HSV-1 IGG Test Results & Confusion

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HSV-1 IGG Test Results

5/9/01 Negative Quest
6/21/03 Negative Quest
3/8/04 Heterophile, Mono Screen Positive Quest (relevant?)
12/5/14 Positive 1.77 Labcorp
1/1/16 Negative Lab Unknown
12/19/16 Negative Mayo Clinic
2/1/18 Negative Quest
2/26/18 Negative Quest; IGM Positive (1-night stand, only tested out of fear)
3/2/18 Negative Quest
5/21/19 Negative Quest
1/11/23 Positive 1.29 Quest
5/1/23 Positive 1.76 Quest

I have not been sexually active since 2020. With clean girl from 2018-2020 after 1-night stand in early 2018 (different girl). Only kissed 3 girls (no other physical activity except spooning on a couch with pants on) between 11/2022-2/2023, saw nothing orally on them. Have never had any known symptoms. Urologist tested urine 4/2023, no HSV present.

1) Could HSV-1 positives be false: 2014 (1.77), 1/23 (1.29), 5/23 (1.76)?
2) Do you recommend a Western Blot?
3) I have never tested positive for HSV-2, but due to “cross pollination” in IGG tests, I worry that the WB could come back positive, thoughts? The girl I kissed 1/2023 apparently had HSV-2 (again, no other physical activity except spooning with clothes on). My test for HSV-2 in 5/2023 was negative.

[Terri Warren]

I absolutely would recommend the western blot. The low positives could be accurate or not. I take it you’ve never had a cold sore on your lip or in your nose?
The western blot doesn’t have “cross pollination”, that’s the IgG test.

Terri

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Correct, I have never had a cold sore anywhere that I’m aware of, and I have been worried about this stuff since the 1990s.

PLEASE READ CAREFULLY:

I understand there is no cross pollination with the WB. I have never tested positive for HSV-2. I kissed a girl in late-January who had HSV-2. We did spoon on a couch with clothes on. My HSV-2 test in early-May was negative.

1) Based on these facts alone, do you think I have any reason to be concerned about the WB coming back positive for HSV-2?

I hesitate to even mention this concern because I feel it has been resolved and I do not want to make things any more confusing, but here it goes. My penis has had zero contact with anyone since 2020. In February, I had what would be best described as a pimple or ingrown hair on the shaft, there was no pain. I went to my dermatologist who has seen plenty of herpes, and he was adamant that it was not herpes of any kind (I asked him several times). He mentioned and is aware of such tests as PCR, and I would think if he had any concern/questions about it he would have done a PCR. I respect this DR the most of any I have.

I did see an infectious disease DR about the positive HSV-1 test, who did absolutely nothing for me regarding that. But I mentioned the pimple/ingrown hair, and she said these things do happen, especially as we get older. By this time it was healed and nothing to see.

2) Do you think I can feel comfortable in dermatologist’s assessment?

Finally, my urologist tested my urine for STDs including HSV-1/2 in April and nothing was found. I was having discomfort in my urethra, etc. for approx 8-10 weeks which eventually went away. I took anti-inflammatory drugs for 5 days (maybe 4 weeks in). It was just a little better after that and completely gone a few weeks later.

3) Do you know anything about HSV urine tests (DR said it tests cellular DNA)? And if the WB is positive for HSV-1, but the urine was negative, can I assume the infection is not genital?

[Terri Warren]

I don’t believe there is any real concern about the WB coming back positive for HSV 2, but as you may know, the IgG test misses 8% of HSV 2 infections so it is theoretically possible if you’ve ever had intercourse in your lifetime (before 2020).And kissing someone who has genital HSV 2 is not a risk factor for the acquisition of HSV 2.

If you have no herpes lesions in the urethra at the time of a urine test, it will be negative. But people who have herpes aren’t always shedding virus from the urethra so that test is more like a poor swab test than an antibody test that can detect infection even when no shedding is happening.

A positive western blot for HSV 1 will tell you only that you have HSV 1, not where.

And it isn’t necessary to tell me in caps to READ CAREFULLY.

Terri

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Facts (tell me if you disagree):

HSV-1: 3 low positives IgG over a 9-year period with several negatives in between (no known symptoms). One positive IgM (but I think you have said those should be disregarded).

HSV-2: No real concern about being positive via WB (IgG have always been negative).

Questions:

1) What are the chances of WB being negative for HSV-1?

2) Have you had patients with similar facts have WB come back negative?

3) Any reason I should NOT get WB? I think I’m just afraid of the unknown. But ultimately, this is the only way to know my status. Considering my last HSV-1 test was positive, it seems I have nothing to lose. I’m just about ready to do this, I just need a little push.

4) Any thoughts on my previous post above regarding pimple/ingrown hair that my dermatologist was certain was not herpes?

5) As mentioned I did spoon on a couch with a girl who was HSV-2 positive, is that a concern?

Sidenote: It does not help that DRs I have seen are so dismissive and simply want people to accept HSV-1 results as is, considering no symptoms. If in fact the last test was accurate, then they would be right. But I just think it’s crazy that they don’t know about or offer other more thorough testing. I feel like you are the only person out there that knows anything and understands that this is a big issue to people (regardless of what the DRs’ think). They are acting like I am crazy.

[Terri Warren]

It is possible that the IgG is a false positive but I surely wouldn’t count on that. I have had similar situations with patients come back both positive and negative.

As for the HSV 2, it is unlikely to be detected by western blot, but the IgG test misses 8% of HSV 2 infections compared to the blot.
There is no reason you shouldn’t get the blot, no
HSV lesions don’t look like pimples – they don’t have that white pus in them, most often.
No concern about spooning

Terri

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