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Positive and Negative HSV2 Results
Folks, I really don't know what to think. I had a protected contact with a female, whose status I did not know. I got nervous and got STD tests done about 3-4 weeks after contact. All tests have come back negative, except the following scenario. The first HSV test was an IGG test (not sure if it was type specific) at Planned Parenthood. The test result came in positive for HSV2 (HSV1 was negative) - at about 1.36. I then took a type specific HSV1/2 IGG test a few days later (done through Labcorp) that was completely negative for both HSV 1 and 2. I went to my doctor at about week 4, and he tested me for all STDs. Everything was negative, except the IGG HSV2 test, which was positive at about 1.34. So, in this 4 week window, I had one slightly positive test (not sure the type of test run by Planned Parenthood), one type specific test at Labcorp which was negative, and one IGG test from my doctor that was slightly positive. There have been no other contacts since this last contact.
During this time, I was feeling some irritated skin sensations underneath the base of my penis - between the penis and scrotum. I have noticed that I think I have sebaceous prominence underneath the shaft of my penis, but I'm not sure if this can cause any skin irritation. It's amazing what you find when you are really looking! I also have what my doctor has determined is come kind of heat rash on both sides of the inside groin area - which I have battled for quite some time - between the leg and groin area. It doesn't really bother me at all, but I wonder if it is a bacterial infection?
Here is the part that I just can't understand. It is now week 12, and I took the IGG HSV1/2 Type Specific test again (done through Labcorp) and HSV1 and HSV2 are both negative. What the heck am I supposed to believe? Am I negative or positive for HSV2?
I am still feeling some irritation between my penis and scrotum, but I have never had an outbreak of any kind. I have several questions that I need help understanding:
1) Is 12 weeks after contact a reasonable amount of time to feel pretty good that I do not have HSV2?
2) Are my previous HSV2 positive test results so low that they could be false positives?
3) If one were really positive for HSV2, wouldn't the level of antibodies increase in the body, making the HSV2 test result numbers significantly higher after 12 weeks?
4) At 4 weeks, I tested negative for gonorrhea, syphillas, clamydia, and HIV was negative after 12 weeks. Are there other STDs that could cause this irritation if it is not from HSV2? What about HPV? I have not been tested for this.
Thanks.
During this time, I was feeling some irritated skin sensations underneath the base of my penis - between the penis and scrotum. I have noticed that I think I have sebaceous prominence underneath the shaft of my penis, but I'm not sure if this can cause any skin irritation. It's amazing what you find when you are really looking! I also have what my doctor has determined is come kind of heat rash on both sides of the inside groin area - which I have battled for quite some time - between the leg and groin area. It doesn't really bother me at all, but I wonder if it is a bacterial infection?
Here is the part that I just can't understand. It is now week 12, and I took the IGG HSV1/2 Type Specific test again (done through Labcorp) and HSV1 and HSV2 are both negative. What the heck am I supposed to believe? Am I negative or positive for HSV2?
I am still feeling some irritation between my penis and scrotum, but I have never had an outbreak of any kind. I have several questions that I need help understanding:
1) Is 12 weeks after contact a reasonable amount of time to feel pretty good that I do not have HSV2?
2) Are my previous HSV2 positive test results so low that they could be false positives?
3) If one were really positive for HSV2, wouldn't the level of antibodies increase in the body, making the HSV2 test result numbers significantly higher after 12 weeks?
4) At 4 weeks, I tested negative for gonorrhea, syphillas, clamydia, and HIV was negative after 12 weeks. Are there other STDs that could cause this irritation if it is not from HSV2? What about HPV? I have not been tested for this.
Thanks.
To the last two posters, I cultured positive for HSV1 a year after my exposure, with no encounters during that time. My blood tests have never been positive.
I had 13 negative IgG tests and one negative Western blot (up to 11 months out). My IgG index values were around 0.50 three times that I saw them.
Until the outbreak at a year I never had "typical" symptoms, much of my symptoms were like those of the original poster. I don't want to be a fear monger, but I think it's prudent to let you know of my experience.
I had 13 negative IgG tests and one negative Western blot (up to 11 months out). My IgG index values were around 0.50 three times that I saw them.
