HSV2 IgG Low Positive

[Sig041000]

Terri,

After blacking out for 20-30 mins (due to alcohol consumption) on the morning of 4/16, with no recolection of a sexual encounter between that time (or the entire night) I went to get tested for STDs on 4/29 (without any symptoms/outbreaks). Received my results on 5/1 :

HSV 1 IgG, Type Spec : <.91
HSV 2 IgG, Type Spec : 1.48 index

I’m not showing any physical symptoms of herpes. I have had some small red spots appear on my penis, post masturbation on 4/29, that dissapeared after a few hours (no lesions/scabs present).

I have had one partner since September ’08, but unprotected sex out of the relationship around the summer of 2013. My partner was diagnosed with HPV in March of ’14.

Do I fall in the range of a false positive for HSV-2? If so, when can I take the UW Western Blot to confirm?

Started taking 400mg of Acyclovir (twice a day) since 5/1.

*had a negative test done in February of ’15 prior to this last test. My partner will have her test done on 5/4.

[Terri Warren]

You are definitely in the low positive range. You need a western blot. Acyclovir can interfere with western blot results so if you were my patient, I would ask you stop medicines completely until after testing so as to not complicate the picture. So you have not had sex since 2013 with anyone else except your regular partner with the exception of a possible encounter in April? What makes you think you might have had sex then? So you had an actual herpes test in February? If your partner tests negative for HSV 2, you should certainly pursue the western blot and we can order that for you.

Terri

[Sig041000]

Thanks for the reply.

To answer your questions/doubts:

*I haven’t had sex with anyone but my partner since summer of ’13.
*I have no recolection of about 20-30 minutes from the night of 4/16. There was no residue on my penis, no anal lesions/injuries. I remember most of that night and I can assure you I wasn’t with anyone. Unfortunately those other minutes are unaccounted for. I don’t know what has compelled me to think I had a sexual encounter that night. I do feel extremely guilty about my infidelity in ’13 and have been feeling guilt for not having an STI with repercussions, much like my partner has experienced.
*Yes, had an actual herpes test in February.

How long do I have to be off of Acyclovir before taking the UW Western Blot (currently taking 25mg of Hydroxyzine 2 times a day for the anxiety this has caused)?

Would it be a fair assesment to say that a low index score means the infection is/has been dormant or would it indicate that it happened recently?

Is there a numerical probability that this is in fact a false positive?

I feel some slight tingling in my foreskin (not on the head of the penis). Been feeling it since 4/29, could this and the red spots showing up post masturbation be considered a symptom? Again, no lesions/scabs

Thanks in advance.

[Sig041000]

Terri,

Some questions I left off on the other thread:

*If my partner tests positive for HSV-2, would the index value matter as it pertains to a false positive/negative?

*When can I take the UW Western Blot (I’m assuming that is the WB you were talking about earlier)?

*What could cause for the IgG test to trigger a positive for HSV-2 with such a low number?

[Sig041000]

Terri,

Some questions I left off on the other thread:

*If my partner tests positive for HSV-2, would the index value matter as it pertains to a false positive/negative?

*When can I take the UW Western Blot (I’m assuming that is the WB you were talking about earlier)?

*What could cause for the IgG test to trigger a positive for HSV-2 with such a low number?

Thanks in advance.

[Terri Warren]

How long do I have to be off of Acyclovir before taking the UW Western Blot (currently taking 25mg of Hydroxyzine 2 times a day for the anxiety this has caused)?

It depends upon when you started the meds in relationship to the possible encounter. But really – if you were that drunk, it isn’t likely that your penis got hard enough for sex, right? If you stop the meds now you’ll be fine. If you really really think you had sex then, you should wait 4 months to have a western blot. If you are wondering if this low positive is from a previous encounter, you could test any time now.

Would it be a fair assesment to say that a low index score means the infection is/has been dormant or would it indicate that it happened recently?

You could have a low index score for one of three reasons: 1) it is a new infection and your index value will climb
2) it is a false positive
3) you are infected and that is just your value. Period

Is there a numerical probability that this is in fact a false positive?

I feel some slight tingling in my foreskin (not on the head of the penis). Been feeling it since 4/29, could this and the red spots showing up post masturbation be considered a symptom? Again, no lesions/scabs

I don’t consider those symptoms, really.

*If my partner tests positive for HSV-2, would the index value matter as it pertains to a false positive/negative?

Yes, it matters because it could be positive for any of the three reasons I mentioned, including that you are not infected.

