HSV-2 Low Positive results

[kamov]

Hi Dr. Warren,

I took a HSV-2 IGG test (from Quest Diagnostic) on Aug 1. HSV-2 came back low positive 1.27. HealthLabs suggested I take a Confirmation Test which I did on Aug 3. The results came back normal. The confirmation test results mentioned that they were unable determine % INHIBITION since the first part of the confirmatory test (HSV 2 IGG SCREENING INDEX) came back negative < 0.9. I took a third IGG test (again Quest Diagnostic) 3 week later, on Aug 26th which came back low positive again at 1.21
I think it’s important to mention that the 1st and the 3rd test (low positives) were performed at the same lab. The second test (Confirmation Test) was performed at a different lab and different platform. I don’t have any symptoms (2 months after encounter). I don’t know what to make of these results. Should I take Western Blot or the above tests are considered conclusive (false positives)?

Thank you

[kamov]

To summarize the timeline:

June 28th
Encounter (unprotected oral)

Aug 1st:
HSV1 IGG: 43
HSV2 IGG: 1.27

Aug 3rd:
HSV2 Confirmatory Test: (could not be performed. Negative HSV2 < .90)

Aug 27:
HSV1 IGG: 45
HSV2 IGG: 1.21

Sep 1:
Ordered a new Confirmatory Test. Pending…

Why would the lab that performed the two normal HSV test give low positive results while the lab that performed the confirmatory test give negative <.90 results. Is quest using different (more accurate) platform for confirmatory test?)

I had done several std test in the past (2021 and prior) with Quest. Always came back negative for HSV2. Always tested positive for HSV range 30-39. This time around even HSV1 level was higher 43-45 range

If it’s a false positive what could cause it? Any other infection in the last two years (covid)?

[Terri Warren]

There’s good agreement between people who get a negative inhibition assay and they subsequently get a negative Western blot. With this low positive from Quest on the first and third test, but a negative inhibition assay, I think the odds are very high that this represents a true negative for you. We don’t know what causes false positives but what we believe is going on is that the first test that Quest does picks up proteins associated with something else and says that they’re due to herpes. This first test that was done by quest has a very high false positive rate. It’s very disturbing to me that they continue to use it.

Terri

[kamov]

Thank you for you reply Terri.

Yesterday I got the results of the second inhibition assay from Quest. Same outcome…”The HSV-2 IgG screening assay was repeated on a different platform as part of the inhibition test, and the result was negative; thus the Inhibition result could not be determined”.

So basically both IA tests at 5 and 10 weeks came back negative. Should I move on and consider myself hsv2 negative at this point? Should I consider WB at 12 weeks? You mentioned above that there’s a good agreement between WB and Negative IA.

[Terri Warren]

Yes, now you should move on. If you find yourself continuing to be concerned about this, you could do the blot at 12 weeks out.

Terri

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