Until the outbreak at a year I never had "typical" symptoms, much of my symptoms were like those of the original poster. I don't want to be a fear monger, but I think it's prudent to let you know of my experience.
I am going thru the same thing, I had intercourse with my current boyfriend and I broke out really bad. I had two tests done for hsv2 and one came back positive and one came back negative. I was single for two and a half years before my boyfriend and was with the same person before that for 5 years and never in my entire life have I ever had a break out. There for my boyfriend went and got tested becuz the person he was with before me was 2+ months before me and all his tests came back negative. So wat does that mean. All my hsv1 tests are negative and I have done some research and there are a couple of other things it could be like choncroid, but how do u get tested for that. I will keep u in my thoughts knowing I'm not the only one going thru this and will keep high hopes for the both of us. Good luck
Hey guys I need pretty much have the same type of question, although my situation is different because I've been sexually active since summer of 2007 and was too chicken to get tested (and yes I know i put peoples health at risk and feel horrible) BUT SOME GOOD NEWS, I recently man-ed up and got a full std panel from this website www.stdalert.com they sent me to 'quest diagnostics' to get the test done (hiv, ghonnorea, chlymadia, hsv1 and hsv2, syphillis, hep a-b-c. All my tests came back 'negative' or 'non reactive'
Question about the hsv 2...
today someone told me that just because a blood test came back negative- doesnt mean you dont have herpes (genital), and that you need to get tested when you have an outbreak. My results for the hsv 2 test was based on a range index of 0.00-0.89 and my 'in range' score was .51, also on the same range index, my hsv 1 score was .33
Question about the hsv 2...
today someone told me that just because a blood test came back negative- doesnt mean you dont have herpes (genital), and that you need to get tested when you have an outbreak. My results for the hsv 2 test was based on a range index of 0.00-0.89 and my 'in range' score was .51, also on the same range index, my hsv 1 score was .33
i have recently been tested for herpes simplex 2. I was reading all the chatter back and forth about the ratio's. I had a reading of 2.0 on my test. I was involved in a situation 2 days prior to testing that had me worried. Yet I have read that nothing will show up through labcorp for at least a couple weeks. I have been with the same woman for 8 years now and she is not infected yet we didnt always use protection. With a reading of 2.0 and .9 on herpes simplex 1 is it possible that i have had a false positive or should it be determined that i have had this condition for quit some time now.
you had a 2nd WB or just the original one that was inconclusive?
Ned and Hunter are the std experts. Terri Warren is the herpes expert here on medhelp. You can find links to both of their forums on the right hand side of this forum.
grace
Ned and Hunter are the std experts. Terri Warren is the herpes expert here on medhelp. You can find links to both of their forums on the right hand side of this forum.
grace
Grace,
I did the WB at about the 6 month mark, that's the confusing part.
Can I please ask you one more thing? Where on the site can I submit a question to either Dr. Hook or Dr. Hansfield? I realize that this is something I have to pay for, but I could not find it on the site.
Thx. :)
I'm honestly not sure what your question is.
I suggested previously that you repeat the WB at the 6 month mark and they will compare both tests to hopefully get you the final answer. I also suggested you stop valtrex previously. I have no other advice to give.
grace
I suggested previously that you repeat the WB at the 6 month mark and they will compare both tests to hopefully get you the final answer. I also suggested you stop valtrex previously. I have no other advice to give.
grace
Grace,
Get this. I had a routine physical exam from my doctor, and he decided to test for HSV2 one more time - almost a year after a suspected contact. I am still measuring very low positive about 1.4 with the HerpeSelect test. All of my test results have generally been between about 1.1 and 1.4. I have not had any other contacts since the last suspected contact, almost a year ago. Of course, I did the WB at 22+ weeks and it was indeterminate. My doctor is now starting to think that these are false positives, but can't be conclusive. I have never had an outbreak of any kind. He is a good doctor, but isn't too up to snuff on the HSV2 data on this site. I apologize for the lengthy post below, but I hope this compilation of info can be of use to others here.
