Changing IgG levels

[concernedasymptomatic]

Hello, 3 weeks after episode of unprotected sex IgG level from Labcorp was 1.10. 8 weeks after my IgG level was 2.080. Both tests ordered from healthlabs. Does this indicate that I was exposed and am making more antibodies? What is considered a “significant shift?”. Both readings are ‘low positive’, but numbers have risen. I have had zero symptoms and the girl didnt have any noticeable symptoms and denied having any previously. Curious as to if this could be false positive or if the rising numbers indicate probable infection. Should I order western blot? I will take the ‘confirmation test’ test. I had zero suspicion I could have had it, it was just included in their ‘comprehensive panel’. Any thoughts on the probability of a true positive vs false positive?

[concernedasymptomatic]

Clarification- second test was done at CPL labs. First done at Labcorp. Both ordered through healthlabs.

• This reply was modified 3 months, 1 week ago by concernedasymptomatic.

[concernedasymptomatic]

Also no reflex done as Labcorp was out of them and CPL didnt offer. Positive values for each lab:
LabCorp: 1.09
CPL: 1.00

[Terri Warren]

The changes are not significant in any way AND these are in the range of possible false positives. If these values hold at around eight weeks, you need a western blot for clarification.

Terri

[concernedasymptomatic]

Thank you. Do you mean 8 weeks from (16 weeks) or 8 weeks post exposure (when second test was done).

Thank you

[concernedasymptomatic]

Ok, update. I got the Quest HSV 2 IgG inhibition confirmation test and results are:

HSV 2 IgG screening index: 1.12
% inhibition: 95.1
Interpretation: positive.

To recap-
LabCorp test 3 weeks from last encounter: 1.1 (no inhibition as they were out)
CPL labs 8 weeks from last encounter: 2.080
Quest confirmation (done 2 days after CPL labs) 1.12 with positive confirmation at 95.1

I have yet to have any symptoms and am currently 9 weeks from my last encounter. I would have never even been tested (per CDC rec’s) but was included in the healthlabs order, so this caught me off guard.

questions: 1) what do you think the chance is I am truly positive? (I know by scale, my LabCorp and Quest both would say about 90% chance of being false positive, but the positive confirmation and random higher reading of 2.080 in between the two test (maybe CPL labs does things different than quest or LabCorp?) is making me think maybe I really did contract it)

2) what do you suggest for path forward?

3) if high likelihood I have HSV2, as a completely asymptomatic individual, would you recommend treatment? I am hesitant because I am not even sure what would be treated? (I know- asymptomatic shedding, but in absence of any symptoms and I havent seen much in terms of reserach on shedding rates of people who never had even 1 outbreak). I have seen different doctors recommend different approaches, with one doctor friend saying “all the test tells me (if true positive) is you’ve been exposed to it, not even that you have it” – although from my understanding exposure and having it are correlated 100%.

4) previously you said “if levels hold at 8 weeks get WB” did you mean 8 weeks post exposure or 8 weeks from that post (16 weeks after exposure)

Thank you for all you do, you have done more to shed a light on testing than any singular person in healthcare 🙂

[concernedasymptomatic]

sorry, I forgot to ask : is my understanding that exposure with immune response= 100% chance of contracting HSV correct? I’ve had a few doctors tell me they think it’s possible to have antibodies without having contracted it (killed virus before it settled into nerve) although I have seen absolutely zero research on that, and I don’t have false hope for that, I am legitimately curious.

Index value of 1.1 has been shown to be 90% false positive, is there data on percent of low positve WITH positive confirmation and reactivity rate of 95% at quest?

Also- in the case that I have HSV2 and my IgG levels are as low as possible (literally at the cut-off for positive) does this indicate some type of immune problem on my behalf? Logically thinking, a robust response would include high numbers of IgG. If I am truly positive, I was kind of hoping for a rise in IgG to indicate my immune response is kicking in. I am now 9 weeks from my last encounter (nothing special about that encounter, ie my partner didnt have any outward signs and she told me she hasnt noticed anything and said her last STD was fine (after our encounter) but it probably didn’t include HSV2 as it’s not indicated to test without symptoms so it could have been any encounter since my last test a year ago).

I also purchased more questions because I think last question was my limit.

[Terri Warren]

questions: 1) what do you think the chance is I am truly positive? (I know by scale, my LabCorp and Quest both would say about 90% chance of being false positive, but the positive confirmation and random higher reading of 2.080 in between the two test (maybe CPL labs does things different than quest or LabCorp?) is making me think maybe I really did contract it)
It’s difficult to say but I would trust the western blot over the inhibition assay, certainly

2) what do you suggest for path forward?
Western blot

3) if high likelihood I have HSV2, as a completely asymptomatic individual, would you recommend treatment? I am hesitant because I am not even sure what would be treated? (I know- asymptomatic shedding, but in absence of any symptoms and I havent seen much in terms of reserach on shedding rates of people who never had even 1 outbreak). I have seen different doctors recommend different approaches, with one doctor friend saying “all the test tells me (if true positive) is you’ve been exposed to it, not even that you have it” – although from my understanding exposure and having it are correlated 100%.
If it turns out through western blot that you are truly positive, and you are having sex with someone who is HSV 2 negative, daily suppression would be appropriate. If you are not having sex, I’m not clear that you need suppression.

4) previously you said “if levels hold at 8 weeks get WB” did you mean 8 weeks post exposure or 8 weeks from that post (16 weeks after exposure)
8 weeks post exposure

Terri

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