HSV false positive?

[questions]

I think I have recently ruled out a false positive for HSV2. I wanted to make sure that I was done enough with the process. I also wanted to clarify that my partner had had appropriate testing.

In 2008 and 2010, I was tested for HSV1 and HSV2 IgG and results were all below .91. The 2010 test was six months after my last sexual partner. I had not been sexually active or romantically kissed anyone until my recent tests which I got as I’ve begun dating someone new in October. We were both tested for many STI’s including herpes. Her tests from May 2014 were below .90 for HSV 1 and HSV 2 IgG.

My test results from 2014 included HSV1 IgG less than .91, HSV IgM less than .91 and HSV2 IgG 1.18. The primary care nurse practitioner told me I was definitely positive.

My graduate work included courses on how scientific research gets translated into practice, so I knew there’s often a lot of gray area in medicine, and I went online and looked for information about HSV false positives. I read about the Western blot test and scheduled an appointment with my GYN nurse practitioner about getting it. She talked to her lab’s doctor who said he thought a false positive was likely and that I should definitely have an additional test. He recommended a multiplex flow immunoassay BioPlex 2200 and said it was better than a Western blot. I decided to do it because it was much easier and cheaper than a Western blot. From what I read, it did not sound more accurate, but I thought I could always do the Western blot later if I needed to.

The BioPlex results came back negative. I am assuming this is adequate. Would you still recommend a Western blot? My results of 1.18 seemed quite low. I seem clinically low risk: no symptoms, no recent partners, I’ve never had intercourse was a man, I had unprotected oral sex with one man years before my first sets of HSV tests.

Also, I remember reading in one of your posts that you wrote if you were someone who did not have HSV you would consider having the Western blot test as a screening test for you and your partner because it has fewer false negatives and false positives. Could you say more about your thoughts on this? I know herpes is common and usually manageable, but it also seems worth skipping when possible. I have had many less sexual partners than my girlfriend, but I know it only takes once for either of us.

Thank you for having this forum for questions.

[Terri Warren]

I think with the most recent negative, it is not necessary to get the western blot. I would not agree that the test you took is better than the western blot, however, as the western blot looks for all the proteins associated with HSV antibody, not just one as the other testing mechanisms do. We don’t know much about false positives except with the usually used tests, the herpeselect ELISA, but in my experience it also holds true for the Captia test.

It is true that the western blot has no false positives and fewer false negatives than the screening tests usually used.

Terri

[questions]

Thanks for your answers

In terms of screening, it sounds like a Western blot would be more accurate. But it also sounds like it’s probably pretty rare to use for screen because it would also be more complicated, and expensive. False negatives for herpes so there are 10 to 20%?

I haven’t read about the Captia test. Was my multiplex flow immunoassay BioPlex 2200 a captia test. Or close enough in terms of understanding the results?

Thanks.

[Terri Warren]

A western blot is only good for screening when plenty of time has passed, four months optimally. For HSV 1, the false negative rate is 10-20%, correct. For HSV 2 probably more like 3%

Your Bioplex was not Captia, that is a completely different test. But close enough in terms of understanding, yes.

Terri

[Author]

Posts