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What are the chances my hsv 2 test is a false positive?

I recently took a full STD screening after receiving unprotected oral from a new partner. About 2 to 3 weeks later I noticed some minor itching and swelling of my penis glans which I believed to be a yeast infection or balantis as I am uncircumcised.

All results were negative with the exepction of hsv 1(35.0) and hsv 2 at 2.72 these where Igg test and its looks like an additional simplex test was conducted which was also positive.

Needless to say I was shocked and was really only concerned about the more popular diseases. I've never had any severe itching or lesions that I'm aware of. I'm obviously more concerned about type 2 than type 1 as I've had cold sores periodically what feels like my whole life, I never know they were considered herpes.

My question is what are the odds my hsv reading is false given the lower index? I also recently(7 months agp)was hospitalized and tested positive for EBV and CMV which I now know are apart of the herpes family? Any chance that factors into the 2.72 reading??

Thanks for help in advance, I need some peace of mind so I can eat and sleep again lol
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The EBV and CMV wouldn't factor in, but at a 2.72, even with the positive additional test, can still be a false positive. Anything under a 3.5 can be.

The closer it is to a 3.5, the better the chances that it isn't, but the chances are about 50/50, maybe a little worse, that it's actually positive.

Usually, the reflex or supplemental tests are the exact same tests, which doesn't really tell us much.

You can have a Western Blot test done to confirm this. Your doctor can order it, or you can go through Terri Warren at the Westover Heights Clinic, but you'll have to self-pay.

Having hsv1 can make hsv2 mild, so not having severe symptoms doesn't mean much here. The number means the most. How long has it been since your most recent possible exposure? (Oral sex isn't really a risk for hsv2, since oral hsv2 is really pretty rare.)

The symptoms you had could still be balanitis or a fungal infection. It doesn't mean those symptoms were herpes, even if you have it.

If you need to talk to your doctor about getting the Western Blot, show them this:


"The most commonly used test, HerpeSelect HSV-2 Elisa might be falsely positive at low index values (1.1–3.5) (334-336). Such low values should be confirmed with another test, such as Biokit or the Western blot (337). The HerpeSelect HSV-2 Immunoblot should not be used for confirmation, because it uses the same antigen as the HSV-2 Elisa. Repeat testing is indicated if recent acquisition of genital herpes is suspected. "

If your doctor is testing for and treating STDs, they should be familiar with and adhering to the CDC's STD Treatment Guidelines. (I'm assuming you're in the US because of the ease in which you got the blood testing. If you aren't, let me know.)

If you need to go through Terri Warren, you can do so here - https://westoverheights.com/getting-a-herpes-western-blot/

I don't want to give you false hope - there is definitely a chance that you have hsv2. If you do, we'll get you through that. This is all going to take time, though. While you wait, you can read the Herpes Handbook - https://westoverheights.com/herpes/the-updated-herpes-handbook/

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Thanks for your insight.

If oral is a very low risk then it would have to be an old infection from years ago. I haven't had vaginal or anal sex outside of my marriage, only oral. So maybe 5 or 6 years ago would be my last possible exposure. My wife I'd faithful and Is taking a test next week. I will look into who offers western blot in my area
It's entirely possible to be an old infection that you never knew about. That happens all the time, actually. If your wife tests positive, there's no way to know which one of you had it first, unless she came into the relationship with no previous partners.

Oral hsv2 is rare, and when it happens, it rarely recurs, and rarely sheds, meaning it rarely transmits from the mouth. If you do have it, it's likely an old infection you didn't know about.

Shedding rates: (and you can find all this in the herpes handbook - https://westoverheights.com/herpes/the-updated-herpes-handbook/)

HSV 2 genital 15-30% of days evaluated

HSV 1 genital 3-5% of days evaluated
HSV 1 oral 25% of days evaluated

HSV 2 oral 1% of days evaluated

If you can get your doctor to order a Western Blot, he can do that here - http://depts.washington.edu/herpes/pages/frequently_asked_questions#faqCat-4

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