've a secondary question, you seem very knowledgeable. Is there anything that could cause someone who is sincerely positive for that long to maintain a very low IgG count? Due to the pregnancy, i just had a whole blood panel done, and my white counts are normal and all, so I *shouldn't* have any reason to think I'm immuno surpressed or anything. Would having a low (but truly accurate) IgG count be why I have monthly sores, as opposed to folks who have 1 or 2 in a year?

Yes, you're correct about the reverse engineering. I struggled to find an answer for my thumb for those 5 years between when it first occurred and 2012, when I mentioned it to a co worker who is a doctor, and she immediately said "it must be viral, if it's always on the same thumb. Have you been tested for Herpes?" Went home, did a ton of reading, and thought well, darn it could very well BE a whitlow, and talked it over/cried it over with husband then. i never really questioned it after that. I bit my nails literally to the bleeding point for 25 years of life, and assumed I very well could have contracted it from non sexual contact with a cold sore or other bodily sore and left it at that. Until today.
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Avatar universal
Yes fair point, pregnancy in a small number of people may result in a depressed reading. I still believe what I wrote to be correct.

Your thumb doesn't sound like HSV2. HSV1 would be far more probable, even then there's something that seems out in your presentation for even that.
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