[Question #6140] HSV2 IgG: Equivocal followed 3 months later by Negative - Status???

17 months ago

Summarized history:

  • I was tested on 5/21 due to a scare that I thought was herpes but my Dr insisted was not. HSV2 IgG was negative

  • I had unprotected sex with my last partner on approx 7/14/19. She was “unknowingly” HSV2 positive due to her Dr’s staff giving verbal results. Started using condoms after her doctor reviewed her test results with her. Sort of besides the point but wanted to be thorough. 

  • Equivocal (0.96) test followed 3 months later by a Negative test (0.56)




My question is typical:

I had an equivocal result (0.96) followed nearly 3 months later by a much lower result (0.56). What do I tell my next partner? That I have a really good immune system? (joking of course)


Detailed history:

5/21/19 - outbreak that Dr insisted was a canker sore (he stated 99% certainty. Didn’t want to do a swab). Prescribed antibiotics and cleared up in 4 days.

5/21/19 - HSV2 IgG < 0.9 (self-ordered a full panel with LabCorp). HSV1 is 59+ and has been for years.

7/14/19 - probable exposure to HSV2 unprotected

7/25/19 HSV2 IgG = 0.96 equivocal (LabCorp)

10/11/19 HSV2 IgG < 0.9. I specifically called the lab for the exact measurement and it is 0.561.


Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
17 months ago
Since your equivocal test did not go on to become positive (and indeed decreased), I think that this should relieve you of having to tell your partner anything except that you test negative for HSV 2 (which you now do).  Your doctor is correct that canker sores are not herpes.  The other thing is you don't know exactly what test was done on your previous partner (IgG or IgM) or the index value so this could not even be real.  I think you've done a good job of following up and can be reassured with 92% certainty that you don't have HSV 2.
Terri
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17 months ago
Thank you for the detailed answer.  I will share this with my previous partner.   

I’d like to ask a follow up question.  If you  feel this thread is closed I understand and would be happy to open another. 

Regarding the Western Blot test. I’ve tried to locate more detailed information about it but  not been successful:
- is it just a more quantitative test? ie: less open to interpretation by the lab?
- is there a timeframe after exposure when WB is decidedly more accurate than the typical IgG test performed by LabCorp/Quest?

Can cankroids recur if the initial antibiotic treatment didn’t quite eradicate it?

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
17 months ago
The western blot is available only at the University of Washington.  It looks for all the proteins associated with HSV antibody vs. a single one that the IgG seeks.  It can clarify false positives or other issues with the IgG test.  It is advised that you wait 12 weeks from any concerning encounter to get this test.  You can send for the kit by calling 206-685-6066.  You will need a clinician to order this test for you - your own provider or I can do it for you via video conference

Terri
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17 months ago
That would be great. Please let me know the process for having you order the WB test. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
17 months ago
you can definitely work with your own provider and the UW to get this test or if they doesn't work for you, I can arrange it for you.  If you want me to get this ordered for you, you would need to set up an appointment with me at westoverheights.com, the box on the home page that says video conferencing.  If you want to order the kit to work with either me or your provider, you can call UW , 206-685-6066

Terri
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