HSV 2 Confirmatory Testing

[orange10]

I had a Herpeselect HSV 2 IGG type specific test done through my primary doc with following results:   1.77,    0.00 – 0.89 Index,  Interprtation = POSITIVE.  NEVERhad any outbreaks, lesions, etc…  I asked my primary if there were any false positives with the Herpeselect and she gave me a resounding ‘No’ and said a retest would be a waste of time considering the positive result.   Did some research on my own and learned that low-end positive Herpeselct results may, in fact, be false positive.  Was retested at Westover Heights with the Focus Inhibition Assay with following results:  HSV2 IGG screening index, 1.98;  % inhibition, - 13.3,  inhibition study interpretation = FALSE POSITIVE.  Talked to a nurse at Westover just to confirm my false positive results, which she did.  I have yet to discuss my new results with my primary.  I must admit I’m a bit apprehensive as to what her take will be of the Inhibition Study – if she even knows what that test is.  Just wanted to know what the difference between the Herpeselect and the Inhibition Study is in terms of interpreting results.  Might my primary doc just in the dark about confirmatory testing?  Thanks in advance.

[sammy640]

A related discussion, ???????? tests??????????? was started.

[orange10]

Thanks a lot, Dr. Hook.   Any suggestions as to how to broach the topic with my primary doc that there are, in fact, other tests that provide an increased level of accuracy?   She seems of the opinion that the result of my Herpeselect is absolute.  I very much feel like I’m running into a brick wall.  Considering the significance of a positive hsv2 result, it’s been quite upsetting trying to get her to accept my false positive result from the Inhibition Study.  And just out of curiosity, do you have any data on the percentage of false positives occurring with the Herpeselect?

[Edward W Hook, MD]

Because of your experience and concern, you have taken this to a level beyond that of many health care providers.  The folks at Westover are well known to us and are experts at interpretation of this test.

To expand a bit, the test is very reliable but, like most tests is not perfect.  Among positive tests using the standard Herpeselect, those at the lower end of the positive range are the ones that are most likely to be false positive (if you think about this, this does make sense) while the stronger the positive test result, the less likely it will be false positive.  it is just because of situations such as these that we do not routinely suggest that everyone with concerns and low risk exposure get tested--these situations would be more likely to occur in such situations.  The inhibition test goes to the next step and improves the diagnostic accuracy.

You did the right thing to work through this with the folks at Westover.  Most health care providers have a lot of faith in their diagnostic tests and, in most cases this is appropriate, but it is not reasonable to expect everyone to know the ins and outs of every test.

Hope this all makes sense.   EWH