I have read a lot of info on this site from both Dr's. There are many opinions, but both Dr's seem to agree here that it would be very, very unusual not to have higher antibody levels after a significant amount of time (almost 12mos for me now) - even while taking suppression therapy. Here are a couple of Dr comments about antibody levels:
by H. Hunter Handsfield, M.D., Mar 03, 2006 12:00AM
To: (deleted)
Antiviral therapy does not affecte the blood test results. You don't need to stop acyclovir.
by Edward W Hook, MD, May 22, 2008 10:02PM
3. They don't delay it much (I am inserting "antivirals" here, as it was part of the discussion). To be retested now would be very low yield. You had exposure to a low risk partner and were negative at 12 weeks. I would suggest that you should accept that you did not get herpes.
HHH, MD
************************
The Dr's also seem to suggest that in RARE cases (of which I hope I am not one), it is possible that the production of antibodies could be delayed by starting suppression therapy soon after diagnosis. I have been taking 500mg of Valtrex since I was first diagnosed, mostly because I didn't want to deal with an outbreak.
by Edward W Hook, MD, Apr 19, 2009 05:49PM
Among experts there has been discussion of rare patients with initial HSV-2 who have DELAYED antibody development as measured by both HerpeSelect and Western Blot which has been attributed to immediately starting suppressive therapy after diagnosis. In these anecdotes, when the patient is taken off suppressive therapy they sometimes go on to develop antibodies (and recurrences). This is a rare occurrence and there are no studies of this phenomenon at this time.
********************
Dr. Hook seems to indicate that if antibodies have not increased substantially (in the below example after only 4 more weeks and in my case now 11+ months), then this increases the odds of a false positive reaction.
by Edward W Hook, MD, Apr 14, 2008 10:12PM
To sort things out, I would repeat the HerpeSelect about 4 weeks after your last test. If the result is in the same range, this would even more strongly suggest a false positive reaction. If the result has increased substantially (to above 2.5-3.0) then you may have acquired HSV-2.
**********************
In this post by Dr. HHH, he seems to indicate that it would be virtually impossible to still test low positive after a year and be truly infected.
by H. Hunter Handsfield, M.D., Aug 14, 2008 03:46PM
You were misinformed about test interpretation. At least 90% of people with supposedly positive results, but with ELISA ratio values around 1.0 to 1.2, do NOT have HSV-2. And since you have not had sex for 2 years, it is not possible for you to have acquired HSV-2 recently. That would have been an unlikely explanation for the results you had, even if you had been at risk -- but in your case, a new HSV-2 infecion (infection) is simply impossible. And cross reaction with HSV-1 also isn't possible in the presence of a negative HSV-1 test result.
So the answers to your specific questions: "Would it be possible to contract it in September (or two years earlier, more likely) and still be reading such low numbers?" No, impossible.
"Or is the more likely explanation HSV-2 oral transmission?" That is also impossible, for all practical purposes.
You can move on in life confident you don't have HSV-2. Don't worry about it. (But if you want still more reassurance, ask your provider to do a confirmatory test, using either the BiokitUSA HSV-2 test, or the Western blot test. If you'll use the search link, you can find a large number of other discussions on all these points.)
Best wishes (and congratulations on being uninfected with HSV-2!)-- HHH, MD
***********
In this post by Dr. HHH, he indicates that a primary outbreak (which I have never had) would be followed by another outbreak (in most people) within 6 months, even if suppressive therapy is given.
by H. Hunter Handsfield, M.D., Jan 08, 2007 12:00AM
Too bad culture wasn't done. Why not? Culture shoud be done for every first episode of genital herpes.
Most likely your "primary outbreak" was not herpes at all. That's quite a bit more likely not developing measurable IgG antibodies after 6 months. Also, most people given suppressive therapy this soon after initial herpes would have had symptomatic recurrences within 6 months, despite Valtrex treatment. So if you have had no further outbreaks, that also suggests you didn't have herpes in July.
