[Question #639] HSV Testing Results

46 months ago
Hello, 

I was hoping you could help clear up some info involving HSV testing I've had done over the past several years. My doctor seems to have a bit of archaic knowledge when it comes to HSV testing and I have received somewhat of conflicting responses from them. First let me provide you with my testing results

6/17/2009
HSV 1 - 1.52 IgG positive 
HSV 2 - .19 IgG negative 

1/13/2010
HSV 1 - 0.1 IgG negative 
HSV 2 - .06 IgG negative 

2/24/2012
HSV 1 - <0.01 IgG negative 
HSV 2 - <0.01 IgG negative 

6/20/2015
HSV 1 - .15 IgG negative 
HSV 2 - .07 IgG negative 

Each test also states that the assay is type specific for HSV 1 and HSV 2 IgG

Now my doctor also orders an IgM test along with the IgG, but everything I've read on here and the CDC website states that they shouldn't be used with adults in diagnosing HSV. Would that be correct? I've brought this up with my doctor and they didn't seem to know anything about it and also charged me for the IgM tests even though I never request them when getting tested. Hence why I think their knowledge of HSV is a bit archaic.

I've also asked my doctor why my first test for HSV 1  back on 6/17/09 was positive, but the subsequent three after we're all negative. I asked if it could've been a false positive, but they have never given me a direct answer. I'm lead to believe it is, but never knew for sure. My questions are as follows. Based on my IgG results, is it safe to say that I do not have HSV 1 or HSV 2? Could my first test for HSV 1 on 6/17/09 be a false positive? I've also never had any classic symptoms  of HSV and each test was administered a minimum of 3 months after my last sexual encounter. I'm just looking for some clarity so I can move on. Thank you very much for your help!




46 months ago
Hello,

I posted the below question a couple days of ago, but not sure if it got lost in the mix.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
46 months ago
Hi Kevin,
I'm not sure what happened to my response either but let me give it a try again.  The test for HSV 1 turns out not to be a great one - it misses one of four infections and so it is difficult to interpret your results with any accuracy.  Your results for HSV 1 are a bit all over the place.  Let me ask you - have you ever in your life had a cold sore on your lip or in your nose?  Not a canker sore, inside your mouth, that's different.  And remember that 56%, at least, of the population has HSV 1 infection so it would not be surprising if you were infected, and perhaps well before this encounter that concerns you.

Your HSV 2  is firmly negative, and compared to the gold standard western blot, it misses about 2 out of 100 infections only.

Terri
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46 months ago
Thank you for the response, Terri.  No, I have not had a cold sore on my lips or in my nose within my memory. I checked with my parents, and they said I've never had one either. I've also never had any symptoms on my genitals either. I guess that's what was confusing me,  my intial test being positive and the subsequent 3 being negative without ever experiencing symptoms. 

I've done some research on Medhelp.org (that I noticed you and Dr. Hook and Handsfield were a part of) and saw some threads stating that if no symptoms were ever present and an intial IgG test was in the low positive range (which I'm assuming my 1.52 was) and the subsequent test were all negative that the first test was most likely a false positive and the negative results were to be believed. It also stated that HSV testing results can fluctuate in numerical range and that a .01 for one test and a .50 for another doesn't mean anything and that they are both just negative. Would you agree with both points? Just trying to get some clarity so I can try to move on. Thanks again for your help!
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
46 months ago
The problem is that the material to which you refer is mostly applicable to HSV 2 - HSV 1 is actually a different matter when it comes to testing.  And I would disagree that there is little difference between .01 and 0.5.  If I saw both, and the 0.5 was after the .01, I would be concerned about seroconversion happening - going from negative to positive.
You could get a herpes western blot and get greater clarity about your HSV 1 status - we are actually doing a research study of the accuracy of ELISA IgG vs. herpes western blot (see our website at westoverheights.com - research section - and you could get the testing through us or directly through the University of Washington.  I will tell you that even if you do eventually test positive for HSV 1, you cannot know if this is oral or genital, just that you have it somewhere in your body. 

Terri
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