Inquiry regarding equivocal results

[bf1008]

I am male. I had unprotected oral and vaginal sex about a dozen times during a two and a half year period with a woman who I later learned to be HSV-2 positive. The last time I had sex with her was May 28, 2023. (I also had unprotected sex with a few other women during that time period but highlight her because she reports being HSV-2 positive.)

On June 7, 2023, I began taking 50mg of naltrexone. Naltrexone was prescribed to help me drink less alcohol.

I also began taking 10mg of generic Lexapro on June 9, 2023.

I had a full panel STD test on June 10, 2023. I was negative for everything including on the HSV-2 Igm test. The HSV-2 Igg result was equivocal at 1.01.

I tested again for HSV-2 Igg (no Igm) on June 17, 2023. The results again was equivocal at 1.00. I had what I thought may have been a HSV-2 outbreak on my scrotum so I also had a swab test done at that time. The swab culture was HSV-2 negative.

I will take a follow up HSV-2 Igg test on July 22, 2023.

I understand that the equivocal test could mean that I have a new infection and will soon show positive via blood test. That said, it could mean a protein in my blood is causing the equivocal result.

My last STD test before the recent ones was in January 2021. That test, and all prior ones, were negative for everything, including HSV-2.

Is it possible that the equivocal result is truly a negative–could either drug I take, particularly the naltrexone, be causing issues with the protein in my blood leading to the equivocal result?

[Terri Warren]

I would guess that the equivocal result most likely represents a negative result, not a positive one. I’ve only had three people in my entire 40 year career that had an equivocal IgG for HSV 2 and went on to have a positive western blot.
None of those drugs would cause an equivocal result on the HSV 2 IgG test.
If you have an equivocal result in July, I think you should believe that you are uninfected. If you can’t do that, pursue the western blot for greater certainty

Terri

[bf1008]

Thank you for the response. I will take an Igg test this month and report back.

I will likely decide to take a Western Blot test regardless of the Igg test’s result for certainty.

If my last sexual encounter was May 28, 2023, when is the soonest I can take the Western Blot test and get a reliable result?

[Terri Warren]

August 20.

Terri

[bf1008]

Thank you Terri. A brief refresher on my case:

I am male. My last sexual encounter (oral and vaginal) was on May 28, 2023 and with a woman who is HSV-2 positive.

I tested equivocal on a HSV-2 Igg test on two separate occasions:

June 10, 2023
1.01

June 17, 2023
1.00
I also had a negative swab test at that time.

My update is I took a third HSV-2 Igg test on July 28, 2023. The result was negative.

Given the results what do you think is the likelihood that I am truly HSV-2 negative?

I plan to remain abstinent and take a HSV-2 Igg test around August 19, 2023. Depending on the result, I may pursue the Western Blot for certainty/closure.

[Terri Warren]

I think there is at least a 92% chance that you are truly negative for HSV 2. It’s great that you went from equivocal to negative on the IgG test, BTW. You don’t mention condom use? If condoms were used, the likelihood that you are truly negative is even higher.

Terri

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