Low Positive Index for HSV 2

[hotcrossbuns12]

In August 2022 I had sex for the 1st time in 4 years. A few days later, I got a full STD panel. Everything came back negative except HSV 1&2. My index for HSV 2 was 2.21, and it was an IGg test. I went back about 2 weeks later for another IGg test, and it still came back positive with an index of 2.04. I’ve never had any symptoms or signs of HSV, never even a cold sore, and I’ve only had 4 sexual partners in the past 7 years. What are the chances of 2 false positives on 2 separate IGg tests? Should I get the western blot?

[Terri Warren]

I think the chances are good that this is a false positive. The western blot would be very helpful for you here.

Terri

[hotcrossbuns12]

Thank you, Terri! I’m going to a different doctor in a few days to get another test and to see if they can order the western blot for me. One follow up question: I know I’m positive for HSV1, and my index was >5. Is there much cross reaction with IgG test that could trigger a false positive for HSV2?

[hotcrossbuns12]

I don’t know if I’m allowed another question, but I was also wondering if people with long term infections usually have higher values or not?

[Terri Warren]

Most often people with longer standing infections have higher index values, though not every time.
We do see cross reactivity between HSV 1 and HSV 2 on these tests. Did you redo the IgG?

Terri

[hotcrossbuns12]

Yes I did. I’m waiting for my results now, but I know the test was done by the same lab. I also talked to my provider about the western blot. She is looking into it for me. Hopefully I will be able to take it within the next month or two.

[Terri Warren]

Good. You can order the kit from UW and have it on hand when your provider says yes

terri

[hotcrossbuns12]

Hey Terri, I just wanted to update you. My 3rd IgG test came back positive for HSV 1 with an index of 12.4. HSV 2 came back negative with an index of 0.086. Should I accept these results as a true negative?

[hotcrossbuns12]

I also wanted to add that I was taking 1 gram of valacyclovir for 2 weeks, but I hadn’t taken it for about 4 days before I did my blood test. Could that have produced a false negative?

[Terri Warren]

I think we know clearly that you have HSV 1 and it is unlikely that you have HSV 2 but I can’t say for certain. The timing of your two weeks of meds does not suggest interference with the test, no, but the IgG still misses 8% of HSV 2 so I’m just not sure. I don’t have any better advice for you about this.

Terri

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