HSV-1 – false positive or false negative?

[whichoneisfalse]

Hi Terri, thanks for offering this service!

I recently did a 10-panel STD test through Quest and unexpectedly got a positive result for the HSV-1 IGG test (HerpeSelect). The score was 1.18.

I say “unexpectedly” because I had done the same HSV-1 and HSV-2 tests a year and a half ago and both were negative, and I have done NOTHING that could have changed the results in the past 2+ years. (It’s a pandemic, so I’m sure of this… no drink-sharing or any of the other non-sexual behaviors that sometimes transmit HSV-1 in normal times, and no kissing or sexual partners).

So, I know that I got EITHER a false negative or a false positive, but I’m not sure which.

I ordered another HSV-1 test, but haven’t taken it yet. How many re-tests would you take, and when, to determine whether the false result is the positive or the negative one?

Also, I read somewhere that hormone shifts can impact the results… I was in the middle of my period when I got this test. If I wait two weeks to re-test, is that the best timing to eliminate the hormone factor?

As further context: HSV-2 is negative. I *may* have had one cold sore as a kid… I had something that someone told me was a cold sore… but I remember it well and it was more like a cut on the corner of my mouth that took a while to heal, nothing like any of the pictures I’ve seen online. I’ve never had any other symptoms. I’m a woman who dates women, so this ambiguous and unexpected test result after thinking all was fine is definitely freaking me out.

Thanks.

[whichoneisfalse]

Also, if I did eventually want to do a Western Blot test, is there anywhere near Boston that will do the blood draw and send it?

[Terri Warren]

Sorry I missed this post.
There is an excellent chance that this is a false positive
Yes, I know of places near Boston that will draw blood for the western blot

Terri

[whichoneisfalse]

Thanks for the reply. I just retested and it came up negative (0.90). Would you take that as a final answer and assume at this point that the last one was a false positive?

(If not, what course of action would you suggest, and what if anything would you suggest I tell future partners if I choose not to get further testing at this point?)

Thanks!

[Terri Warren]

I do think you can take that as a final answer, yes. We know that the IgG test misses 8% of HSV 2 compared to the western blot but I can’t say if you fall into that 8%

Terri

[whichoneisfalse]

Hi Terri, can you clarify that response for me, please? My question is about an HSV-1 test and your response is about HSV 2.

To recap:
HSV-1 was negative a year and a half ago. I had NO possible chance of exposure in the past two years, but HSV-1 came up positive (1.18) last month. I re-tested two weeks later and HSV-1 came up negative again.

Consider negative the final answer for HSV-1 and assume the positive was a false positive?

Thanks!

[Terri Warren]

Sorry, you’re right I did mix up your question thinking it was about HSV two and it’s about HSV1. The problem is that the IgG test for type one and this is 30% of infections. So it’s difficult for me to say with a high degree of certainty whether your test is accurate or not. Do you have a couple of options here. The first is to obtain the herpes western blot if you want the best antibody test for HSV one and the other option is that you could accept your previous negatives combined with a very low positive recently followed by another negative. Given the poor performance of this test, I don’t think I can offer any other recommendations than those I’ve described above.

Terri

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