Elisa IGG Blood Test for HSV

[silentrican20]

Approx 8 years ago I was diagnosed with genital HSV 1 after I noticed one cold sore on the tip of my penis. Two years after my diagnoses I met my wife who had genital HSV 2. We were married for 6 years and never wore any protection after we got married. During the separation I decided to get a full std test completed. My last sexual encounter I had with my ex before the std test was conducted was 13 weeks. To my surprise Quest Diagnostics advised me that my specific IGG HSV blood test results for type 1 and 2 were negative. I was real doubtful about the results so I visited Labcorp who performed the specific IGG HSV blood test. By the time I had the second test done by Labcorp, it had been 24 weeks since my last sexual encounter with my ex. Again, Labcorp advised me that I was negative for type 1 and 2.

One of my questions is how am I negative for HSV 2 when I had unprotected sex with my HSV 2 positive ex-wife for six years?

How accurate are the specific IGG HSV blood tests at Labcorp and Quest Diagnostics?

Should I take a Western Blot to confirm? The antibodies that specific IGG HSV blood test picks up should have been seen after 24 weeks, right?

[Terri Warren]

Not everyone who has sex, even for a long time, with an infected person gets infected themselves. The female to male transmission rate with no antiviral therapy taken daily by her, no sex with outbreaks and irregular at best condom use is about 4% per year. That is, if 100 uninfected men were having sex twice per week with 100 HSV 2 infected women, four men would become infected. Now that statistic applies when herpes is known to be in the relationship. That was the case in your relationship, I take it. Of course the other possibility is that she really isn’t infected with HSV 2, but you would know far more about her diagnosis and outbreak history than I do at this point.

The LabCorp and Quest ELISA IGG tests are very accurate for HSV 2, less sensitive for HSV 1. Which bring me to another question which is how were you diagnosed with HSV 1 genitally? Swab test? Visual exam? Are you not wondering why the antibody test didn’t pick up your HSV 1 infection?

Terri

[silentrican20]

I found out that I had HSV1 genitally through a culture, so I’m 99% percent sure I have it. I never get outbreaks so I plan on testing with the Western Blot next week because there might be that chance that the culture was wrong. I know its slim but I’ll take chances like that any day of the week over no chance.

The following are my follow up questions?

1) Based on what I already told you, do you think I should worry too much about testing positive for HSV2 with the Western Blot next week?
2) Why are Elisa tests so much more sensitive for HSV2 than HSV1?
3) What was the chances that both of my Elisa tests from two different labs were wrong? Did I not wait long enough from my last sexual encounter with my ex?
4) If I find out next week that I only have HSV1 genitally, do you recommend I take medication? I never had to but just curious.

Thanks again for your help.

[Terri Warren]

1) No, I really don’t! How are you getting it done?
2) I don’t know what the ELISA is more sensitive for HSV 2 than HSV 1, but this tests misses about 1 out of 10 HSV 1 infection, while missing about 3 out of 100 for HSV 2
3) Again, I don’t think they are wrong. And yes, you definitely waited long enough to be tested for greatest accuracy.
4) The only circumstance under which I would think medicine daily would be useful would be if you enter into a relationship with someone who tests negative for both HSV 1 and 2 and is concerned about transmission. HSV 1 is shed infrequently from the genital area, but I have definitely seen genital to genital transmission from time to time. Asking someone if they have either HSV 1 or HSV 2 does not often give a reliable answer – testing is far better.

Terri

[silentrican20]

I plan on sending it over to the University of Washington this Monday or Tuesday.

My last two questions:

1) Through your experience what are the main reasons why HSV2 is missed with Elisa testing? I understand that testing too early can cause a false negative but what are the other reasons than that?

2) How rare are false negatives compared to false positives? Are there more false negatives or positives through your experience?

Thanks again for everything. This service is awesome and has been super helpful. Take care.

[Terri Warren]

Oh, you live in Seattle? I was just wondering how you were going to get it there.

1) Testing too soon after exposure OR testing after taking too much antiviral therapy. The therapy reduce the amount of virus present and thus the immune system could not detect it.

2) Well, statistically, there are about the same number of each. The stated sensitivity of the test for HSV 2 is 97% which means 3% of negatives are false negatives. On the other hand, about 6% of people who test on the ELISA HSV 2 test, obtain values within the low positive range, which is 1.1 to 3.5. Half of those are false positives. So that makes the false positive rate about 3% as well.

Let me know if you have more questions (you an opt for more at the registration site) when you get your test results back.

Terri

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