Low positive and unsure of what to do

[Worried1987]

Terri,

I’m a 27 year old male from Virginia. I have been sexually active for 11 years. I believe my number of partners over that time is around 25 +/- . Of those partners, around 5-7 included at least one unprotected sexual encounter. I would estimate 80% of the time I wore a condom during sex since becoming sexually active. However, I have never (to the best of my knowledge) had any symptoms of HSV-2.

A week ago I went into a Patient First for a burning sensation during urination and sometimes ejaculation. All my STI tests came back negative except HSV-2. I’m almost through the prescribed antibiotic and haven’t had any burning in a couple days. Needless to say, I was taken by complete surprise by the results and am still in shock. I had had unprotected sex about 6 weeks prior to my visit and before that, had not had sex in 14 months and unprotected sex in approximately 18 months. But as I had mentioned earlier, I can’t recall any HSV-2 symptoms.

The results of my Quest “IgG Aby” are as follows: Type 1 IgG – 0.41 Type 2 IgG *2.41 A. (Shown as I see it on the page)

Again, I’m in total shock from the results and it’s hit me really hard. Having done a lot of reading, part of me is still holding out hope for a false positive. Also, I’m not sure the best course of action to take with the person I had sex with 6 weeks ago (and again 3 weeks ago). She’s someone I’m quite interested in long term. Should I have the results confirmed via the Western Blot and hold out hope for a false positive?

Thank you for your time.

[Terri Warren]

I can see that you are shocked and dismayed by this test result. That’s a pretty normal response!
Yes, absolutely you need the results confirmed by western blot.
So the challenging issue here is timing. If you had sex with her three weeks ago and six weeks ago it is possible that you contracted HSV 2 from her, right? I think a forthright discussion is in order. Not only is your HSV 2 test positive, you were also treated for urethritis, correct? She needs to be evaluated and treated as well. have there been any other women that you’ve had sex with in the past six weeks?
She needs testing for HSV 2 as well. I think with tact, this discussion can be a good one. Your value is definitely in the range that needs confirmation. If her test for HSV 2 is negative when was the last time you had sex with anyone other than her? I’m trying to determine the proper timing for the western blot.

Have hope. 50% of the people who test positive at your index value are false positives.

Terri

[Worried1987]

I’m really sorry, I mistyped my HSV-2 IgG result. As you can imagine there’s a lot going through my head. The HSV-2 IgG was 2.36 and not 2.41. It’s lower but by just a bit. I’m not sure how much of a difference it makes but I wanted to make sure you had the right numbers.

It had crept into my mind that based on the result and the timing that I could have contracted it from her, yes. It’d be surprising but I guess you don’t really know unless you’ve talked about it with that person, and we haven’t.

Yes I was treated for urethritis and tested positive for HSV-2. All the other STI tests, chlamydia, gono, hepatitis, HIV, were all negative.

I haven’t had sex with anyone other than her over the past six weeks.

Prior to her it had been 14 months, while using a condom with someone I had been with a few times over a couple years. I believe all of those interactions, except oral sex, involved condoms.

Since it looks like I should get the WB, what’s the best way to go about that. I don’t have a PCP and haven’t since I saw my pediatrician. Would a Patient First type facility be able to collect the sample and send it away? Or do I need to work with a PCP?

What could cause that level of that particular antibody?

Thank you for the sense of hope and information.

[Terri Warren]

Those two results are virtually the same.
Other things can cause urethritis than the traditional stuff like gonorrhea and chlamydia, so good that you were treated.
If it has been that long since you had sex with anyone else, then if your partner recently tests negative for HSV 2, it is fine to do the western blot now.
Our clinic can order the western blot for you at a Quest lab near you.
If your western blot is negative, then we don’t know what exactly causes a false positive but it is likely a cellular protein that you just have that looks similar to the HSV 2 antibody.

Terri

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