High HSV1=HSV2 False Positive?

[HSV2QUESTION]

Hello,

I recently got tested for all STDs and was a little surprised at the results. I have had cold sores my whole life, so I was not surprised to see a positive HSV1 result but was completely shocked to see a positive HSV2. Which, I know is consistent with most people who have the virus, since a crazy amount of people show mild or no symptoms at all. My results for my type specific test were (performed by LabCorp):

HSV 1: 37
HSV 2: 2.06

I could myself fighting a cold sore at the time. My last sexual encounter was 4 months ago with my then girlfriend. We dated for 6 months and always wore protection. Before that I had unprotected sex 2 years ago once and prior to that had unprotected sex 3 years before with another girlfriend at the time. A relatively small sample size of unprotected sex.

I’ve never had any obvious symptoms that would suggest HSV2…

I’m scheduled to see a DR Friday but have read that most doctors are not as “hip” to this disease and may not be very knowledgeable. Is it possible that such a high HSV 1 can create a false positive for HSV 2?

Thanks!

[Terri Warren]

It is certainly possible. At an index value of 2.06, the chances are about 50-50 that you are actually infected. I have been seen a lot of LabCorp values in this range with high HSV 1 values, and often they do not confirm. You need a herpes western blot test to find out for sure, however.

Do you know from your previous reading on this blog how to do that?

Terri

[HSV2QUESTION]

Just saw doctor and set up western blot blood test. So I get to stress out over that the next few days. However, another question I have is; can I carry hsv1 and hsv2 both orally? Doctor said I could, and I haven’t read that anywhere.

What causes the false positives? I read that people with hsv1 are more likely to have false positives than people without, so is there some sort of cross connectivity between the two where a high hsv1 can skew a hsv2 result?

(I’ll count tbat as my 2 follow up questions since Ill know in a few weeks anyway my hsv2 results)

Thanks for the service you provide.

[Terri Warren]

I’m concerned that you said you contacted your doctor and set up a western blot. That is generally not possible. Are you absolutely certain it is a herpes western blot going to the University of Washington? Please double check. I a concerned that he may have ordered something else. The western blot is not normally available through your doctor’s office. Please double check.

Yes, commonly false positives are due to cross reactivity between HSV 1 and HSV 2.

Terri

[HSV2QUESTION]

Yes I confirmed with doctor twice and the lab tech that drew the sample tbat it was indeed the western blot test. She even showed me in the computer that it is indeed going to UW. The doctor was familiar with the test and says they send them out occasionally from time to time, mostly for HIV tho. Even my paper work says sample for western blot. I feel confident it’s going to Seattle (which I only live 4 hours from).

However, could you answer my question regarding having type 1 & 2 in the same location (in my case it would be orally). The doctor said this can happen and I’ve read nothing confirming that’s a thing. Is that indeed possible?

Thanks.

[Terri Warren]

It happens occasionally that people have both HSV 1 and HSV 2 in the same location, yes, I couldn’t tell you how often though. I have seen it and I know that it is seen in HIV patients who are immunocompromised.
Not to beat a dead horse, but what lab do you think your doctor used to transport the sample to UW?

Terri

[HSV2QUESTION]

I have no idea by what means they get my blood sample there. The doctor’s office shares a building with a blood testing laboratory, so all my doctor did was set it up with UW and then printed a form for me to take to the lab. I attached a copy of the form describing what I was having done. Based on my doctor’s familiarity with the western blot I have no other choice but to trust that they know what they’re doing.

[Terri Warren]

I have no doubt that that’s correct. I was just wondering what lab he sent you to to get your blood drawn – like Quest or Lab Corp – since it was so easy for you. It would be good for me to know about so that I can recommend that lab for others trying to get a western blot in an easier way. does that make more sense?

Terri

[HSV2QUESTION]

It looks like it’s called alpha medical laboratories. There are a few of them in my area.

[Terri Warren]

Thanks.

Terri

[HSV2QUESTION]

Hello Terri,

Wanted to follow up now that I’ve received my Western Blot results. I’ve noticed most these posts never show any resolution or the outcome so I thought it would be money well spent to show the full timeline so others can see.

My results came back positive HSV1 (as already known) and intermedient HSV2 (or whatever the result in the middle is). Dr. recommended testing again in 16 weeks, and I assume this is because he wants to make sure I’m within the detectable antibody window, but when I took the test originally I was at 18 weeks already since last sexual encounter. What are your thoughts on the result? I have an original low positive value via lab corp and now an intermediate thru WB and have never had any visible symptoms with a low sexual partner history (and a very low unprotected sex partner history). Any more insight? Am I positive? Negative? Should I get retested in 16 weeks??

[Terri Warren]

Hmmmm. That’s difficult. We do see far more indeterminates in people with low positives than we do with the general population. Yes, you should get retested in 16 weeks. In the meanwhile, we are conducting a research study for people with indeterminate western blots, comparing that result to a new test that is being developed in Illinois. You won’t get any results from the new test, but you would be paid $50 and it would help the science of developing a test that might clarify the situation with people like yourself. If you are interested, please contact Rene at our clinic, she can get the blood draw and consent set up for you.

Wish I could be of more help with this frustrating situation.

Terri

[HSV2QUESTION]

Yeah if I can help people not have to endure this ordeal of being in limbo then I would be glad to help. I will be on vacation for a while so getting to a lab for a bood draw might be 3 weeks out.

I understand why the CDC doesn’t recommend routine testing now. This is not a good position to be in and is extremely stressful. What would change in 16 weeks on my western blot that didn’t show up now? Is there any idea what causes the indeterminate result?

[Terri Warren]

well, only 5.5% of patients who get an antibody screen fall into the low positive category. And of those half confirm as positive. A very small portion is indeterminate. In my opinion, it is far better for most people to know they are firmly positive or negative for HSV 2 than to not have anyone test because a few people fall into this difficult position. Just my thoughts on the topic.

Sometimes we see a change after 16 weeks (UW’s recommendation to retest in 16 weeks) but rarely. Usually it stays indeterminate. We feel there is a cellular protein that some people just have normally that is similar enough to the ones the antibody test is looking for that is tripping the test artificially. Does that help?

Terri

[HSV2QUESTION]

Yes Terri makes perfect sense. I work in a science field so speculation drives me crazy and I hate to ask this question but knowing the variables at hand, what would you say my chances of being infected with HSV2 are right now? And, say in 16 weeks I still test indeterminate, what would speculate then on my hsv2 status?

[Terri Warren]

I would guess that you will stay indeterminate which would mean that you are not most likely NOT infected with HSV 2.
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Terri

[HSV2QUESTION]

Thanks for your help. Appreciate the service here.

[Terri Warren]

You’re welcome.

Terri

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