Confused about “normal” and “in range” HSV-2 Inhibition IA results

[galanon23]

Hi Terri,

CW:blood

I’m a woman & as of September 2021, I was negative for HSV-1 & HSV-2. During unbarriered sex with a long-term male partner (my only sexual partner since my 2021 HSV test) in late April 2023, he injured his penis which resulted in a lot of his blood inside of me. I had a full STD panel run two weeks later on 5/10/23.

5/10/23 HSV IGG test via Labcorp:
HSV-1: 20.2
HSV-2: 3.98
Lab note: “low positive HSV-2 screens (Index 0.91-5.00) may be false positive and are reflexed to supplemental testing.” But supplemental HSV-2 test wasn’t run due to “discontinuation of the reagents by the manufacturer.” My gyno told me this meant I have both.

My partner also got tested but via Quest. He was positive for HSV-1, and was told his Inhibition IA result for HSV-2 was “normal.” No index value was provided to him for the initial HSV-2 IGG test. Doc told him that means he’s HSV-2 negative. This prompted me to go to Quest Labs myself and pay directly to have another test run.

5/26/23 HSV IGG w/REFL HSV2 Inhibition test via Quest:
HSV-1: 6.82
HSV-2: 3.69


HSV 2 IGG INHIBITION, IA : In Range
Lab Note: “The HSV-2 IgG screening assay was repeated on a different platform as part of the inhibition test, and the result was negative; thus the Inhibition result could not be determined.”

I was confused by the lab note. Quest doc I spoke to said my Inhibition IA result on her end said “normal,” but on my end, it says “in range.” Still confused, I spoke to a Quest lab director & was told that “normal” and “in range” may be default results when the assay cannot be completed past the first step. Now I’m more confused than ever. I was also told that when the Inhibition IA assay is run fully, the result is either positive, negative, or indeterminate. So does my partner’s “normal” result and my “in range” result mean we’re actually negative or not?

Neither he nor I have ever had sores or lesions anywhere.

Please help me make sense of this and should I get a Western Blot?

[Terri Warren]

What this means is that when Quest went to run the test on a different platform, the IgG was negative so they couldn’t run the inhibition assay. This means according to their testing you are negative for HSV 2. I agree that they way they put it is confusing indeed. So here’s the more general issue with this situation – many providers don’t order the follow up inhibition assay and it isn’t routine so many people would stop at the 3.98 value and believe for their whole lives that they have HSV 2. You were fortunate to have taken the next step and found out you don’t have HSV 2.

Terri

[galanon23]

Thank you so much for the clarification and your insights! I’m so grateful to you for having this forum.

[Terri Warren]

You are most welcome.

Terri

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