HSV2 Results

[1sttrimesterbloodwork]

I am 33 years old and currently pregnant with my 4th child. My husband and I have been in a monogamous relationship since we were both 16 and have no prior sexual partners. I was given a HSV1 & 2 Igg blood test as part of my first trimester screening on March 15th. The results were negative for HSV1 and HSV 2 was 1.67. My husband and I have never had any symptoms of genital or oral herpes. I had the test reordered and blood drawn on April 10th with HSV2 coming back positive at 1.62. The OBGYN indicated that having two false positives in a row was unlikely, but from the research that I have done this seems untrue. He says that I am putting my baby at risk if I do not take an antiviral starting at 36 weeks to prevent an outbreak at birth. Since I do not believe I have HSV2 I feel that there is a greater risk of taking a new medication while pregnant. Is there any other way that I could have contracted HSV2 that is not sexual? Is it worthwhile to do a western blot?

Thank you!

[Terri Warren]

I would bet a million dollars that this is a false positive assuming you have no questions about your husband’s fidelity? I am going to get you a reference to an article we published last year and I would like you to print it out and give it to your doctor. I would also like you to print out the page from the CDC guidelines that discusses low positives. If this does not settle things or you have any questions about your husband’s fidelity, you should get the blot
I actually like testing for herpes in pregnancy but if one is going to do that, they must understand the issues about false positives in the low positive range.

Here you go:
Performance of Commercial Enzyme-Linked Immunoassays for Diagnosis of Herpes Simplex Virus-1 and Herpes Simplex Virus-2 Infection in a Clinical Setting. Agyemang E, Le QA, Warren T, Magaret AS, Selke S, Johnston C, Jerome KR, Wald A. Sex Transm Dis. 2017 Dec;44(12):763-767.

https://www.cdc.gov/std/tg2015/herpes.htm

Terri

[1sttrimesterbloodwork]

Hi Terri,

Thank you! I have no questions about fidelity. I am a pharmacist and when he gave me the diagnosis I knew something was not right and immediately went home and began researching the blood test I was given. When the OBGYN called me with the results of the second Igg bloodwork I tried to present him with the information on low positive results and offered to send him the articles I had found, but he indicated that he was aware of the information and the chance of two false positives in a row was unlikely. I asked him about the Western blot and he said he had no reason to order it because it would not change the outcome of the pregnancy and I could choose to take the acyclovir or not. He did agree to call the lab about the western blot. When he called back he told me that the lab informed him that the Western blot is outdated and that I should have the newer more accurate PCR DNA blood test and he ordered that for me. After a little research I found that the PCR test should be used as a swab test not a blood test so I will not be doing that. I will be seeing an OBGYN at the office I used to go to ( an hour and a half drive) as I cannot trust an OBGYN who will diagnose me with HSV2 based on a blood test he does not understand. I will bring the information you gave me to my appointment Monday. Thank you so much for confirming what I already believed!!

[Terri Warren]

Wow, that is so awful! And you are trying to manage this while pregnant. Stunning. I am so sorry. He is obviously NOT aware of the research (it just came out last year) nor is he aware of the CDC guidelines about low positives. You know yourselves – neither of you have had other partners. If you want the blot, I will order it for you or hopefully the other OB will. I cannot imagine how frustrating this must be for you at this very important time -kind of erodes your trust, I would imagine.

Terri

• This reply was modified 5 years, 5 months ago by Terri Warren.

[1sttrimesterbloodwork]

Hi Terri,

I saw the new OB today and she was not very knowledgeable about false positives but was receptive to the information. She agreed that I was low risk, but when I asked how I could have gotten it she said a toilet seat or from some with an HSV2 cold sore kissing me as a child. I said it seems more likely that the test is wrong and she agreed that the risk is low. But she did say I should take an antiviral at the end of pregnancy and if I did not and had any tingling, itching, burning or questionable lesion they would have to do a C section. So we agreed it would best to get the confirmatory test, which I informed her was the Western blot. How do I go about getting this done? I saw that you recommend the Anylabtest now labs we do not have one in our area but I happen to be flying from Cincinnati next Tuesday and would be able to have a blood draw at a location near there next Monday. Your help is greatly appreciated!

[1sttrimesterbloodwork]

Also, I forgot to mention that she looked back in my file and I had HSV testing in 2013 and tested positive for HSV2 at 1.11. I was never informed of this at the time. Does this change anything about the values being false positive?

[1sttrimesterbloodwork]

Sorry for the multiple posts. I was able to find a local lab that will draw my blood and have ordered the test kit from the University of Washington. My OB will do the order for me.

[Terri Warren]

Wow, this is all pretty surprising to me. first, that you had a positive test and no one told you and 2nd, that this OB told you that you could get herpes from a toilet seat. I feel so badly for you that you get all this crazy stuff happening to you. Now you have two low positives and have not increased significantly in your index value. that further confirms that this is likely a false positive, yes.

I’m so happy that this OB will order the test for you, that’s terrific.

This is your last post on this subscription. If you have more questions, feel free to renew.

Terri

[1sttrimesterbloodwork]

Hi Terri,

I wanted to post an update so that others can see the results of my Western Blot, my results came back negative for HSV1 and HSV2. It was a long process because of a labeling error and failure of my doctor’s office to return a call from the University of Washington my first sample was discarded and I had to have it redrawn and sent out again, so from the time of my first draw it was 7 weeks before I got my results. I wanted to thank you for the service that you provide, it was invaluable to have access and support from an expert in this area. I am so happy to have my negative result and to move forward with this pregnancy with a clear mind. I am also concerned for others in my area who may be being misdiagnosed during routine screening and may not be aware of the high false positive rate associated with the Igg test. I feel fortunate to be able to read journal articles and guidelines and understand them, as well as be in a committed relationship which allowed me to challenge my OBGYN on this diagnosis. That being said, this was still a VERY stressful situation and if I could help others to avoid this situation I would like to do what I can. Do you think that it would be appropriate to send a letter to my former OBGYN (who ordered the Igg test and was certain that I had HSV2 based on my Igg result) and provide him with my Western Blot results along with CDC guidelines and information about the Western Blot?

Thank you again!

[Terri Warren]

I knew it! And I’m so happy for you – good for you for taking charge of your own health and driving this process. How stressful this must have been for you.
Yes, I think you could send the western blot results and print out both the articles I sent to you via this forum and send them along. The OB needs an update!

Terri

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