Low positive hsv2

[pnt1987]

Hello, I have been reading through numerous posts on this forum about low positive hsv2. I was std testing about 2months ago and was informed that my hsv2igg was 1.40, positive. I returned the following week for another IgG hsv2 test which came back as 1.05, which my doctor tol me was still positive (I thought this was equivocal?). I went to my PM 2wks ago and again tested for IgG hsv2 and again my index was 1.40. I have not had sex in 2yrs, both my previous partners are negative and I have never ever had symptoms, no sores, no burning....nothing. I am extremely concerned and very worried. I am in a new relationship and don't really know how to tell my new partner I have herpes! I have read a lot of scientific journals that state that an index between 1.1-3.5 could be low positive and I most likely need bio kit testing or western blot. My doctor does not do bio kit testing an is not willing to help me find someone who does, she tells me to "accept you have herpes and move on". I just need to know if I really should just move and tell my partner I have herpes or if I really most likely do not. Another article I read states people of African origin have more false positive, is this true? I am of African origin. Thank you so much for your help!

[Edward W Hook, MD]

I'm sorry you are hainving trouble.  Quest needs to get its act together.  Here is a link to another post where Terri Warren comments on the Western blot test availability -

http://www.medhelp.org/posts/Herpes/Western-Blot--additional-questions/show/1110656.

As you will see, The University of Washington can send your PCP a kit to draw the blood and send it directly back to them.  They just need to call 800-713-5198 (the UW number)  to arrange it.  EWH

[pnt1987]

Good morning Dr.Hook. I have been to 2 Quest labs and Iboth have told me they have no clue what the western blot and instead of the western blot sent IgG and IBM again which again came back as 1.46. Again my levels have been 1.4, 1.05,1.4, and now 1.46. I have not had sex in over 1.5yrs if I was truly hsv2 positive would this number not be higher. My last partner was tested again a few weeks ago and is still negative. I am beyond frustrated as I do not know how to move forward with this issue. I have a new partner that I was hoping to start a sexual relationship with, at this rate it's not looking like that can happen.

[Edward W Hook, MD]

False positve tests can come from a variety of sources, including cross reactions of the antibodies to childhook chickenpox with the test.  

Fluctuation in the testt values of the sort you noted is completely typical and an expected characteristic of the test.  eWH

[pnt1987]

Thank you very much, your response was very helpful. I will sen the western blot and will hopefully be able to resolve this. Is it a bad sign that I have had index of 1.40 on 2 separate occasions though? Also do you know what causes false positives?

[Edward W Hook, MD]

Welcome to our Forum.  I'll try to help.  You sound to be rather low risk for herpes and the values of your HerpeSelect test are in  the range where the majority of equivocal or "positive" test values are actually falsely positive.  I certainly would not feel any need to notify partners or potential partners of your test results at this time.  The chance that you have herpes or will infect a partner is low.  

In terms of how to resolve the values that you do have, your doctor can ask to have a specimen sent to the University of Washington Virology laboratory for a herpes Western blot –most laboratories can do this.  If he/she is not sure, the link for their web site is http://depts.washington.edu/rspvirus/herpes.htm .  The test may take about a month to get back to you. If the result is indeterminate, given your history, you can be confident that you do not have HSV.  Obviously if it is clearly positive or negative, then you will also have the result you need.

As far as the issue of your African origins, what we do know is that when these tests (i.e. the HerpeSelect) have been used in sub-Saharan Africa, there are higher rates of indeterminate and falsely positive results.  Whether that pertains to your situation I do not know.  I am confident however that a Western blot assay will help you to sort out your situation.

I hope my comments are helpful. EWH