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Avatar universal

False-positive iGG or false negative biokit?

Hello Doctor,
About 70 days ago I had a one-night stand with a girl.  I had only 2 sexual partners up to that point.  There was no intercourse (no penetration), but she kept wanting to and there was some genital rubbing.  Also there was oral from her to me and me to her.

About 45 days later the tip of my tongue became irritated and i noticed a clear fluid-filled pocket under my tongue that wasnt painful (was a little anooying so i tried to pop it).  I went to the doctor the same day she asked me if i was worried about stds...looking back on the encounter I said i am now.  She ordered an IGM & IGG for HSV1 and 2, as well as HIV and syphilis.  2 days later the irritation was gone as was the pocket, so i stopped thinking about it.

I got a phone call a week later saying the results were in and to come get them with my prescription.  I panicked thinking what could they have found.  When I got to the clinic, it was almost closing time and they said the doctor had left but they handed me an envelope with the test results.

IGM HSV1/2 came back at 1:10 which the test said was positive.
IGG HSV1 came back negative < 0.9
IGG HSV2 came back positive 2.72
HIV negative, syphilis negative.

I went back to the doctor the next day but it was a different doctor on call and he said the results meant it was genital herpes, and i told him about the tongue sore and he said that no it was definitely genital, even though i had never experienced symptoms down there.  He said i was just one of many asymptomatic HSV2 people.

I took a biokit test 2 weeks later which came back negative (60 days post questionable encounter).  I told my first doctor, he said he had never heard of that test and that the iGG was conclusive.  I either have it or I don't...I keep getting conflicting results.  Should I test again?  Is the biokit accurate at 60 days?
6 Responses
300980 tn?1194929400
MEDICAL PROFESSIONAL
Welcome to our forum. I'll try to help but, having read some of your other 12 posts over the past two week on the HSV Community site, I worry that your problem is primarily resolving the fact that your personal doctors are wrong in respect to their understanding of the HSV IgG tests-(I have nothing to say about IgM tests except that they are a waste of time and you would be far better off if you'd never been tested with that test).  From what you say, your doctors, like many, believe that tests will always be correct when ordered- this is simply not the case, particularly with the HSV IgG tests.  The information you've been given on the HSV Community site is right on target.  Here is my analysis of your situation>

1. You went to your doctor with a sore tongue and, being thorough, your doctor included consideration of HSV.  That's not a bad thing- she was being thorough. HOWEVER, there is little evidence that your sore tongue was due to herpes and in fact, it is unlikely that that was the case- a.) your symptoms only lasted a few days, symptoms of initial HSV lasts 2-3 weeks; b.) your low positive test was positive for HSV-2, which is very, very unusual as a cause of oral HSV.

2. Retrospectively, your exposure history is not suggestive of HSV.  There was no genital contact and your onset of tongue symptoms was long after the 4-14 days it takes for initial HSV outbreaks to appear.

3.  Your HSV-2 IgG test was a low positive, in a range where about half are falsely positive.  The way to resolve this is with a second, unrelated test such as the Biokit or the Western blot. Your Biokit was negative.  If your positive IgG test result was due to HSV-2 as opposed to being falsely positive, the Biokit would have been positive.

4.  But your doctor disagrees. Sorry, on this matter your doctor is incorrect.  

Hope this helps. It is now time for you to put this entire matter behind you and move forward. You certainly do not need further testing.  EWH
Avatar universal
Thanks doctor...Ill sleep better tonight given your expertise.  It makes me mad that doctors can be so cavalier about diagnosing a lifelong disease with all the anxiety it causes without any knowledge on the subject.  I'm going to finds new doctor.  

Given my hsv1 was negative, what could cause my igg to be so high (more than twice the cutoff)?  That part doesn't make sense to me.
Avatar universal
Oh and just for thoroughness sake, I did have a couple of what I thought were pimples on my buttocks a couple of weeks post that experience which were a little painful to sit on. Those were only painful for about 2 days as well though...could that be related?  Have you heard of primary outbreaks on the buttocks?
300980 tn?1194929400
MEDICAL PROFESSIONAL
Humans are highly variable and amongst humans, so is the misture of antibodies they have and the chemical composition of their blood. Because of this it is logical that there would be variable antibody cross reactivity in persons who do not have a disease.

No, the pimples you suggest do not suggest herpes.  

let's try to move on and put this behind you. EWH

Avatar universal
Hey Doctor,
Sorry about another post - you probably get a lot of anxiety-fueled posts but after I was feeling a lot better last night after your comments, I noticed a large bump on my buttocks in almost the same location as the aforementioned symptoms that occurred 2 weeks post possible exposure.  It is quite painful to touch.  I examined it in a mirror and it is a large red bump (dime-sized).  It felt like the pain was from pressure, so I tried squeezing it and it popped pretty easily with a lot of pressure and thick whitish/yellowish puss following by a lot of blood.  This morning its still red but the head is kind of purple-ish.

I've tried googling instead of bothering you on here but that just made me worry more since i keep reading that herpes can be a chameleon most symptoms are atypical and can be mistaken for a pimple.  I also read that quite a few people get symptoms on their backside.  Should I go get this cultured?   Can a herpe be popped like that?  I dont really recall getting these symptoms before this all started.
300980 tn?1194929400
MEDICAL PROFESSIONAL
This will need to be my last answer.

The bumps you describe sound like follicultitis, not herpes.  Folliculitis occurs when the pores in your skin get plugged.  This allows that normal bacteria that are present on just about every-one's skin to grow and cause what is essentially a pimple.  Some of these just appear as red bumps which may or may not be  tender while others go on to actually form pus-filled pimples.  

Whther you seek medical evaluation is, of course, up to you.  Given your high anxiety, I anticipate that this might be reassuring for you, irrespective of whether it is medically needed or not.

This concludes this thread. EWH
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