False Positive Results or Early Signs

[Anonymous]

Hi! What is the likelihood of a false positive with my results and situation? I tested about 5 weeks after last sexual encounter. I never was sexually active prior to this time, and I also have only been with one person but I don’t know their status. My Igg results for HSV1 were 55 and for HSV 2 were 2.29. Since I was a child I always got cold sores from time to time on my mouth which I assume is HSV1. Otherwise, I never had any genital lesions or symptoms at all to date. My test results say that a conformation test is needed (inhibition test) for low positive values which I fall under. I am really anxious about this. What is the likelihood that this is a false positive or could this be early sign of HSV2?

[Anonymous]

I wanted to add more information. This person that I had the encounter with says they never had any symptoms or lesions in their life and also never tested positive for HSV1 or HSV 2. I wasn’t shown any proof of testing but according to this person the last time they tested was about 3 months before our encounter. I’m still waiting on the supplemental test.

[Terri Warren]

There is an excellent chance that this is a false positive result. The preferred confirmatory test is the herpes western blot but you could do the inhibition assay if you wish. We have also seen false positive inhibition assays, as compared to the herpes western blot which is the gold standard for antibody testing.

Terri

[Anonymous]

Thank you for the response. How common are false positive results with the inhibition test? Is it reasonable to say that a positive inhibition test means it’s less likely to be a false positive? And if the inhibition test is negative, how likely is it to be a false negative considering I tested at 5 weeks?

[Terri Warren]

Quest used to do that test more often in the past and now they are doing it again so I would say that I don’t have enough data currently to know the answer but I’m starting to gather it again now. I would have far more confidence in a negative inhibition assay result than a positive one at this point.

Terri

[Anonymous]

Thank you for your replies. I purchased more questions because I believe I used up the questions I had.

What do you think is the probability of me being truly infected with HSV2 based on my test results and sexual history? I don’t know my partner’s status but he claims he never had lesions. What worries me is he’s had multiple sex partners before me and I know most of his encounters were unprotected. Does his sexual history puts me at risk even though I had one encounter with him where we had unprotected genital contact (not intercourse) at least twice for maybe no more than 2 minutes but I came in contact with pre-cum? We also had unprotected oral.

I have kissed other people in the past like open mouth kissing. Could this type of kissing have exposed me to HSV2 especially doing it with multiple people?

Lastly, based on my sexual history and test results. Would you recommend that I do the western blot or am I too low of risk that I should consider myself negative and not worry about it? My inhibition test came back positive

Thank you so much for all this help you’re providing.

[Terri Warren]

I always suggest that people who get a low positive get a confirmatory test. Though your sexual history is very limited, your partner’s is not. So that is my only concern. Your contact with that person was very limited but I still would order a confirmatory test if you were my patient. However, I would strongly still suspect a false positive here since you didn’t actually have intercourse with this person.

So we definitely see false positives on the inhibition assay compared to the western blot

Kissing is not a risk for HSV 2.

Do the best test. You’ll feel clearer about your situation

Terri

[Anonymous]

Thank you! We had intercourse that was very brief and protected. Does that change how you feel about the possibility of false positive results here at all? I didn’t mention it because it was protected and super brief too no deep penetration but I should have mentioned it to give you the full picture- sorry.

[Terri Warren]

Very brief protected intercourse presents very close to zero risk of acquiring HSV 2. That supports my concern that this is a false positive result and I encourage you to obtain the western blot either through your own provider or through me.

Terri

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