[Question #628] The Accuracy of Herpes Test

43 months ago
I got back my test results yesterday and they read as follows:
Herpes 1 IgG - Equivocal
Herpes 2 IgG- Negative
Herpes 1 and 2 IgM- Positive 
Chlamydia IgG - Positive 
HIV- Negative
Can you explain the herpes test results. DO I HAVE HERPES 1 and 2?

Thanks
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
43 months ago
It is difficult to interpret your test results without having some idea about your recent sexual contacts.  Could you please tell me when you last had sex, were condoms used, have you had prior testing done, that kind of thing please?

Terri
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43 months ago
Hi, this  test was done on March 10th 2016 and I had  unprotected sex 3 weeks before  with my partner. I have not had test for herpes  prior to this. I have never had an out break nor has my partner. This was just a annual check up at my ob/gyn and I asked for STD blood work to be done (not because I was experiencing symptoms ). Today I took the Biocan  15min test that said I was negative for herpes  1 and 2 IgG and IgM.  I have given blood again today to run test again to see if the results are the same or have changed. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
43 months ago
A test done only 3 weeks after a sexual encounter cannot be interpreted easily unless we know the test result of your partner.  Because 80% of those infected with HSV 2 don't have symptoms that they recognize as having anything to do with herpes, relying on symptoms alone to know if someone else is infected may not be accurate.  I'm not familiar with the Biocan test.  But at least you know, at this point, what your HSV 2 status is - negative.  If your partner tests negative and you've not had sex with anyone else for about 3 months then you have waited long enough for an accurate test.  however, if your partner should test positive for HSV 2, then you would need to wait another couple of months to get your testing redone for accuracy.  The equivocal on the HSV 1 test is also a bit hard to interpret if you don't know his status - have you ever in your life had a cold sore on your lip or in your nose?  If yes, then that's where your equivocal test might be coming from.  I would ignore your IgM test results as they are often wrong, but again, a little difficult to interpret without knowing your partner's status.  Would he be willing to be tested with an IgG test only?  That would certainly help you know what might be going on here.  This is a pretty big topic and it's a bit like a jigsaw puzzle to try to figure out what might be going on.  Also, to work more on the puzzle, it would be good to know when you last had sex with anyone when else, other than this partner?  Herpes testing isn't like a test for chlamydia for example.  With that test, we look at a swab or urine and say yes or no, chlamydia is there or not.  With herpes antibody testing you aren't looking for the virus itself, you are looking at your body's immune response to the virus and that takes time to make.  Please - ask me what you need to know here - again, it is complicated.

Terri
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43 months ago
Thank you for you response. Just one last question if the Rapid Biocan Herpes IgM test came back negative for herpes 1 and 2 does that mean that I do not have either of the two, is it too early to tell or is the Rapid test not reliable. I am just a bit confused as to how the blood work done in a lab would be positive for Herpes 1 and 2 IgM and negative on the the Biocan Rapid IgM test 15 days later. According to the lab test If i am equivocal for herpes 1 and the lab  IgM test gives a false positive reading for herpes 2 because it can not differentiate between the two types of herpes, then why was this not the case with the Biocan Rapid IgM test?...should it not produce the same result as the one done in the lab (positive for 1 and 2 IgM. 
Thanks
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
43 months ago
IgM tests are extremely unreliable, in general.   I cannot explain why one might be positive and the other negative except to say that in my experience, 80-90% of positive IgM test (that other clinicians have ordered for people, not me) never confirm at positive with a subsequent positive IgG test.  They are incredibly variable - please don't count on them in any way, only the IgG test.

Terri
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