[Question #88] Herpes Testing

111 months ago

I am really just learning about herpes but as previously stated I had the Herpeselect testing done at 10 weeks for the IgG assay. The values came out low positive for both, HSV1- 1.47 and HSV2- 1.50.

My question about this testing is, what are the odds that both of these values are falsely positive?

Do you believe that at 10 weeks my antibodies will remain in the same levels? or if this is truly a new infection at 10 weeks they should be higher correct?

Again I haven't had any outbreaks that constitute a herpes outbreak and I have been very aware of my whole body since my last event and always previous ones. Thank you.

Terri Warren, RN, Nurse Practitioner

111 months ago

Both of these tests are in the low positive range and need confirmation. There is just no way to know at this point if they are truly positive or negative. The 1.50 has an 85% chance of being a false positive. We do not have the same kind of information exactly about HSV 1, but if I had to guess, I would say it is more likely to confirm with the best test the herpes western blot. It is possible that at 16 weeks, the antibody levels might be higher, it would likely be worth doing another ELISA screening test before opting for the western blot.

Terri
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111 months ago

Let me ask this:

With the Herpeselect Elisa testing, the wells quest diagnostics uses are read by a computer for their results of whatever is left as a result of the technician washing these wells.

As with the Western Blot the technician's manually look for the many antigens that are associated with the HSV virus correct?

Herpeselect is computer read?

Western Blot is manually read using a higher expertise?

Thank you Terri, I know your probably tired of my questions.

Terri Warren, RN, Nurse Practitioner

111 months ago

The herpeselect is computer read, yes, detecting the intensity of a color change, and the western blot is manually read yes. The western blot looks for proteins that are part of herpes antibody.
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111 months ago

Hi Terri, in reading about interference with the Herpeselect Elisa, I saw that Hemolysis can interfere with results and cause low false positives. I am currently on a Murine Monoclonal Antibody for a blood disorder called PNH that ruptures my red blood cells at a fast rate. I have a LDH in the 280-300 range which is high and causes this hemolysis. Do you think this could play a part in the Elisa testing result of the false positive and the HSV1 being 1.47 so close to HSV2 of 1.50?

Also I read that patients on Monocolonal Antibodies can shares antibodies that cross react and cause false positives itself, with Herpeselect I believe using Goat mAb? What is your take on this?

Terri Warren, RN, Nurse Practitioner

111 months ago

Jeff, I don't know the answer to your specific question. This is not an area about which I am familiar. I will ask my colleagues if they have heard any more about your specific situation and will let you know what they say.

Terri
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111 months ago

Thank you Terri, I do have a phone consultation with you tomorrow which I am highly excited in speaking with you. You have been very helpful in this scary point in my life. I spoke with the people at the University of Washington about the specifics to the Western Blot and they speak highly of you. They asked if I ever had an outbreak which I replied no for either HSV 1 or 2 and they flat out told me that with these low values they have a majority of people who come out confirmed as a False-Positive based on the Elisa and Negative with the Western Blot.

What scares me is the high risk I took with the CSW and the broken condom, I believe I am going to confirm the herpeselect regretfully....

Terri Warren, RN, Nurse Practitioner

111 months ago

Hi Jeff,
I ran your question by Dr. Handsfield (thank you Dr. Handsfield) and he does not feel that your immune situation has likely anything to do with these low positives either. In the end, we cannot know if they are real or false without the western blot. And in reality, it doesn't matter what might or might not make a false positive for you, what matters is if it is real or false. And even if it is real we can't know where exactly you got it and when. We'll talk more tomorrow.

Terri
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