discordant test result

[RGM8791]

I had unprotected sex with woman (penis to vagina and oral) in Mexico for 2weeks. 1 week later I developed spot on my penis shaft that was not painful. I thought it might have been a syphilis chancre. All STD tests were negative (HIV, syphilis, GC chlamydia and bacterial culture of lesion and PCR test for herpes). Spot healed in about a week. She denies any history of STD. I went back and had sex with her again for another week unprotected. Came back and had a similar spot again about 5 days after I got back. Went through tests again at Labcorp. All were negative again except IGM herpes HSV1 was positive. IGM HSV2 was negative. I have had lip cold sores when I get sunburns for most of my life so I assumed the IGM HSV 1 was from that. I think I had a small outbreak on my lip when I was in Mexico. She then claims she had herpes on her labial. I assumed my HSV1 was transferred to her. 3 months later we had sex again with condom. I had lesion on my penis the following week. I got tested again. Now both the IGM HSV1 and HSV2 are positive and IGG HSV2 is positive. What do you think is going on? Do I trust the positive test for HSV2? I had one other sex partner in the same time frame and after I got the positive test I told her to get tested and she was negative for all STDs. Did I give it to her or did she give it to me?

[Terri Warren]

What is the index value of the IgG test for HSV 2? If low, it could be a false positive but I am concerned about the sores that you are having. Has the woman in Mexico been tested for HSV 2?

You should ignore the IgM test and it should not have been done.

Terri

[RGM8791]

My HSV 2 IgG index value was 1.26. My HSV 1 IgG was 33.10. Lab corp also reported a “IgG HSV 2 supplemental test” that is positive. No index value given. What is this supplemental test? LabCorp is also recommending a confirmatory test because of the probability of false positive HSV2 test. I guess the supplemental test is not the confirmatory test? The are charging $126 and are mentioning a blood test that would take 2 to 3 business days to return. Do you know which confirmatory test they do? Is it the Western Blot or is it as good as the Western Blot?
I am currently out of contact with the woman in Mexico. She was never specific if it was HSV1 or HSV2. I think she just had an exam. I don’t think she had blood tests for HSV but she said she was negative for all the other STI including HIV.
So the negative HSV2 IgM test that I had before 6 most ago is worthless to tell me that I did not have HSV2 in my body at the time of that test? I have had negative test before for HSV2 also one year ago. The sores have only occurred after my sexual encounters with this woman. They do not hurt and they do not blister or crust they just seem to fade away in a week. Doesn’t my test history indicate that she gave it to me rather that I gave it to her?

[Terri Warren]

The supplemental test has many, many false positives compared to the western blot – I now have 89 of them. I wouldn’t believe it. You could not get a western blot for $126, no way. The supplemental IS their confirmatory test, but if they are offering yet another test, I would love to know what it is. Could you please find out for me? Yet another wrinkle in antibody testing.

Yes, the IgM is worthless. Your HSV 2 is just barely positive and has an 85% chance of being a false positive. Your HSV 1 is solidly positive and if you gave her oral sex, and your infection is oral, you could have given it to her genitally or you could have had long standing infection with HSV 1 and didn’t give it to her. There is just no way to know at this point.

Get the blot – it will answer your concern about HSV 2. But you need to wait 12 weeks from any concerning encounter to do the test.

Terri

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