March 24, 2021 at 4:25 pm #73129700800Participant
- I’m about to start dating someone. We both tested recently, and haven’t had sex yet.
- Their result on HerpeSelect HSV-2 IgG was 0.96 and approx 40 index value on HerpeSelect HSV-1 IgG. No awareness of HSV-2 symptom history as far as I know. They haven’t had sex in the past 6 weeks at least, I didn’t ask beyond that.
- I’m negative for HSV-2 and HSV-1 (IgG HerpeSelect), never had symptoms.
- I’m polyamorous. I have a wife, and she’s in the 2nd trimester of pregnancy. So HSV-2 risk is higher (wife is negative for HSV-1 and 2 IgG). But we accept all kinds of risks in various areas of our lives, and this is no different. Goal is risk minimization not risk elimination.
- I’m aware that “The risk for transmission from women to men was 1.7 transmissions per 1,000 unprotected sex acts (95% CI, 0.6-4.4) and 0.6 per 1,000 protected sex acts (95% CI, 0.2-1.7)”.
- I’ve read that 2.54 is the index value where it’s 50% positive 50% negative and a 0.96 is overwhelmingly likely to be a false positive.
What I’d like
- To minimize (not eliminate) the risk and to have reassurance
- It to be as easy as possible for the person taking the test. Redoing the IgG is easy because I can handle the logistics myself. I don’t want them to have to do something high effort, as I feel that would end the relationship before it starts. For example, I feel that asking them to do a WB would end the relationship before it starts, so I’d prefer not ask for that.
- To get some kind of result asap
- What options exist for reducing my risk that might fit my goals
- The current plan is for them to redo HerpeSelect IgG 2 weeks after the original test. If the result is 0.9 to 1.1 equivocal again, what’s the odds of it being a true positive
- What’s the index value increase (with a 2 week re-test gap) that would imply true positive, early infection? >1.1? >3.5?
March 30, 2021 at 3:13 pm #73158Terri WarrenKeymaster
I would disagree with whoever told you that .96 is almost certainly positive. it is equivocal and nothing more. I have only had one person with an equivocal IgG test positive on the western blot in 35 years of practice.
If the person redid the IgG and was now at 3.5, that would suggest that they have recently become infected and were in the process of seroconverting when the equivocal result was obtained.
I would ask when the last time they had sex with someone else was to try to help sort this out.
Accepting other types of risks in life really isn’t comparable, in my mind, of having a baby born with HSV 2 infection because its mom recently acquired HSV 2 herself. But that’s just me.
Certainly, if you decide to have sex with this person you would want to use condoms and if uncertain about her infection status, she could take daily antiviral medicine.
But we really don’t know her status. And though another IgG may help, it may also be in that low positive – equivocal range and you won’t know without a better test.
April 1, 2021 at 5:47 pm #73175700800Participant
Ok thanks. Doing WB sounds good.
> If the person redid the IgG and was now at 3.5, that would suggest that they have recently become infected and were in the process of seroconverting when the equivocal result was obtained.
They redid and it is 1.17 with positive reflex on the new test taken 2 weeks post the first test (two different labs, first was quest which didn’t include a reflex and second was labcorp). My understanding is that if their last sexual encounter was over 12 weeks ago, then it’s 85%+ likely to be a false positive. But if their last sexual encounter was less than 12 weeks ago, then it may be in the early infection phases. Either way, a WB test is the only way to get a confirmation. Is that all accurate?
Is there a simple way they could do the western blot without needing to do anything other than show up to a lab for a blood test (could I handle the rest for them), or if not, what is the simplest way that they could do it that minimizes effort on their end?
April 4, 2021 at 6:44 pm #73182Terri WarrenKeymaster
If the person redid the IgG and was at 3.5, I would be quite concerned. I don’t believe the LabCorp confirmatory test for a single second with an index value that low. If their last sexual encounter was 12 weeks or more ago, with that index value, there is closer to a 90% chance that this is a false positive. The western blot is the way to know.
You could order the western blot kit for them and do the paperwork for them and ship the sample once it is drawn. they could just show up at the lab and have their blood drawn. but I’m surprised they don’t want to know their own status enough to get the testing done.
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