[Question #5960] HSV-2-is it possible to have repeated false positive with Herpeselect

19 months ago
I'm 48 year old straight female. Always got a full round of STD testing between partners since I became active at 15. 10 years ago, I dated a man with genital herpes for less than 2 years. Chose to not wear condoms as he didn't have outbreaks and said none of his partners ever had symptoms. I've never had symptoms since. I don't remember what test I took after we broke up, but it came back positive. My homeopath at the time told me it was probably a false positive. I started dating shortly after. That partner chose to not wear condoms after I shared I tested positive-we stayed together 2 years. I trusted him and didn't test after him. Next partner chose no condoms-we stayed together 5 years. I tested in 2016 as I had recurrent UTI's/yeast/gardnerella. Doc chose to do DNA NAAT as part of full STD screen. HSV-2 came back negative. Last partner I had chose no condoms. We broke up this May. I got tested on August 16, 2019. Herpeselect igG antibody elisa shows positive for HSV 1, and 1.1 for HSV 2.  Questions: 1) is it possible that this is a false positive for the HSV 2 at 1.1? If I'm understanding right, between 1.1 and 3.5 is still a grey area, yes? 2) I know all 3 above mentioned partners never tested (I can understand why they wouldn't want to unless they got symptoms). Is there research showing what percentage of people in this low a range infect others? 3) Is there research showing whether people around that range (1.1) ever get symptoms? 4) What does that number actually measure? Why are people at 1.09 not positive and 1.1 positive? 5) And last question: would it make sense for me to take a different test and which one would you recommend? Asking as I just had a very traumatic experience. For the first time ever, I didn't tell new partner before having sex. We met over Friday, hung out at his hotel with friends Friday night-I slept there-just kissing and hugging, nothing else. He was at a wedding all weekend, we were going to hang out at the hotel again Sunday. H-
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
19 months ago
I would say the odds of a false positive here are greater than 95%.  The low positive would likely indicate a false positive, but if a true positive, the index value has not meaning in terms of infectivity.  The CDC recommends that you obtain a confirmatory test - the best is the herpes western blot done only at the University of Washington. You can work with your own provider to get this OR if they won't or can't do it, you can work with me and we will get it ordered at westoverheights.com.  I would NOT take this at face value.
Terri
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19 months ago
Thank you so much nurse Terri! Would you please clarify your response: "the index value has no meaning in terms of infectivity"? Does it mean that, if I'm positive, people would be as likely to get HSV-2 from me as if the number was much higher? And/or that they would be as likely to have outbreaks if they did get it from me as from a person with a much higher index?  Also, the Western blot is expensive, and, if there is 95%+ chance that the test I did is a false positive it seems to be a huge investment, with still a window of having a false positive, right? The Western Blot is not 100% accurate, is it? Thanks again!
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
19 months ago
Yes, the index value could be high or low, but if truly positive, you are the same amount of infectiousness.  And the frequency of their outbreaks would be the same, determined by their own immune response.  The western blot is 99.9% sensitive for HSV 2 while the IgG, in a screened population (vs. people with herpes symptoms) is 92%.  I have seen people be truly positive at 1.1 but not often.  Yes, the blot is expensive but what are you going to do now, if you don't do that?  Assume you are negative?  Assume you are positive?  Disclose your status, not disclose?

Terri
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19 months ago
Nurse Terri: Thank you for the clarification.  The biggest factor for me is finances-I just don't have the money at this time. Last question: would the quest HSV- igG inhibition assay be a good test for my case? Why or why not? I read that it is much cheaper than the Western Blot. And to answer your question, I would just assume I am positive and continue having the conversation with potential partners.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
19 months ago
I am NOT  fan of the inhibition assay as I have seen many results that are positive by inhibition assay but negative by western blot.  This is such a shame because I seriously seriously doubt that you have herpes and if you have to disclose to everyone that you are infected, this won't always, every single time, go well.  where do you live?

Terri
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19 months ago
I know, I have had a few horrible experiences talking about it with people over the years. It's frustrating, both from people who are not careful at all, as well as those who respond as if you had slept with every person on the planet-I'm joking, but, I've witnessed otherwise wonderful people become terrified or incredibly judgmental and walk away from what could have been a great relationship over this. Anytime I start dating again, my stress level goes up over this. I am in Texas and have no insurance for the first time in my life. Self-employed-1 person very small business. This year has been quite challenging financially. I see a homeopath every few months and she told me yesterday that she could order the Western Blot for me-she didn't know the price though.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
19 months ago
The price for test alone is about $260 - you can call UW and ask about the current price, 206-685-6066.  They will send you a kit that you need to get the blood drawn.  I'm so pleased that  found someone to work with you on this, even though it may be a while before you can afford to do it.  I'm betting good money it will be negative.  Honest.

Terri
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19 months ago
Thank you so much! I will definitely let you know when I do it. Thank you for what you do <3
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
18 months ago
You are most welcome

Terri
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