Question about confusing herpes results?

[Lamps]

Ok, so i received two different IGG antibody tests that came back positive for hsv-2, and negative for hsv-1. The first was an ELISA test, and it was equivocal the first time they performed it. Then they performed it again a minute later and it came back low-positive (2.6). The second test was I think- but am not sure- a Bioplex 2200. They didn't report the value, but if I had to guess, I would say it was a low-positive too.

This is all so confusing because I have been with only one sexual partner, and that was 10 years ago (I am a male, and was with a female). When I spoke to her, she was as mystified as me, and said she never noticed any symptoms of anything in her genital area. She goes to her gynecologist regularly as she has an IUD and needs regular tests related to that. Whether she has ever been tested for hsv-2 is anyone's guess. In addition, I have probably slept with her a total of about 35 times, and not in one period of time, but rather a week here, a week there, etc.

Moreover, I myself have never had any symptoms. Now *believe me*, I have always paid very close attention to all details of my sexual health, to the point that people who know me well think I'm a hypochondriac. I have never noticed anything amiss in my genital region over the past 10 years since I was with my ex. I had a couple of cases of very classic intertrigo a couple of months ago, both in the folds of my skin (I am overweight and tend to sweat a lot), but the doctor took one look at them and said they definitely weren't herpes. Other than that, I have had no symptoms.

But then again I have these two low-positive tests for hsv-2. Do I have genital herpes? Is this something I should just accept and move on? Or is this something that warrants me sending out the Western Blot? I have fooled around with another girl, but she is/was a virgin, and the only other thing I can think is that maybe I got oral hsv-2 from her, as unlikely as that is.

[Lamps]

Sorry to post twice. I am just having a really hard time coming to terms with the fact that, despite my ex-girlfriend's claim that she tested negative for hsv-1 and hsv-2, I have two positive tests for herpes simplex, type 2. One of them was a low-positive, and I honestly don't know what the other one was, although it *could have* been a low-positive, too, but that is just pure speculation on my part. How does a person who is truly negative for herpes simplex, type 2 nonetheless test positive on two different IGG antibody tests, which use two different methods of testing to test for herpes, which use two different antigens to detect those antibodies? It just seems so very unlikely to me. It seems that, in turn, the prior probability that my ex-girlfriend is lying to me must be pretty high, given the sheer unlikelihood that my two IGG antibody tests are false-positives. I don't know, it's hard for me to sort it all out. Like I said, I can't see past these two positive herpes tests, and until I get an authoritative test that definitively says I am negative, I will remain suspicious.

[Lamps]

Hi Terri, just a quick update, my partner got tested for herpes simplex type 1, and herpes simplex, type 2, and she said both came back negative. She has been very helpful in talking to me and reassuring me throughout all of this. I am assuming she got tested with the IGG antibody test, because her infection would have to have been around 10 years ago when we were together, and she has never had an active outbreak, so an IGM test would have made no sense. She incidentally got tested by her ob/gyn. Anyway, I sure hope that raises the odds that my Western Blot will come back negative. i was fortunate to be able to order it through your clinic. Thanks Terri

[Terri Warren, RN, Adult Nurse Practitioner]

I know there were two positive tests, but with the false positives, they are repeatedly positive over many tests.  Some protein, probably one in our own bodies, keeps tripping the test artificially.  So I'm not surprised that you had two.  

Yes, post as soon as you get them

TErri

[Lamps]

I sure hope you're right, Terri. Unfortunately it isn't just the one positive test, but two positive tests. I had the HerpeSelect ELISA, and another IGG antibody test that was (I think) the Bioplex 2200. They didn't tell me the antibody levels for the Bioplex, but I imagine it was low-positive as well, just like the ELISA. At this point, I have a sinking feeling the Western Blot will come back positive, but I can only wait and see what the results are.

I think a large part of what I am feeling can be described as simply denial, given the sheer unlikelihood of having hsv-2. But I will post the results as soon as they become available.

[Terri Warren, RN, Adult Nurse Practitioner]

I answered this earlier, not certain where the answer went?

Yes, of course we evaluate test results in the context of the sexual situation and though your risk situation is very low, there still is a 50% chance this is a true positive

If I had to bet a millions dollars, I would guess it is a false positive, given your history.  Let me know the western blot results.

Terri

[Lamps]

Hi Terri!

Thanks for your response.

Both of my hsv-1 tests were negative. However, I did have the shingles about 5-6 years back, and I was thinking maybe that was making tests positive for hsv-2, although this is pure speculation on my part.

I was doing some further reading, and I read a study that basically said that lab tests for hsv-2 should not be read in isolation from other relevant information. This study said that the accuracy and predictive power of positive lab results for herpes type 2 should be considered holistically within the context of all known facts and circumstances. They referred to this as the pre-test likelihood of hsv-2. Now, my pre-test likelihood of hsv-2 is about as low as it can really get: one partner in my whole life, 10 years ago; no genital symptoms whatsoever; I am male; young (22) at the time we were together; and she herself doesn't remember ever having symptoms of anything like this.

I will try to get in contact with her again to see if she has been to her gynecologist, and whether any relevant test results are in. In the meantime, I will also send out for the Western Blot.

[Terri Warren, RN, Adult Nurse Practitioner]

I think your situation definitely warrants a western blot.  It will be good to know the results of your partner's testing, if she is willing to do it.  Do you think she would be?  With an index value of 2.2, there is a 50% chance it is a true positive and 50% chance it is a false positive.  Is your HSV 1 test positive or negative?

Terri