********************
In this post by Dr. EWH, he indicates that an indeterminate WB (which I have had) and low positives from other test assays (I believe HerpeSelect was referenced in the below post) are likely false positives. Also, evidently there are many things which can cause one to test slightly positive for HSV2 using the HerpeSelect test.
by Edward W Hook, MD, May 28, 2008 03:46PM
The indetrminant tests (on Western Blot I presume) just makes it more likely that this is not HSV. As to why your blood tends to be somewhat reactive- I cannot say. Ther are many potential reasons. Taking all that has gone on, my opinion is that it is unlikely that you have herpes. Hope this helps. EWH
by (deleted), May 28, 2008 04:16PM
To: Edward W Hook
Dr. Hook,
I really appreciate your time and perspective. They suggested a WB again in 3 months. Is it worth it, or should I just leave well enough alone.
by Edward W Hook, MD, May 28, 2008 04:25PM
If indeterminant or nagtaive at that time you will know that you do not have HSV. EWH
Get this. I had a routine physical exam from my doctor, and he decided to test for HSV2 one more time - almost a year after a suspected contact. I am still measuring very low positive about 1.4 with the HerpeSelect test. All of my test results have generally been between about 1.1 and 1.4. I have not had any other contacts since the last suspected contact, almost a year ago. Of course, I did the WB at 22+ weeks and it was indeterminate. My doctor is now starting to think that these are false positives, but can't be conclusive. I have never had an outbreak of any kind. He is a good doctor, but isn't too up to snuff on the HSV2 data on this site. I apologize for the lengthy post below, but I hope this compilation of info can be of use to others here.
I have read a lot of info on this site from both Dr's. There are many opinions, but both Dr's seem to agree here that it would be very, very unusual not to have higher antibody levels after a significant amount of time (almost 12mos for me now) - even while taking suppression therapy. Here are a couple of Dr comments about antibody levels:
by H. Hunter Handsfield, M.D., Mar 03, 2006 12:00AM
To: (deleted)
Antiviral therapy does not affecte the blood test results. You don't need to stop acyclovir.
by Edward W Hook, MD, May 22, 2008 10:02PM
3. They don't delay it much (I am inserting "antivirals" here, as it was part of the discussion). To be retested now would be very low yield. You had exposure to a low risk partner and were negative at 12 weeks. I would suggest that you should accept that you did not get herpes.
HHH, MD
************************
The Dr's also seem to suggest that in RARE cases (of which I hope I am not one), it is possible that the production of antibodies could be delayed by starting suppression therapy soon after diagnosis. I have been taking 500mg of Valtrex since I was first diagnosed, mostly because I didn't want to deal with an outbreak.
by Edward W Hook, MD, Apr 19, 2009 05:49PM
Among experts there has been discussion of rare patients with initial HSV-2 who have DELAYED antibody development as measured by both HerpeSelect and Western Blot which has been attributed to immediately starting suppressive therapy after diagnosis. In these anecdotes, when the patient is taken off suppressive therapy they sometimes go on to develop antibodies (and recurrences). This is a rare occurrence and there are no studies of this phenomenon at this time.
********************
Dr. Hook seems to indicate that if antibodies have not increased substantially (in the below example after only 4 more weeks and in my case now 11+ months), then this increases the odds of a false positive reaction.
by Edward W Hook, MD, Apr 14, 2008 10:12PM
To sort things out, I would repeat the HerpeSelect about 4 weeks after your last test. If the result is in the same range, this would even more strongly suggest a false positive reaction. If the result has increased substantially (to above 2.5-3.0) then you may have acquired HSV-2.
**********************
In this post by Dr. HHH, he seems to indicate that it would be virtually impossible to still test low positive after a year and be truly infected.
by H. Hunter Handsfield, M.D., Aug 14, 2008 03:46PM
You were misinformed about test interpretation. At least 90% of people with supposedly positive results, but with ELISA ratio values around 1.0 to 1.2, do NOT have HSV-2. And since you have not had sex for 2 years, it is not possible for you to have acquired HSV-2 recently. That would have been an unlikely explanation for the results you had, even if you had been at risk -- but in your case, a new HSV-2 infecion (infection) is simply impossible. And cross reaction with HSV-1 also isn't possible in the presence of a negative HSV-1 test result.
So the answers to your specific questions: "Would it be possible to contract it in September (or two years earlier, more likely) and still be reading such low numbers?" No, impossible.
"Or is the more likely explanation HSV-2 oral transmission?" That is also impossible, for all practical purposes.
You can move on in life confident you don't have HSV-2. Don't worry about it. (But if you want still more reassurance, ask your provider to do a confirmatory test, using either the BiokitUSA HSV-2 test, or the Western blot test. If you'll use the search link, you can find a large number of other discussions on all these points.)
