High HSV 2 Igg Antibody Test, Western Blot to Check False Positive

[interestedhealth]

Hello,

I’m a Male, in his late 20s who wanted to get more info on false positive possibilities. In July of last year 2014, I went in to get a full blood work done because I kept getting sick and my immune system felt weakened (I had Shingles – Herpes Zoster, and Strep Throat that year). My doctor informed me that I was positive for HSV-2 based on the antibody test they had done (I am quite sure it was an Elisa test). My initial value at that time was as follows:

HSV2 Ab IgG Res 3.48 H

I knew that the test had some issues with false positives, so I decided to wait some time and reorder my test. I had unprotected sex with only a single partner in the months prior to this test, and before that have only ever had unprotected sex with my two longer-term girlfriends I’ve had years ago. I contacted the partner I had unprotected sex with and asked her to get tested as well, and she says that her results came back negative (she says she also informed her current partners whose results also came back negative). I got some bumps in August of that year that I thought were my first outbreak, but it turned out they were just Molluscum Contagiosum. I got retested though in September, w/ the same blood test and my results came back even more strongly positive:

HSV2 Ab IgG Res 8.39 H

When I heard from my partner recently that she tested negative, and given that I’m in a lower risk population, I decided I wanted further confirmation. I know there are false positives w/ ELISA sometimes, but could a false positive return such a high number? I’ve got other strange things going on in my blood work like really really high cholesterol (though I’m generally in good shape). I’ve just ordered a Western Blot kit that just arrived from the University of Washington, and I will go have my blood drawn tomorrow at my doctor to send in. That should give me confirmation, and peace of mind either way, but I was wondering out of curiosity what you think the possibility of getting such a high antibody result would be, to have it turn out to be negative by WB. From this study, the highest instance of WB disagreeing with the ELISA results was something around ~3.0. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2648390/ Have you ever encountered such a high false-positive before?

If the WB comes in negative, my understanding is that I should follow that as what the true verdict. Is that correct?

I really appreciate the service you are providing here – you are doing a fantastic job!

Thanks!

[Terri Warren]

First, thank you, I try.
Second, I would be quite surprised if an HSV 2 ELISA at 8.39 came back negative on western blot. Do you know if you had both tests done at the same lab? If different brands are used, there can be some variation in the index values, though this is a very big difference.

If the western blot is negative, I would believe it, yes.
I have not personally seen a false positive this high, but then, I don’t western blot people who have a value this high. I have seen false positives above 4.5, just in the past year.

Terri

[interestedhealth]

Hey Terri,

Thanks for your response, and apologies for the delay on getting back to this initial post, I had to send the WB again a second time because of some issues filling out the paperwork the first time I sent it.

I just received a result now for the WB, and it came back Atypical/Indeterminate. I spoke with a clinician at University of Washington’s lab about how I should interpret the result, especially in light of the fact I had shingles, strep throat and a generally compromised immune system at the time around when I received the ELISA positive results. He suggested that it’s likely that those conditions and my weakened immune system could have tripped up the ELISA test to give a false positive, even though they are very high false positives. My understanding from my discussion with him, and my own research, is that the ELISA tests can return incorrect results for a variety of reasons, for example the presence of antinuclear antibodies caused by the immune system reacting to some other viral infection.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC179872/ (Panel D tricky samples).

Given that my date of infection would have been at least 5 months before when I received the WB, they suggested that it may well be the case I’m not truly HSV-2 positive, and that I should do another Western Blot in 6 months, and if that one also comes back atypical, or negative, I should safely assume for all intents and purposes I’m not infected. I wanted to write here too, and follow up to get your thoughts on this story, and the interpretation provided by the UW lab.

Looking forward to hearing your thoughts.

Thanks!

[Terri Warren]

Hello,

I totally agree with UW on this one. I think the test where you got a 8.39 result on the screening test was likely not the traditional herpeselect ELISA or the Captia test, but that’s a guess. The fact that your test was indeterminate is very interesting and I think optimistic for you. You can certainly test again, but since the last possible date of your infection was 5 months ago, I seriously doubt that your results will change over that time but good to do.

We are conducting a research study of people who get indeterminate on their western blot result, evaluating a new test for herpes antibody. We would certainly like to include you in our study. We would talk with you over the phone, send you a consent form, then sent you a kit that you can take to a local Quest lab for the blood draw, then they would ship it back to us. We would then do some sorting and send it on to Southern Illinois University for testing using the experimental test. You would not receive results from any testing done as part of the study, but you would help to advance the science of HSV testing. If you would be willing to participate, I would like you to call Rene at our clinic.

Terri

[interestedhealth]

Thanks for your response Terri. I will get another Western Blot test done in 6 months to see if there has been any change in my results.

I would be happy to participate in the research study. Is this the phone number that I should be contacting: 503-226-6678 , and ask for Rene?

Thanks again for providing this service.

[Terri Warren]

Yes that would be great.

Terri

[madsmith1219]

Hi!
I’m having similar results with a similar situation: any updates on your western blot?

[Terri Warren]

I believe this person will let you know when they have something to share with you.

Terri

[Terri Warren]

If your repeat blot is also indeterminate, UW suggest that you should consider yourself negative and do no more testing.

Terri

[Author]

Posts