Help! equivocal result

[shannon89]

Hey,

So I was in a short relationship that started at the end of April and ended at the beginning of July, we started having sex at the beginning of May.

I got tested back in the middle to end of July ( about 10 weeks after first sexual encounter)using a 8 panel STD test, everything came back negative expect HSV type 2. My result was equivocal rated at .95. I got retested at 8 weeks later using a Herpes type specific test for type 1 and 2, again my result for type 2 was equivocal now at .96. Its been 13 weeks since last sexual exposure.

What should I make of my results?

Thanks!

[Terri Warren]

I think that infection with HSV 2 is very unlikely. I’m not sure why you are pushing the edge of positive here. Have you had any symptoms of herpes at all? The problem is that an equivocal value is really neither positive nor negative – it is kind of in never never land and your results are so close in value, I just don’t know how to guide you. You may wish to repeat it at 16 weeks and if it is still equivocal, consider the western blot for clarification. We don’t often see this combination of tests.

Terri

[shannon89]

What normally causes results to be equivocal? Would bring on medications such as birth control mess with results? I have my yearly gynecologist check up on a week, should I ask for additional testing such as a swipe test? I don’t think I’ve had any symptoms, although I did experience flu like symptoms after my last period. I don’t think I had any herpes sores, but I do have Fordyce spots, maybe they blended in together?

[Terri Warren]

We honestly don’t know why people get an equivocal result. Not birth control pills, no.
Requesting a swab test if there are no lesions present is NOT useful. Fordyce spots and herpes do not blend together, no. I think you need a western blot when 16 weeks have passed since that sexual encounter. That would hopefully give you more certainty about your herpes status. Our clinic can order that for you, if you need help with that.

terri

[shannon89]

I think I would like to get the blot test to confirm my status, would I just call the number listed on the website? How does the blot test work? would I get a number result or just a negative/positive result?

[Terri Warren]

Yes just call the clinic at the number on this website and set up an appointment with me.
The western blot gives only a positive or negative result, not a numeric value. Quite rarely, we get an indeterminate result on the western blot where the lab at UW is also unable to get a clear answer on the test.

Terri

[shannon89]

I have my yearly GYN check up tomorrow, so I am planning on ordering the western blot test after my doctor checks me out (I did ask to get tested also, I’m hoping that my results don’t come back equivocal). What would your recommendation be if I did get a indeterminate result on the western blot? ( do those with equivocal results tend to get indeterminate results?)

I have a quick question, I read on another forum that you mentioned that sometimes certain proteins can mess with a persons results, do you think that might apply to me? can you please clarify.

Thanks!

[Terri Warren]

Let’s not go to the indeterminate question at this point – it doesn’t happen all that often and I don’t recall if I have seen it with equivocal results or not. Also, it is possible that the cellular protein thing applies to you but we won’t know that until the western blot comes back. Usually that happens more with low positives.

Terri

[shannon89]

Hi Terri,

So it’s been about 18ish weeks since last sexual exposure. I was thinking of trying to get tested one more time before considering the western blot test. I mentioned to my doctor about my results, she told me to not worry about them since I’ve haven’t had any lesions and that my results could be due to the fact that I had the chicken pox when I was little. Not sure how to take her advice…

Anyway I have two questions:
1. Do you recommend the herpes type 1 and 2 Immunobolt test? The last type specific test was just Abs type specific. I heard the Immunobolt is a very good test.

2. Both my herpes type 1 results were .91 which is the highest negative result number. What could be the reason for such a high number? Could it because of some protein? Could this be linked to my type 2 results?

Thanks!

[Terri Warren]

In my opinion, the immunoblot is not a good test. It is a subjective read, a color change that can be very difficult to sort out. We stopped using this test many years ago because the results were so tough to read. The type specific test that gives a number is, in my opinion, a better test because the numbers are clear, even when they yield an equivocal like yours did.

You know, I’m thinking you are reading that incorrectly. My guess is that the results says <.91, not exactly .91. Look at it again. terri

[shannon89]

Yes, it says <.91

[Terri Warren]

Yup, so you are negative and that’s what we need to know right now. There is no value attached to that negative, specifically. so it is not equivocal, it is negative.

Terri

[shannon89]

Hi Terri,

We spoke over the phone last Thursday and I was able to order the western blot test and received it in the mail today. I just realized that when I spoke to you I mixed up my dates, I said that my last sexual encounter was August 30th… When it was June 30th. I’m currently around the 19th mark, so would taking the test be okay?

Also, you mentioned that my two Hsv type 2 results being equivocal would result in me being highly negative… Would you say 90 percent? Since my equivocal results were on the lower side, is that a good thing? or does it not matter?have you ever had someone with a equivocal result test positive?

Since my two results for type 1 being negative, would you say that I’m in the clear? Or is there a chance that I could be positive for type 1?

I’m going to get my blood drawn this week, so figures crossed!

Thanks!

[Terri Warren]

Yes, definitely it would be OK to take the test, you’ve had plenty of time to make antibody. I think I said that your equivocal result would result in the high likelihood of a negative – I would say 90%. There is definitely a chance your HSV 1 could be positive since the screening test misses 1 out of 4 cases of HSV 1. We’ll look forward to getting your western blot results to you.

Terri

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