[Question #9206] HSV-2 Low positive test result

35 months ago

I had an HSV-2 IGG test result of 1.30. I have never had any symptoms. I noticed CDC guidelines for low positives on the report but my gyn did not want to cosider that it might be a false positive and do another test. I have an upcoming appt with my pcp and would like evidence to convince her to do a confirmatory test. Can you direct me to a journal article or something? Also, should I do a lesser confirmatory test or go straight to western blot? Cost is a consideration, but I will pay for the western blot if necessary but if a simpler test can clarify the result that would be good.. One thing my gyn said is that since I was positive for HSV-1 it didn't really matter what my HSV-2 result was. SInce I have no symptoms I realize my positive HSV-1 could have been acquired orally or genitally, but I still consider it important to know my HSV-2 status with a decent level of certainty.

Terri Warren, RN, Nurse Practitioner

35 months ago

You most certainly need a confirmatory test as there is about an 85% chance that it is false positive. There is no better test than the western blot, albeit expensive.

Of course it matters if you have HSV 2! You need to know in terms of sexual transmission. I don't understand your doctor's thinking on that one. And what is the index value on your HSV 1 IgG test?

Terri

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35 months ago

HSV-1 12.30

35 months ago

Correction:

HSV-2 IGG index is 1.33 and HSV-1 IGG is 12.30

Thank you, Terri! I trust your respect and trust your credentials/knowledge on this topic. But for the benefit of my getting my (different) dr's cooperation, is there a particular article I can cite to demonstrate the high rate of false positives with this 1.33 index?

What other confirmatory test could I do before considering

The Western Blot necessary?

35 months ago

Also, should there be a waiting period before doing a confirmatory test? I have not had any sexual contact at all in 5 months.

Terri Warren, RN, Nurse Practitioner

35 months ago

Performance of Commercial Enzyme-Linked Immunoassays for Diagnosis of Herpes Simplex Virus-1 and Herpes Simplex Virus-2 Infection in a Clinical Setting.

Agyemang E, Le QA, Warren T, Magaret AS, Selke S, Johnston C, Jerome KR, Wald A. Sex Transm Dis. 2017 Dec;44(12):763-767.

There are no other good confirmatory tests for HSV infection. Both the LabCorp and Quest confirmatory tests have had false positives in comparison to the herpes western blot. Your timing is fine to do the blot if you wish now - UW likes 12 weeks from any concerning sexual encounter before doing the blot.

I think there is an excellent chance that your high HSV 1 is exhibiting some cross reactivity with the HSV 2 test.

Terri

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