Is my low positive a false positive?

[lemon]

Hi Terri,

On June 26th, I had a pap smear that came back “Epithelial cell abnormality. Atypical squamous cells of undetermined significance. Cellular changes suggestive of Herpes Simplex Virus.” Although I have been getting the cell abnormality and atypical cells for the past couple of years, the herpes was new. I pushed for more testing (after being told I had herpes by my gyno and doing a ton of my own research) because I have never had any symptoms and I learned that a pap smear wasn’t a good way to diagnose herpes. I got bloodwork done on July 31. I have not had sex since Jan 28, 2023, which was is six months before testing.

HSV TYPE ½ IGG & IGM ANTIBODY
HSV IGM AB .42 (negative)
HSV TYP 1/2 IGG AB 1.19 (positive)

The 1.9 triggered a Glycoprotein test.

HSV TYPE 1 IGG, AB. <.01 (negative)
HSV TYPE 2 IGG, AB .08 (negative)

My gyno told me to test again in two weeks. I waited until Aug 31 (now 7 months after the last time I had sex) and my results were, essentially, the same.

HSV TYPE ½ IGG & IGM ANTIBODY
HSV IGM AB .74 (negative)
HSV TYP 1/2 IGG AB 1.22 (positive)

The type test was triggered.

HSV TYPE 1 IGG, AB. <.01 (negative)
HSV TYPE 2 IGG, AB .11 (negative)

My gyno called the lab who said it was possible that, with that initial low positive, I was exposed to herpes but, since I never had a lesion, that the pathologist feels my risk is low for contracting herpes.

I pushed for the western blot and was told that the lab said the western blot would not be helpful in light of the two tests that I had already taken.

I continued to push, citing CDC guidelines, and my gyno finally placed the order. I will take it soon. In the meantime, I was hoping to get your perspective. What do you think my chances are that this is all a false positive based on the above (“suggestive” pap smear with regular abnormal paps, negative iig type and igm, but with positive iig before it was typed)?

Thanks!

[Terri Warren]

It is NOT correct that you may have a low positive because you were exposed to the virus but did not become infected. That is just ridiculous. You probably had a low positive once because the IgG tests are notorious for false positive and the CDC says now to never do them unless you have concerning symptoms. They also say never to do IgM test but I see that was also done.

I would bet a lot of money that you have a negative blot for HSV 2.

Terri

[lemon]

Thanks for your expertise, Terri! It makes me feel more at ease. I knew their response about being exposed but not contracting it was ridiculous from your handbook and used your pregnancy metaphor when I said that’s not what the research says. It earned me a snarky comment in my chart saying that I was going against medical advice by insisting on the western blot, despite the fact the CDC was, quite literally, my source. I will be finding a new gyno after this. I can deal with her not knowing something but for her to write me off so quickly despite the fact she clearly doesn’t know what she’s talking about (since she’s had to call the lab in an attempt to answer my legitimate questions) and to not be willing to either a) do her own research when a patient has questions about test results or b) accept the research I’ve done (I’m a librarian – I know what I’m doing when it comes to research), really convinces me she is no longer someone I want in charge of my care.

Ok. That was really just a rant. I am just horrified by how I’ve been treated throughout this whole process and the lack of knowledge and concern my gyno has shown. Shoot. She originally diagnosed me on pap smear alone! Thanks for listening. And thanks for having a website where people can get real answers to their herpes questions 🙂

[Terri Warren]

I agree that a change is likely going to be the best move. Her behavior doesn’t suggest that she is aware enough of the details about herpes testing to order this test for patients, in my opinion.

Terri

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