Best wishes (and congratulations on being uninfected with HSV-2!)-- HHH, MD
***********
In this post by Dr. HHH, he indicates that a primary outbreak (which I have never had) would be followed by another outbreak (in most people) within 6 months, even if suppressive therapy is given.
by H. Hunter Handsfield, M.D., Jan 08, 2007 12:00AM
Too bad culture wasn't done. Why not? Culture shoud be done for every first episode of genital herpes.
Most likely your "primary outbreak" was not herpes at all. That's quite a bit more likely not developing measurable IgG antibodies after 6 months. Also, most people given suppressive therapy this soon after initial herpes would have had symptomatic recurrences within 6 months, despite Valtrex treatment. So if you have had no further outbreaks, that also suggests you didn't have herpes in July.
********************
In this post by Dr. EWH, he indicates that an indeterminate WB (which I have had) and low positives from other test assays (I believe HerpeSelect was referenced in the below post) are likely false positives. Also, evidently there are many things which can cause one to test slightly positive for HSV2 using the HerpeSelect test.
by Edward W Hook, MD, May 28, 2008 03:46PM
The indetrminant tests (on Western Blot I presume) just makes it more likely that this is not HSV. As to why your blood tends to be somewhat reactive- I cannot say. Ther are many potential reasons. Taking all that has gone on, my opinion is that it is unlikely that you have herpes. Hope this helps. EWH
by (deleted), May 28, 2008 04:16PM
To: Edward W Hook
Dr. Hook,
I really appreciate your time and perspective. They suggested a WB again in 3 months. Is it worth it, or should I just leave well enough alone.
by Edward W Hook, MD, May 28, 2008 04:25PM
If indeterminant or nagtaive at that time you will know that you do not have HSV. EWH
Grace,
How long should I stop the Valtrex before taking the WB test again? It is beginning to sound like I do actually have it, from what you are saying. Am I reading you correctly?
We don't know exactly how much starting suppressive therapy early on would delay detectable igg herpes antibody detection. Seems that in some folks it does and in others it doesn't. Since you have had such a convoluted time of testing, it's worthwhile stopping it and testing one more time.
grace
grace
Carphone,
I'm trying to understand what you are saying. So, if I read your comments correctly, you are intimating that I may actually have hsv2, but the valtrex is not allowing the creation of antibodies, is this correct? How is this possible? Is there cited research data that you can direct me to that suggests Valtrex can delay the creation of antibodies?
I think you should stop the Valtrex(include all anti-herpes drug) and retest, if you want get it clear. these drug might delay you antibody.
Grace,
Is it possible the Valtrex can produce low positive or inconclusive results with both the WB and the HerpesSelect? Can Valtrex stop or slow the production of antibodies to HSV2? From what I have read, your body will produce antibodies regardless of the Valtrex, but perhaps there is other data out there that I have not seen. This is really strange.
Any ideas?
At this point I'd stop the valtrex and repeat the WB at the 6 month point. If they know you already had one questionable WB, they'll compare the 2 of them.
grace
grace
wow i thought the w.b was like gold standered like 99% almost 100% accurate especially w low scores under 3.5.i wonder how many times this happens w the w.b.? i feel very sorry for you that you have to go though all these tests! You should have had take only take one test and get the results.also thats a ton of money/time/pokes/blood wasted. ;( intermediate is techinacally not positive or negative(more than positive) same as equivicol i guess lol. im wondering if your chicken pox,mono, hsv1, and you taking valtrex i think spoofed your scores. also i would get a immunization titer number for chicken pox etc...(i noticed mine are 3 times over the normal-dont know what that means ;( ) im just really suprised and dont know what to say or tell you! have you called to talk to anyone at the univ. of washinghton?(also fax those records to someone "knowlegable" and maybe they can help as well) have you tried a rapid bio kit?(tie breaker in some cases-somewhat same senisitivity as w.b.-might be better than those other serology tests) you could try to retest (very costly) oh also try to see an immunologists(might be helpful)
there needs to be more research on this before they digianose more people lol or falsely diagnose
there needs to be more research on this before they digianose more people lol or falsely diagnose
Grace,
So, I have the results back from the HSV2-WB test. The test came back indeterminate. They noted in the results that there was an "atypical reactivity", which may not be from HSV2. I took this test at 23 weeks, and it's not specifically positive, but not negative either. I really don't know what to make of these results. Is it possible that I am just barely starting to convert, even after 23 weeks? Is it possible that there is something in my body that is triggering these results? Could chicken-pox or mono cause this, both of which I have had?
