[Question #7006] Past Results

10 months ago
Hi doctor, I'm reaching out about anxiety over past STD results.  In 2015, I had an ASCUS HPV + pap.  I was shocked bc I had very few partners and was always careful. My gyno wasn't concerned bc I was young.  I switched to another gyno, who then tested me for HPV two months later.  The test came back ASCUS but negative for HPV.  I was tested every 6 months and I have had normal paps and negative HPV since.  In 2016, I had sex with someone who took his condom off without my knowledge.  I immediately realized and left, so it was a brief sexual encounter.  I did not receive oral sex from him, and he did not have any visible cold sores present.  Still worried and upset, I went for a full STD panel 2 months later and everything was negative except HSV 1 positive at 1.6 igg.  I was not experiencing any symptoms or sores.  I have one other test to compare that to.  A year prior, I had a routine test done, and I was negative for HSV 1 igg.  I know the test can miss some infections, but I believe odds are I was truly negative.  I never had a sore, and my mom made an effort to protect me from exposures as a child, like kisses on lips from relatives.  Between the time of the first HSV 1 negative test and the second low positive test, I did not receive oral sex, and I believe I kissed 3 guys including the man from the sexual encounter.  None of which had any visible cold sores.  I talked to my gyno about the 1.6 igg score and bc of my history, the fact that I've never had symptoms, and the low score, he believed it could be false positive.  Do I have reason to still worry about HPV?  Because of one test result in 2015, I feel like I am contagious despite the negative results after.  Also, is it possible to receive a false positive HSV 1 test with a low score?  Bc this happened years ago, I fear that further testing will increase my anxiety, even though I'm aware of how common this is.  I really would like to move on and stop carrying guilt into my new relationship. Thank you!
Edward W. Hook M.D.
Edward W. Hook M.D.
10 months ago
Welcome to our forum and thanks for your question. I’m sorry to hear of the problems you’re having. I suspect at least part of them relate to challenges in interpreting laboratory results. I will do my best to address those issues and to to offer some additional thoughts.

Let me first address the issue of your HSV test results. Unfortunately, all too many panels include HSV blood tests in their offerings. These tests should not be used for testing of persons who are asymptomatic and not otherwise at risk. Your experience is an example of the problems that can occur when they are.  The value of your HSV-1 IgG test is very low and in the range where far more of these results are falsely positive than actually informing persons of the presence of true infection. Further, when combined with your history and the fact that you have never experienced oral lesions, Isuspect that is the case for you.  The fact that subsequent tests have been negative only adds to this sentiment.  I would urge you not to be concerned about the possibility that you might have HSV-1 and be infectious to partners.  I suspect you are being misled by an inaccurate bloodTest which is being used in a way which is not recommended.

Now let’s address the issue of your positive test for HPV. Please understand that among unvaccinated adults, over 80% of persons will acquire HPV at some time in their life. In well over 97% of these cases, the infection resolves without causing complications or problems. That appears to be what has occurred in your case.  The ASCUS Pap smear finding may sometimes be caused by HPV but many times it is not. The fact that your subsequent HPV tests have been negative strongly suggest that you were HPV has resolved, and that you are not at risk for transmitting HPV to future partners.

Thus, to summarize, it is unlikely that you have HSV one or the do you continue to have HPV. There is no reason for further testing and no reason for you to fear transmission of either of these infections to future partners. I urge you to move forward without concern. Parenthetically, I would suggest that you strongly consider taking the HPV vaccine. We recommend It for all patients who may have new partners in the future.

I hope that the information I have provided has helped to address your concerns. If there are continuing concerns or if any part of this reply is unclear please feel free to use your up to two follow ups for clarification. Take care. Please don’t worry. EWH
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10 months ago
Thank you so much!  I forgot to mention that I did receive the Gardasil shots around age 13.  Thank you for putting my mind at ease.  I've been holding on to this anxiety for far too long, and it's very helpful having someone clearly explain my results and answer my questions.  
Edward W. Hook M.D.
Edward W. Hook M.D.
10 months ago
Great. N.Y. Your Gardisil vaccination
will help protect your going forward.  EWH  
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