Can WB pick up Glycoprotein G deficient samples

[anxiousconfused27]

Hi. I have had 1 sexual partner ever and he would get cold sores. He had IgG testing that was positive for HSV-1 and negative for HSV-2. Early in our relationship, he would perform oral sex on me…never during a breakout, though.

Anyway, I had an episode of vaginitis >3yrs ago (erythema in the vagina, itching, swollen groin nodes). There were no lesions so no HSV swab was done. I left without a diagnosis. However, I returned to my regular doc approx 3wks after symptom onset and asked for HSV serum testing. At that point, my partner hadn’t performed oral sex on me in many years b/c I forbid it once finding out that he gets cold sores. Anyway, my HSV I/II IgM testing was positive at 2.54. I now know that that test is prone to false positives and is not recommended. My HSV I and II IgGs were both negative.
B/c I’m aware that HSV IgG needs time to form, I had repeat IgG testing a couple of months ago (3yrs after the vaginitis episode) after breaking up with my one and only sex partner. The IgG testing was negative. I then got the testing again 1 month ago and it was negative again. My doc told me I should put this in my rear view. Also, I haven’t had another vaginitis episode.
While trying to figure out what to tell my new potential partner, I began researching the chances of IgG false negatives. I read that some forms of HSV I are glycoprotein deficient, which could lead to false negatives.
So now, I’m wondering what my chances are of truly having genital HSV-1. Of note, I’ve never had cold sores.
What do you think about my story? And will the Western Blot detect antibody production to glycoprotein deficient producing isolates?

Thanks

[anxiousconfused27]

And for clarity sake, my repeat x2 negative testing was HSV I and II IgG. And in regards to my question about whether or not I could have a glycoprotein G deficient isolate: Since my partner has a positive HSV 1 IgG, would that infer that whatever he passes on to another person would not be considered a glycoprotein G deficient isolate?

[anxiousconfused27]

And I’ve also read just now that 5–10% of people don’t produce Glycoprotein G antibody. So will those people be able to rely on a Western Blot? I’m not certain of the ins/outs of that test.

Btw, I guess I’ve just reached my 1 question and 2 follow up max.

[Terri Warren]

Yes, the western blot looks for all the proteins associated with herpes antibody, not just the one. And four have to present to be called positive, way more thorough. If you want to be certain about your status, the western blot is the best option. Clearly, you’ve been thinking about this for a long time – maybe best to get this behind you with the best test. You can work with your own provider to get this test (assuming you don’t live in NY) or with me – both come out the same

Terri

[anxiousconfused27]

Ok, thank you. I’ve already ordered a test kit so hopefully, I can find a provider to order the send out lab.

Just going back to my question on your thoughts about my scenario, more specifically, what are your thoughts on the IgM positivity at 2.54 on the Labcorp test?

[Terri Warren]

In my experience, the IgM has about a 85-90% false positive rate compared to an IgG that was drawn at the appropriate time.

If you have trouble finding someone to do the blot, I can order it for you as part of our study comparing IgG to western blot. Link on this site.

Terri

[anxiousconfused27]

When you say 85-90% compared to an IgG drawn at the appropriate time…are you meaning when the IgM and IgG are drawn at the SAME time AND at the appropriate time for the IgG…3-6 months out? My first IgM and IgG were drawn 3 weeks out.

Also, I scheduled a virtual appt and called an AnyLabTest now in my city and she stated that they don’t do labs draws on demand for send out tests. I’m not sure what to do next?

[anxiousconfused27]

And when an IgG is drawn at the appropriate time (3yrs later x2 in my case), can you comment on how often you see HSV-1 false negatives? Do you have data on how many people don’t develop the antibody to glycoprotein G? I see differing info in the literature.

[anxiousconfused27]

My most important question to address: When you say the IgG can miss up to 30% of HSV-1 infections, does this number decrease if greater than 6months has passed since a possible outbreak?

[Terri Warren]

The 85-90% is when at least 12 weeks have passed since a concerning encounter. The Mayo Clinic stopped offering this test in 2019 and Quest and LabCorp will stop offering it by the end of 2022.
We used to see very few false positives on the HSV 1 IgG, everyone above 3.0 confirmed, but now I am seeing more – I don’t have statistics on this, just anecdotal comments.
I’m not sure how many people don’t develop antibody to glycoportein G but I don’t think it is quite common.

The number of false negatives on the IgG test for HSV 1 probably remains the same long term though generally, people who do the IgG and then come to me for the western blot don’t repeat it again in 6 months. But I would guess that it stays the same as I have seen several people retest years later and it is the same

Terri

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