*When can I take the UW Western Blot (I’m assuming that is the WB you were talking about earlier)?

see above answer

*What could cause for the IgG test to trigger a positive for HSV-2 with such a low number?

You may have a cellular protein that is just part of you that has enough similarity to the herpes antibody that it triggers a false positive on the test. Happens all the time.

You could get the western blot now. If it is positive, it will not change over time. If negative, you should repeat. The clinic can order this test for you to be drawn at a location near you.
This is your final post on this subscription. If you have other questions, please feel free to renew.

Terri

• This reply was modified 7 years, 1 month ago by Terri Warren.

[Sig041000]

Terri,

Didn’t answer this question: is there a numerical probability that this is in fact a false positive (given lack of symptoms, low index score)?

Attached some pictures of a place on the shaft that I’ve been monitoring over the past few hours. Is this a lesion? Pics come from the same spot just under different light/angle.

I would like to do the WB now and retake in a few months if applicable. It is the UW WB, correct?

How often are HSV – 2 IgG Labcorp tests incorrect (Or diagnosticating false positives) with the index values listed?

Thank you for your time.

[Terri Warren]

There is about an 85% chance that this is a false positive. Nothing in these pictures looks like herpes to me.
Yes, the UW western blot. Our clinic can order this test for you, is you wish.

Terri

[Sig041000]

Thank you for responding. I have contacted your office and will be taking the WB in the upcoming weeks.

A few more questions:

* It has been confirmed that my partner tested negative on her Labcorp IgG today, and assuming that I didn’t have sex on 4/16 (I’m confident I didn’t, and you confirmed that it is very hard for my penis to become erect when so intoxicated), what is the numerical probability that my recent IgG is wrong,? This would also consider the fact that my last unprotected encounter with someone else was in August of ’13.

*Based on the info above, what is the probability that my partner’s test is correct? Again, considering that my last unprotected sex outside of the relationship was August ’13.

*I had two negative IgG tests since my last encounter outside of my relationship on August ’13. One test was in April of ’13 and the other test was in February of ’14 (all Labcorp IgG). It is very unlikely that my WB to be taken soon will be positive, correct? I have been monogamous ever since August of ’13.

*Do you see these type of situations (low IgG positives = false positives) pop up all the time?

If herpes is so common then why are doctors so misinformed regarding low positives and potential false positives? I find it so hard to believe that it is out of apathy or lack of education. The stigma associated with this STD and the psychological issues that it brings are too much to bear to just brush it off aside.

Thanks Terri.

[Terri Warren]

we talked today, right?

* It has been confirmed that my partner tested negative on her Labcorp IgG today, and assuming that I didn’t have sex on 4/16 (I’m confident I didn’t, and you confirmed that it is very hard for my penis to become erect when so intoxicated), what is the numerical probability that my recent IgG is wrong,? This would also consider the fact that my last unprotected encounter with someone else was in August of ’13.

There is an 85% chance this is a false positive

*Based on the info above, what is the probability that my partner’s test is correct? Again, considering that my last unprotected sex outside of the relationship was August ’13.

There is a high probability that your partner’s test results are correct.

*I had two negative IgG tests since my last encounter outside of my relationship on August ’13. One test was in April of ’13 and the other test was in February of ’14 (all Labcorp IgG). It is very unlikely that my WB to be taken soon will be positive, correct? I have been monogamous ever since August of ’13.

Corrrect, very unlikely

*Do you see these type of situations (low IgG positives = false positives) pop up all the time?

I guess you could say frequently on this forum, yes, but people reach out to me because of them so hard to say overall how common this is.
Terri

[Sig041000]

Terri,

Yes, we spoke today. Thank you for taking the time to chat.

One thing I forgot to ask. Today I got a negative reault from a Labcorp IgG test taken on 5/1. I took one dose of 400mg of Acyclovir 1 hour before the test was done (it was my first pill ever). Could that of affected the test? What about Hydroxyzine, can that affect the test as well?

[Terri Warren]

Neither of those would affect the test, no.

I count seven posts here, this is your final post on this subscription. If you have more questions, feel free to renew.

Terri

• This reply was modified 7 years, 1 month ago by Terri Warren.

[Sig041000]

Terri,

Woke up today with a few red dots on my penis. After masturbating today my penis looks like this (see attached pic).

Is this an outbreak? It does not itch, burn.