They mentioned in the results that "full antibody profiles to HSV may take 12-16 weeks to develop, especially if anti-viral therapy was given." I have been taking 500mg of Valtrex every day for over 2 months, perhaps as long as 3 months, so I wonder if the Valtrex has skewed my results to make them "indeterminate"?
What am I supposed to make of these results? I am very confused by this. I would think that by 23 weeks, I would be showing pretty positive if I really had HSV2. Should I retest in 2-3 months? This is really frustrating.
i dunno but i think the captia has less false positives w scores under 3.5 than the herpes select. im not even sure about trinity's scores yet lol
Grace,
So, it is 23 weeks after suspected contact and I just took the Type Specific HSV2 HerpesSelect test again at Labcorp. I tested slightly positive this time at 1.26. If you recall, I have consistently tested negative at Labcorp, when tested at the 4 week and 13 week marks.
I have consistently tested slightly positive at Quest with the same exact test, ranging from about 1.13 to about 1.4, and through roughly the same time frames as above.
Frankly, I now think I am positive for HSV2. With that said, I can get the WB test done at Quest (test #34534) through an online source - Advanced Testing Center. It's not cheap at $350, but at least I will get some kind of confirmation. Wish me luck and say a prayer that it comes back negative. I will post the results of the WB when I get them.
yeah i know lol (all 2 well unfortinuetally) you have to find a (doctor) lab to draw that can actually process/ship out the specimen etc... once you find a doctor that can actually "do it"-meaning having a "certain level-i think its a level 5 liscence" liscence to draw for the w.b test. most dont because you need complicated lab equipment etc.. for example a lab that can to process difficult viruses like siphilus (if tha makes sense). then take all your past hsv 1/2 records w you and explain as well that you need a w..b. done to test the false positive ratio.(mostly everyone thinks the herpes select is like 98% accurate all together so most just go w those results but not w scores under 3.5/3.0 and most doctors/health professionals wont admit it because theres not a lot of info, trials,cdc,fda etc..explaining why all these problems happen w scores under 3.5/3.0(this actually happens a lot after my 10 months or so "investigation" lol or like the info in my blog you could try a immmunoblot by i think captiva. some people test positive w alissa and not immunoblot(strange i know but dont know why) or try a rapid bio kit ;( hope everything works out ok!
I called a local Quest lab. They told me that I can get the WB test done, but need to have the test approved by my doctor, which for me means fat-chance. This is really frustrating....
Grace,
I found this post:
http://www.medhelp.org/posts/show/693527
Supposedly, this person contacted Quest directly, but I assume she needed a doctor to order the test, right? Is there any chance of finding the Quest phone number?
Thanks.
Quest won't let you order the WB on your own without your doctor's order. You can call your local lab and see if you order the WB kit yourself if they will draw the blood and send it for you. No idea what they'll charge for that.
Another option is check around for herpes support groups in your area and see if anyone in them were able to get a WB from a doctor in your area and go thru them.
grace
Another option is check around for herpes support groups in your area and see if anyone in them were able to get a WB from a doctor in your area and go thru them.
grace
Hi Grace,
So, it is now 19 weeks after contact and I am considering the WB test. I assume 19 weeks is enough time for conclusive WB results, right? My doctor will not even discuss the WB test, as he thinks I am HSV2 positive and no further testing is necessary. Heck, I might be, but it is worth knowing for sure.
Please forgive me for asking this again, but how can I get the WB test done thru Quest if my doctor will not approve the test? I know you gave me the test ID number. Is there a phone number that you have which I can call so I can expedite the process thru Quest? BTW, any idea how much it costs?
Thanks.
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Herpes spreads by oral, vaginal and anal sex.
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Syphilis is an STD that is transmitted by oral, genital and anal sex.
