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 ordered 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!

I agree exactly with Terri's responses in your other thread. The business about low positive ELISA ratios in the HSV antibody tests indeed applies to HSV2, i.e. a gray zone result like your value of 1.52 would be considered a false positive for HSV2. However, HSV1 results have not been carefully studied in this regard, so most experts would consider that result positive. Therefore, at this point your HSV1 status remains uncertain. Given the subsequent clearly negative results, my best guess is that you don't have it, but it is possible that it's the later results that are falsely negative.

That said, I really don't think you need worry about HSV1. Having had no symptoms to suggest either oral or genital herpes, it is likely you will never any, and probably will never infect another person.

As for HSV2, all results are solidly negative and for sure you aren't infected. Unlike HSV1, the HSV2 antibody test picks up all infections for practical purposes. In case you're concerned about the slighly variable HSV2 numbers, they are not a consideration. Such variation is normal and the test is definitely negative as long as the ELISA ratio is under 0.9 (and yours are well under that level). Even the very same specimen tested several times will give different numbers.

In summary, you can move on without worry about any of this. Best wishes--

HHH, MD