I had a Labcorp IgG test that came back positive at 1.48 for HSV2 on 5/1 (test was on 4/29). Did a secondary test on 5/1 (a few hours later) and got results back a week later that were negative for HSV2.

I’m super scared here and don’t know what to do. I already did the UW Wester Blot through your office but I’m very worried about this stuff on my penis.

[Terri Warren]

This picture looks nothing like a herpes outbreak. However, if a patient presented to me with this picture, I would seriously consider candida balanitis. This is an infection caused by a fungal condition. There are likely other possibilities that a dermatologist could sort out for you.

Have you had the western blot drawn yet?

terri

[Sig041000]

Read that candida ballantis can be a byproduct of herpes. Is this true and if so would it appear on someone that was recently infected? This would also consider my recent positive and negative on the Labcorp IgG.

Took the WB on 5/11. When should I expect results?

[Terri Warren]

Candida balanitis and herpes are completely different infections and conditions! May I ask where you read such rubbish and I will try to correct that misinformation.

The results will be finished for the western blot anywhere from now until two weeks from now.

Terri

[Sig041000]

Here is the link that mentioned this : http://www.patient.co.uk/health/balanitis

I’m feeling a slight burn/tingle so that’s why I’m freaked out.

How can an IgG test taken on 4/29 come up positive with a 1.48, only to come up negative when taken on 5/1?

[Terri Warren]

Because the cutoff for negative is 0.9, your negative value could have been something like 0.85 – I guess you don’t know the value, but 0.85 is actually very close to 1.48, isn’t it? My guess is that your negative is a high negative.

Terri

[Sig041000]

The test was IgG Type Specific AB Herpeselect. Wasn’t given a value, it just says negative. This is some confusing stuff!

Is the Herpeselect test considered less equivocal than the Labcorp IgG? Just realized that the test was actually performed in the lab on 5/6, would that have to do anything with the outcome?

I’ll just have to wait for the Western Blot results. Going to a dermatologist tomorrow to see about the pics. Would Candida Balanitis be a factor in causing the IgG Labcorp exam to come up positive at 1.48?

Are my chances of having a false positive greater or lower due to a possible Candida Balanitis?

[Terri Warren]

I would say that both LabCorp and Herpeselect are about the same accuracy. Candida balanitis would not impact a herpes antibody test, no. Either way.

Terri

[Sig041000]

Terri,

Wanted to thank you for your guidance, knowledge and support throughout this process. Your work is truly admirable.

My lab results arrived today and they were negative on all fronts.

To all those out there who have lost hope, find it in yourself to persevere and go forth. Life has a weird way of teaching you lessons.

To those who didn’t fare on the good side of fortune, keep your head up. Life goes on and your strength will inspire you to live a great life.

[Terri Warren]

I’m so pleased for you. I know this is the result you were so hoping to obtain.

terri

[Sig041000]

Terri,

I know we spoke earlier in the week, jus wanted to clarify what I had originally asked you:

Based in my history (see above), if I did have an encounter back on 4/17, and that encounter is what triggered my IGG HSV 2 score of 1.48 on 5/1, then it would have shown up on my Western Blot from 5/12, correct? Either as positive or indeterminate?

I’m asking because you mentioned that 4 months have to pass in order for thw WB to be 100% accurate. Just want to get my facts straight so I can put this to rest.

My biggest fear is that I did have an encounter on 4/17, I tested too early on the WB and there’s still a chance I have this. I know this sounds a bit of a stretch, it is just that this whole ordeal has been very difficult to understand.

Thanks in advance for your help.

[Terri Warren]

Yes, you need four months for the western blot to be the most accurate, from the time of the encounter. Your current western blot reflects input from January backwards but does not include the date you are concerned about, no. But we’ve talked at length about how unlikely the risk was during that 20 minutes. You can retest later, August, but I just really don’t think that is necessary!

Terri

[Sig041000]

If i did have an encounter on 4/17, what are the probabilities that they would show up on the WB from 5/12 as either positive or indeterminate?

I just can’t shake it from my head that something couldn’t of happened on 4/17, otherwise the IGG (Labcorp) from 5/1 wouldn’t of came back positive at 1.48.

Took the Herpeselect on 5/1, got test back on 5/7 as negative. No index was reported.

I’m scared.

[Terri Warren]

Well, that was 4 weeks after the counter. At 3 weeks, 50% of people will have made antibody to HSV 2 if they are infected. At 6 weeks, 70% of people who are going to make antibody will have done so.

