[Question #1597] HSV-1 Equivocal 0.95

44 months ago
I am a 30 year old male and last week I took a "10 panel STD test" from an online service that tested for HIV/Chlamydia/Gonorrhea/HSV1&2/Hep/Syphillis. All of the results came out negative except for HSV-1 came out as equivocal at 0.95. It was an IgG test. I took the same test 3 months ago and everything came out negative. I can remember getting cold sores that were painful as a child but since I've been an adult I can only remember a few very tiny sores around my mouth that I attributed to irritation from shaving my face. Anyways, I'm just very perplexed and possibly confused from the results. I haven't had any new sexual partners since my negative test in October. 

I guess I am psyching myself out with any bumps that I see in my genital area. I am very active and exercise usually twice a day wearing spandex compression undergarments, I used to just attribute any kind of bump to sweat and/or vigorous sex. Now it seems that I am attributing any bumps I see to the equivocal HSV-1 test. I am aware that HSV-1 usually only effects the mouth area but can effect other areas as well. I guess my question is what exactly does an equivocal test at 0.95 mean? From what I can see online, it isn't positive or negative? (The online STD place sent me an email saying I tested positive).  I know that a high percentage of the population has HSV-1. Is this something that I should be worried about in causing future problems? I just can't see why the test would now come back positive given that I've remembered cold sores as a child. Would you recommend that I get re-tested?

Sorry for rambling, I'm just probably overly concerned and causing psychological hell for myself. Please let me know of any insights that you have. 
44 months ago
Addition to #1597 This was a big part of my question, I'm not sure how I forgot it. In April of 2014 I noticed that I was ejaculating thick red blood when masturbating. I was tested for STDs and saw my doctor then, all of the STD tests came back negative. They also examined my prostate and could not figure what the problem was, the issue resolved itself in a few days. Twice since then, the problem has recurred but with only a little bit of blood in the semen. Each time, it goes away in a few days but I noticed that I do not ejaculate as much semen for awhile and sometimes feel a dull pain (not excruciating or anything, just noticeable) in my right testicle. Do you have any idea what this is and could it have anything to do with the HSV-1 equivocal test? I did ejaculate a small amount of blood the morning before the test (it prompted me to take the test).
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
44 months ago
If you have ever had cold sores in your whole lifetime, you are infected with HSV 1.  That is the cause of the vast majority of recurrent cold sores and more than half of the US population between 14-49 have HSV 1 infection.  The equivocal that you received on the test likely reflects the test missing a positive HSV 1 infection.  We know that the IgG test misses about 30% of HSV 1 infections.  What we do see sometimes is a high negative or an equivocal on the IgG for HSV 1.  When I see that, I suspect HSV 1, in spite of a negative IgG test.  In your case, you have a history of cold sores so we know what is going on here.  It is a lousy test - nothing about you.  You don't need to be focusing on your genitals - this is from an oral infection.  I don't think the intermittent blood in your semen has anything at all to do with this test result.

Terri
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44 months ago
Terri,

Thank you for your prompt and professional reply. Are the odds high that this is a false positive and would you recommend re-testing? I am just worried about this causing future problems in future relationships. Thanks.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
44 months ago
I think this is actually a positive since you've had cold sores in the past.  Anyone with a history of recurrent cold sores is likely going to be HSV 1 positive - and that covers about 56% of the US population.  Since you describe a history of cold sores, an HSV 1 test wasn't even necessary - we already know you are HSV 1 positive.  I think describing to potential partners that you have a history of cold sores would be a good idea.  I think you will often find that they too have cold sores and then you're all set - no transmission worries at all.

Terri
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44 months ago
Thanks Terri, I am going to go ahead and get on with my life. You have been tremendously helpful. This is a great service and it's awesome that you all provide it. The cost is really minimal for the fantastic advice and peace of mind that you give to a lot of folks. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
44 months ago
My pleasure to help, Michael.  Thank you for the kind words.

Terri
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