Inhibition assay negative test result

[Justneedanswers]

Hey Terri,

I have had sex with 2 women in my life. First time was in 2010 (she had prior sex partners) and it was very brief and I wore a condom. Two years later I had a small red bump on my penis which the doctor said was a pimple. It was not a blister nor painful. I asked for a herpes test and it came back negative for both HSV 1 & HSV 2. This test was conducted in November of 2012. I don’t believe it was an IGM test. The index value range on the test was that if it was <.89 it was considered negative.

The second woman I slept with is now my wife and she had no prior sex partners aside from me.

I have been with my wife since 2012 and recently in Feb 2019 I asked for another HSV test simply out of curiosity. My wife and I have been faithful to one another and I had no physical reason other than my own curiosity to request a herpes test. Up until now, I’ve never had an outbreak aside from thinking that pimple was an outbreak.

The test result came back positive for HSV. 2 (index value of 7.25) and negative for HSV 1.

The next day I went to urgent Care and got retested. That test came back negative for HSV1 and positive for HSV 2 (index value of 6)

I have now been on suppressive 1g/day valtrex for a little over a month. My most recent test was an IgG inhibition test from Quest to make sure the previous tests were not false positives.

My inhibition test came back NEGATIVE.

In 2012–2019 I have been to strip clubs but never had skin to skin genital contact or inserted my hands or fingers into a strippers genital area. I’m baffled as to how I could’ve tested positive for HSV2 never having genital skin contact.

My question is, am I safe to believe that the inhibition test is more accurate than the others and indeed proves that I had false positives?

My doctor said that once you get a false positive it tends to stick with you which is why we ran the inhibition test to rule out any cross reactivity.

My wife tested negative for both HSV1&2 on the IgG test.

Thnx

[Terri Warren]

Interesting case. My issue with the inhibition assay is false positives, not false negatives. In general, I am not a fan. But this is interesting because your IgG is pretty high for a false positive but with a negative inhibition assay and a history that does NOT suggest HSV 2, I think you need further testing. And the herpes western blot is the way to go. You may have a protein in your blood that is tripping the IgG falsely and you might even get an indeterminate on your western blot if that protein is around. But if you did get an indeterminate, you should consider it a negative as you have not had sex with anyone who is not negative in many years. The blot would clear up your questions. I would strongly advise it, given everything you have said so far. You can work with your own provider to get this test with the University of Washington kit or I can help you if you need me.
It does seem odd that out of the blue you decide you are curious about whether you have herpes. Did something trigger this interest?

Terri

[Justneedanswers]

I had shared a vape pen the week before with a friend who is seeing a girl that has had cold sores before. My wife and I were going to start trying for a baby so at my next doc visit I asked to be tested for everything to make sure I was A-ok. In hindset, it was extremely foolish and I regret taking the test.

My main concern is keeping my wife from getting the virus. The logic side of my brain says, that if I tested negative in 2012 (2 years after my first sexual encounter…giving my body plenty of time to create antibodies if I was infected) and haven’t had any skin to skin sexual contact of any kind aside from with my wife, AND she’s also tested negative, that I should believe this inhibition test because it rarely gives false negatives right?

I will ask my provider about the Western blot as well.

Ive read tons on your forum about how people with high indexes can still test negative (thru WB) and how there isn’t enough viral load from touching someone’s thighs, butt or even genital area to transmit HSV2 from ur hands to your own genitals (assuming you don’t have a cut).

I just want to make sure that if I stop taking valtrex I’m not putting my wife at risk and want a professional opinion on whether I should trust this inhibition result given my sexual history, lack of symptoms and wife testing negative after all these years.

[Terri Warren]

You didn’t contract herpes from thigh to thigh contact
If you were my patient, I would not feel comfortable at all leaving things as they stand with the negative inhibition assay and higher positive IgG test. You need the blot. Your provider may or may not be familiar with this test from the University of Washington. You can certainly read up on it and share your reading with your provider. You can order the kit from UW, 206-685-6066, and your provider can sign the lab requisition or if that doesn’t work, I can do it for you. With a pending pregnancy, it is my opinion that you need to get very clear on this issue. I would agree that a true positive is unlikely but possible. Difficult situation for sure

Terri

[Justneedanswers]

I ordered my kit from University of Washington and have it with me. My physician said they only do lab work fm through quest . I am going to ask another doctor but if I can’t get it done I’ll go through you.

If I go through you to get the Western blot , will I have to draw blood from anylabestnow lab? There’s one not to far from me that I can drive to but I believe I’ll need an order from a physician before I can have them draw blood. Is that correct?

[Terri Warren]

You will need an order from me to get the test, yes, if you go through me and I will send you that via email after we have a video conference. that’s routine and part of the whole process.

Terri

[Justneedanswers]

Hey Terri,

Can you please email me the lab order for the Western blot, I still have not received the email. I accidentally wrote in another forum post with a. Slightly similar title (apologies for that), but this is the one I meant to write on.

Thank you!

[Terri Warren]

Of course I will send it – what date did we talk and what are your initials?
I send all the information out the day we talk but in the past month,I have had two people not receive their instructions – not sure what is going on there.

Terri

[Justneedanswers]

Feel free to delete this after you’ve deduced who it is but my initials are G,A and we spoke may 14th 1240pm EST.

Please resend the lab order.

Thank you!

[Terri Warren]

I have resent this to you. Please let me know that you received it

Terri

[Justneedanswers]

Hey Terri thank you for all your help. I took the confirmation test (the Western blot). My result came back as negative despite my Elisa test being positive at 7.2.

That’s now 2 negative test results– a negative inhibition assay from Quest and a negative Western Blot. Thanks again for all your help.

For anybody reading this and curious about ordering the test. Get your kit from University of Washington. Schedule a meeting with Terri online. Then call local urgent Care centers in your area and ask if they’ll draw your blood (tends to be less than $40). Then use FedEx to ship overnight. Took 3 days to get the kit, and 3 weeks to get results back.

[Terri Warren]

Thank you for posting your results here. I have to say I was pretty astounded that someone with a 7.2 was negative both by inhibition assay AND western blot but the negative inhibition assay was my first clue that something unusual was going on here. I’m very happy for you.

Terri

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