You have paid for a total of 12 questions and you have posted 13 times – please renew if you have more questions.

Terri

• This reply was modified 7 years ago by Terri Warren.

[Sig041000]

Terri,

Got tested this Tuesday (7/14, 12 weeks after an unconfirmed sexual contact. Remember that I don’t remember 20-30 minutes due to alcohol consumption) with the Biokit in a clinic that was reccomended by the manufacturer.

Test results came back negative.

Based on my history above and on thia post, should I give this a rest and assume I do not have HSV2?

Thanks in advance.

[Terri Warren]

The Biokit is more accurate, compared to ELISA and then to western blot, than is the ELISA, in terms of false positives. At 12 weeks, and with so very little chance of risk, I think you should believe this result.

Terri

[Sig041000]

Terri,

Thanks for the reply.

So that I understand you correctly, you’re saying that the Biokit is comparable to the WB in terms of accuracy and it is more accurate than the ELISA IGG, correct? Didn’t understand the first part of your answer.

I know that there is a very little chance of risk but these past three months have been hell. Information is very confusing (except when coming from you) so I just want to make sure that I have the clearest outlook possible so that I can finally put this to rest.

How accurate (percentage wise) is the Biokit at 12 weeks?

[Terri Warren]

I don’t have the accuracy of Biokit at 12 weeks.
There is an excellent study using Biokit and western blot as confirmatory tests for low positive ELISA, and yes, both Biokit and western blot were better at clarifying the low positives and they both had pretty similar results, compared to each other.

Terri

[Sig041000]

Thanks.

What are the chances that a WB taken in four weeks will come out as positive?

Sorry, just looking at all angles here.

[Terri Warren]

You have paid for 15 questions and have 17 posts here already. I need to ask you to pay for the questions you have already asked and that would leave one more to be answered.

Terri

[Sig041000]

Terri,

For some reason I overlapped and bought 7 round of questions, so technically I get 21 questions, correct?

See attached invoices.

[Terri Warren]

yes

[Sig041000]

What percentage of people seroconvert after 12/13 weeks?

Outside of the low risk, it is very likely that the WB would come back positive, correct?

Would the Biokit results increase the percentage probability that I don’t have HSV2?

Thanks Terri.

[Terri Warren]

I have seen it extremely rarely – maybe less than 5%?
Yes
Yes, if it is negative it is more likely that you are not infected.

Terri

[Sig041000]

Thanks Terri, I will put this to rest after reading your response.

Thank you so much for your help throughout the past few months.

[Terri Warren]

You are most welcome – I know this has been a rough time for you.

Terri

[Sig041000]

You must be tires of me, last question, promise…

I meant to phrase the second question as :

“Even without the possibility of a low risk, if I took a WB it would very likely come back negative now that I’ve gotten a negative Biokit result, right?”

Sorry about that, just wanted to be clear. Thanks Terri.

[Terri Warren]

Yes, it is very likely that the western blot would come back negative as the Biokit did.

terri

[Sig041000]

Just a few more questions:

*What does a true negative result on a Biokit look like? I’ve read that sometimes the results can be misinterpreted.

*Can a negative Biokit result be mis interpreted or does this only apply to positives?

*I’ve read on some internet forums that there have been high IGG positive scores that have tested negative on the Biokit. Have you ever seen anything like this in the past?

*What makes the Biokit test more accurate than an IGG (labcorp) test?

Thanks Terri. I know I’ve been a pain but I just want to be informed. I forgot to ask these questions before.

[Terri Warren]

A true negative means there is no pink dot on the test, other than the control dot
If there is no dot, it is negative. Period. It’s when there is a dot that it can be difficult to interpret
We don’t use the Biokit and haven’t for years so I can’t answer this question
I couldn’t say why the Biokit exactly is a good confirmation for positives and negatives.

Terri

[Sig041000]

I think I’m just going to take the WB again via your office in a couple of weeks. Based on all your answers it seems like it will come back negative.

The Biokit is a good test (according to you) when it is negative at 12 weeks but I will do the WB for peace of mind.

Thank you for all your help!

[Terri Warren]

You are most welcome.

Terri

[Sig041000]

Just bought an additional round of questions.

I took an IGG test 2 weeks after the date in question here (4/17). One was Labcorp (postive at 1.48) the other Herpeselect (negative).

I haven’t taken anothet IGG exam. If my value had gone up then it would of manifested as an non-conclusive/positive result in the Biokit (taken 12.5 weeks after the date in question)?

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