3 Negative Agg tests, positive swab

[hydrarkt]

Hi,
I think I was exposed to HSV (not sure which type) 1.5 years ago. I say this, as I had a small outbreak of herpes looking blisters on my penis. Approximately 3 months later, I had an HSV IGG blood test: HSV-2= negative. I was positive for HSV-1=positive. But I’ve had oral cold sores since a child, so I figured that was it.
Four months later, I had itching but no blisters in my groin. I went for another full IGG blood test. Same results:
HSV-2=negative, HSV-1= positive.
Four months later, more itching.. thought maybe fungal from steam bath… no tests
Five months later, small herpes looking blisters, no pain at all. I went got them swabbed the same day: on the phone, the nurse said culture reacted to HSV-2. I started with 500 mg Valtrex per day… 2 weeks later, I took another IGG blood test for HSV-2 only = negative.

HSV 2 IGG, TYPE SPECIFIC AB HERPESELECT
HSV 2 IGG TYPE SPECIFIC AB <0.90 01
Value Interpretation
—– ————–
<0.90 Negative
0.90-1.10 Equivocal
>1.10 Positive

So now I’m confused. 3 IGG HSV-2 negatives and one swab positive for HSV-2!!!

I know there are false positive and negatives. And I’ve heard that the swab test is the “gold standard.” But 3 false negatives on bloods seems unlikely.

Any ideas what could be going on?

Thanks

• This topic was modified 7 years, 7 months ago by hydrarkt.

[Terri Warren]

Hmmm. It looks to me like the antibody test missed the HSV 2 infection. Our most recent study of the sensitivity of the screening test confirms the package insert on this one – it misses only about 3 out of 100 cases. Yours looks like it is one. A positive AND typed swab from a recurrent lesion (four thing here: lesion, recurrent nature of the lesion, positive swab, and the ability to type it) suggests that the swab test is correct, not the antibody test. You could do a western blot to see how that turns out.

In my experience, once the antibody screening test misses an infection ,it will miss it every time (or most every time).

Terri

[hydrarkt]

Ok. Thanks. Where can I get the Western Blot done? I live in Boston.

[Terri Warren]

Our clinic can order the western blot for you easily, to be drawn at a lab near where you live in Boston. It will be shipped to the University of Washington for you. You need to call the clinic to make a phone consultation appointment at which time you and I will discuss the testing and arrange it for you.

Terri

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