low Igg results. likelihood of being false positive?

[tm4]

Hi Terri,
I recently found out I am HSV 2 positive as of June 11, 2023.

I have never had symptoms (that I know of). I do often get ingrown hairs, and I get razor burn easily. I have experienced this my whole life, even before being sexually active, and other than these things have never noticed any symptoms. I have researched tons of pictures and descriptions of herpes sores and blisters and I have never had anything that looked similar or has been painful. Now, I have what I thought was an infected ingrown hair that has now scabbed over. I never thought anything of it, until I got my diagnosis. However, it has acted exactly like every other ingrown hair I’ve had and I even pulled the hair out of it. It has also started peeling around the edges which I thought was odd, but it has been healing for over 2 months now, which I know is not characteristic of herpes lesions. I had another spot that I was scared might be a lesion, but I found it literally two days after getting my diagnosis, and it went away the next day. Never any pain or itching. Nothing in clusters.

I know I have HSV 1 because I have gotten a cold sore about 2-3 times in my life, the first time being as an adolescent.

I recently decided to test for HSV2. I have had several STD panels in the past that never covered this, and honestly I was ignorant to what even HSV2 was or how often false positives happen. I really just got anxious one day (I suffer from bad anxiety) and thought I’d just take the test to ease my anxiety and cross off one more STD from my list. Well, this test came back positive. It was an online laboratory test through MyLabBox. I sent my blood in the mail on a piece of paper. My result was 1.105 and it was an IgG test. I am going to my gyno tomorrow to get a blood test done in person. Obviously I am going to wait to see what this result is, but after reading tons of forums online, it seems most peoples reference numbers stay in the same range.

I will continue with my questions below

[tm4]

I wanted to also add that I have only had one partner in the last six months, and he has tested negative twice (about 6 weeks apart) and has not had any symptoms.

My questions are:

What is the likelihood of having a false positive herpes test with the reference range of 1.105? The lab I got tested from says not to use serum values as a reference because they use dried blood.

How often do you see people with numbers as low as mine who end up being truly positive? Is it this low if the infection is new vs old?

Could my HSV 1 status be affecting my HSV 2 antibody results?

Should I expect my index value to change significantly in between tests? I was last tested 7 weeks ago.

If my results from my blood test tomorrow come up similarly, I plan to do the Western Blot through you, but don’t want to jump to that just yet if I don’t have to.

[Terri Warren]

For the record, 1.05 is NOT positive. It is equivocal and in all of my years of practice, I have only seen three people who tested in the equivocal range in an HSV 2 IgG test be positive on the definitive western blot. And yes, someone with a substantial HSV 1 can have false positive or equivocal results on an IgG for HSV 2.

I would bet a whole lot of money you are not infected with HSV 2.
Terri

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