Conflicting HSV1/HSV2 results.

[melib382]

Hi! I am extremely confused and need answers.

In 2018 I contracted (what all of my medical documentation says) HSV2 by assault. The assault was ONLY penetration, no oral. The testing was performed via PCR (swab) on my genitals. I did a blood test at this time as well, it confirmed HSV2 and NOT HSV1. I got blood tested recently, it said I’m positive for HSV1 and NOT HSV2. I got retested yesterday (6/11) and I just got the results again, I’m positive for HSV1 and NOT HSV2. I’m extremely confused. I have NEVER had HSV1. I’ve never had a cold sore, I am extremely careful about not sharing drinks or anything and I have not been intimate with anyone/kissed anyone in 9 months. Contracting oral herpes is nearly impossible with the precautions I’ve taken, my dr agrees on this however she doesn’t know what’s going on past that. Both of my recent partners were negative for HSV1 and HSV2 as well. I have had one outbreak (the diagnosis) and have been on valtrex since 2018. I take L Lysine as well. My IGG number for HSV1 is 2.42. Per my research that is in the “false positive” or “50% you have it 50% you don’t have it”

How could a PCR swab confirm HSV2 and not HSV1? PCR tests are 100% accurate, blood tests aren’t. I’m aware that HSV1 is possible in the genital region but more so common orally. I have ordered the western blot blood test as all of this information is conflicting. My drs don’t know what’s going on/why the conflicting test results (I’ve seen 2 people) I’m extremely confused and frustrated. Please help 😩

[melib382]

Could the HSV1 be a false positive? Why did I test positive for HSV1 and not 2 recently when the swab test (4.5 years ago) was positive for HSV2 and not HSV1?

[Terri Warren]

This is indeed confusing. I’m glad that you are doing the western blot for clarification
Have you had recurrences? have you been on daily antiviral medication since the assault?

Terri

[melib382]

Hi Terri!

Thank you for the reply! I have not had another outbreak since 2018. I have never had a cold sore either. I take 500 mg of valtrex daily along with L Lysine. Do I need to be off of that for when I do the western blot test? Do you think the HSV1 test was a false positive? Why would the most recent blood tests pick up HSV1 and not 2 when the PCR swab picked up HSV2? Could it be a cross reaction? The IGG was 2.42 both times and I know that’s within the false positive range. Any idea what happened?

• This reply was modified 3 months, 2 weeks ago by melib382.

[melib382]

Have you seen this happen in your experience?

[Terri Warren]

I have definitely seen conflicting IgG results in people, yes. False positives, false negatives, all of that. There are some things here that I don’t understand. You said that when you were first assaulted, the HSV 2 antibody test was positive. But if it’s new infection, it should be negative or it’s a false positive. Now it is negative and the HSV 1 is positive. How long have you taken daily antiviral medicine? And yes, it can interfere with both IGG testing as well as the blot

Terri

[melib382]

In 2018 when I was assaulted, I was tested by a PCR swab and blood test about a week after the assault when the symptoms/outbreak was unbearable. Both of them came back positive for HSV2 and not HSV 1. I have taken the valtrex (500 mg) and l lysine everyday since the assault. I’ve never passed it on to anyone. How long should I be off of valtrex for when I do the western blot test? Do you think the conflicting results could be a cross reaction? I want to say the HSV1 is a false positive but am VERY confused why that came up positive when it was negative for years and HSV2 was positive with the blood test and swab which is 99.99% accurate.

[Terri Warren]

For the record, the blood test not even close to 99.9% accurate, though the swab test is much better.
The IgG for HSV 1 misses 30% of HSV 1 infections so that could account for the change in HSV 1 status. You could consider coming off the suppressive therapy for 3-4 months. If you have an outbreak during that time have it swab tested – again. If positive again, there is no need to stay off suppression. If you don’t have an outbreak, you could continue to stay off for the 4 months and then do the blot. If you are having sex with someone who is negative for HSV 2, this will increase the risk that you could infect them. Alternatively, you could accept the HSV 2 swab test as accurate, understanding that being on suppression this long could be impacting the IgG results. If you concern is that the swab test was somehow inaccurate then doing the blot is the right thing to do.

Terri

[melib382]

Will being off of valtrex for 1-2 weeks make a difference? I’m waiting on the western blot test to arrive.

What are the chances of the HSV1 being a false positive?

[Terri Warren]

No, that’s not long enough to be off Valtrex. You will need to be off of it for 3 months
The HSV 1 could be a false positive, yes, but without an index value, I just can’t tell you how likely that would be.
I’m confused about your statement that the PCR could pick up HSV 2 but not HSV 1? If the lesions were caused by HSV 2, the swab would be positive only for two.

Terri

[melib382]

The index value of the HSV1 was 2.42 as of 6/11 (the last test I did). The PCR in 2018 picked up HSV2, not HSV1. I did blood testing at that time and that said I was positive for HSV2 and negative for HSV1. Now I’m positive for HSV1 and not HSV2 per blood test results. I’m confused how now I’m “positive” for HSV1 but not HSV2.

[Terri Warren]

I hope you will continue to be off Valtrex for 12 weeks and then do the blot. The antibody tests are somewhat less er HSV 2 antibody was positive at the time of the assault as well as a swab test, it is likely that you were infected prior to the assault. However, the problem is that there are false positives on the IgG tests and this is confirmed by your now negative IgG test. I’m sorry this is so confusing for you!

Terri

• This reply was modified 3 months ago by Terri Warren.

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