[Question #2020] HSV-2 a Possiblity? FOLLOW UP

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83 months ago

Hi Terri, I purchased some additional questions. This was your last comment on my previous thread: Question #2009 HSV-2 a possibility?

So many questions!  Hope I can answer them all. If you had an equivocal result before, then it is not a surprised that you now have a low positive - you likely have some protein in your blood that is tripping the test but not a herpes related one.  The best test is called the herpes western blot and that is what we recommend for low positive results, to confirm or deny infection, but you are too early for that at this point.  I doubt you were infected at this encounter, but I cannot say for certain with this low positive.  So I think you are OK, but I cannot be as definitive as your previous provider because technically you do have a positive result and if I said "oh you are fine" and this actually represented an infection, that would be bad!  Low positives can also occur due to a new infection, thus my hesitancy to tell you that you are fine.  Does that makes sense?   the antibiotics have no impact on the herpes antibody test, no.

I was able to find a copy of my lab corp results from last year and it was actually taken a little over a year ago in March 2016:

HSV 1 IGG type specific was at 48.90 ( a little higher than my current 46.30) and my HSV 2 IGG, was actually <.91 (current is 1.79), not equivocal. Not sure if that's due to changes in my body or due to previous test being done through lab corp and most recent through Quest. Or if it's truly a sign of acute infection.

Does this change your opinion on your belief that I have a 70% chance of being ok? 

Also, what factors contribute to false positives? I don't think i saw an answer to that in my last set of questions. 

The last partner (prior to my gf) was right after my labcorp results from 2016 (so it was early April 2016). If that person infected me with hsv-2, would my current hsv-2 number be higher?

Lastly, I plan on testing again in 6 weeks like you mentioned. What HSV-2 index would be suffice to say I’m probably negative? Anything below 3.5?

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Terri Warren, RN, Nurse Practitioner
83 months ago
The main cause is a protein that is a similar molecular weight as one of those found on the HSV 2 antibody, but it is not herpes related and it does confuse the test. 
It's difficult to say if your number would be higher if you were infected that long ago - some people just have low positives as their normal solid antibody response. 
If your test is still positive but below 3.5, I would suggest that you obtain the herpes western blot from the University of Washington.  This is considered the gold standard test for those with low positives.

Terri
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83 months ago
Thanks for the follow up. Based on everything are you still leaning towards me being okay? You mentioned in the previous thread I have a 70% shot of being negative with such a low positive. 
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Terri Warren, RN, Nurse Practitioner
83 months ago
I am most definitely leaning towards you being OK.  But I cannot be certain

Terri
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83 months ago
Well that's very hopeful. What are your thoughts  on the Herpes Simplex Virus 1/2 (IgG) with Reflex to HSV-2 Inhibition by quest.  I've seen that's it's being compared to the western blot,  but can pick up on actual antibodies a lot faster.  If it's a viable option do i still have to wait 6 weeks?  And is anal irritation a cause for concern.  I have slight irritation but no blisters or anything. I do have a moderate hemorroid(not painful)  but it's just a little irrirated down there.  Not sure if I'm just being paranoid.  Those are my last 2 questions.  I appreciate all of your input here.  :) 
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Terri Warren, RN, Nurse Practitioner
83 months ago
I am definitely not a big believer in the inhibition assay.  All research studies use western blot as the gold standard.  The inhibition assay is based on the IgG ELISA test that has false positives - how could be better?  The western blot is the gold standard - no question.  I wouldn't accept anything else if I was in your situation.

Terri
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