[Question #82] Herpes False Positive?

39 months ago
Hello, brief description. I am on a monoclonal antibody that is infused every two weeks. I run a normal white blood cell count of 2.0 which is normal for me and in times of infection my immune system does respond. When I do get sick though I usually have to go to the hospital to be evaluated due to my low white count.

The question is in regards to testing and the event that happened. On about May 24th, 2015 I hired a CSW and we made out for a little bit and then proceeded to have intercourse. I used a condom, which I found out a couple minutes later broke after I pulled out. Now since then I have had no other sexual partners.

At my 10 week mark I went and got tested for all STD's including HSV1 and 2 using the Elisa from Quest Diagnostics. At this point since the whole scenario, I noticed I had a abrasion right behind the crown of my penis after I was done masturbating, the following day I had my doctor look at it. This was about 3-4 weeks ago. My doctor told me along with her nurse that it doesn't look typical of herpes. I ended up putting neosporin on it and it healed up the next day. Ever since then I have had no issues.

When I got the results I was negative for everything besides HSV 1 and 2. I had a value of 1.47 for HSV1 and 1.50 for HSV 2. This was at my 10 week mark. Since then I have been severely anxious and sick to my stomach in the anticipation of a new sore or lesion. I have noticed that my lips have become irritated like a heat rash in one spot ever since the diagnoses but no HSV marks. Again I have
been severely stressed and work a very stressful job with the government sector and poor immune system, I should have had an
outbreak by now right :/

My question is:
1. How reliable is a 10 week antibody test using the Herpeselect?
2. Can I expect with these low values that this can be a false positive?
3. If this were my initial infection would I have overt signs and symptoms, unlike what I have reading where many people don't even notice their first true outbreak?
4. Would I expect herpes lesions all around the area where the infection was massaged into ie: penis? And these leisions wouldn't be a small pimple, or mistaken for an ingrown hair or could it with the first outbreak in someone with a low immune system?

Thank you for your time and patience with my worry.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
39 months ago
I think we've talked about this before?  It does sound familiar.

Both of your values are in the low positive range, which means, according to the newest CDC STD treatment guidelines, that you need a confirmatory test to determine if this is a true or false positive result. For the HSV 2 result, there is an 85% chance this is a false positive.   I prefer the western blot as the gold standard.  If these confirm as positive, you cannot know if this is something you've had for years or this is something new from this most recent partner.  It is possible to miss a first infection, yes.  Have you ever in your life had a cold sore on your lip?  Eighty percent of people with HSV 2 infection don't know it so not everyone has typical looking lesions, right?  The symptoms might be minor or they might be remarkable.  That's why I asked you about the cold sore history.  A person with a history of cold sores is less likely to have remarkable symptoms when they acquire HSV 2.

Terri
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39 months ago

Hi Terri, I tried emailing the staff at your clinic because I was having issues but I never got a response back. I found this board which is amazing.


I have mentally calmed down a lot and my anxiety is subsiding. To this date in my life I have never had any cold sores (typical of the pictures or what you see in the average person with cold sore). I am trying to wrap my head around everything Herpes wise because I was never properly educated, and I have never had the typical herpes lesions.


I have tested 2 times in the past about 2-3 years ago and came back negative for both HSV-1 and 2 both times. I will be pursuing the Western Blot I believe with your clinic in the future once I reach the 16 week mark.


In your professional experience and length of practice with the virus and testing have you ever seen false positives with HSV-1 in the herpeselect IgG test from quest diagnostics?

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
39 months ago
I'm so sorry you didn't hear back from our staff at the clinic.  I wonder where you email went.  It's best to write to info@westoverheights.com
So glad to hear your anxiety if lessening.
Yes, we have most definitely seen false positives for both HSV 1 and HSV 2.  We don't fully understand why false positives happen - actually I don't think we understand at all.  We used to think that being HSV 1 positive could cause false positives on HSV 2, but we didn't see that in our most recent study.  Unfortunately, when people have these low positive ELISA values we sometimes also see indeterminates on the western blot - not often, but from time to time.
Yes, when the 16 weeks has passed, set up a consultation with me at the clinic and we'll arrange for you to get the western blot.
You have one post remaining - anything else you can think of for me, Jeffrey?

Terri
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39 months ago

In your opinion, given my background and non-symptomatic HSV-1 and 2 result scares.

1. Would you think this is positive in my favor that I am Not infected with Both HSV 1/2?


2. Is 10 weeks enough time for a person to make antibodies? Would you expect my values to rise much more if these are true values and indeed infected?


These are my only last questions please.

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
39 months ago
So 10 weeks is not officially long enough for the western blot to become positive, no, and even, I think HSV 1 and 2, necessarily, but you are technically positive for both at this point.
The odds are in your favor in terms of the HSV 2 being a false positive - we do not have as good data for HSV 1 for me to make a statement either way.

This was your last question on this subscription.  If you have more questions, feel free to renew.

Terri
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