Positive combined HSV TYPE ½ IGG test but NEGATIVE Type specific tests?

[EP621]

Hi Terri,
I’ll start this by saying I’m really thorough about my own testing, and have always requested type specific IGG tests for HSV 1 and 2. They have always come back negative. I test before and after each new partner, and I have made all 5 of the men I have slept with in my lifetime get tested for herpes as well. All were negative, except one ex who was positive for HSV1. I have still tested negative for type 1 for many years after the relationship.

The other day I went to a well woman exam at a new practice. I did my usual, and asked for type specific IGGs for HSV1 and HSV2, like I’ve learned from you.
Got my results in my portal now and am utterly confused:

First to result out:
HSV TYPE ½ IGG & IGM ANTIBODY: (this was all as a combined test)
HSV TYP 1/2 IGG AB 3.11 IV
“Specimen tested positive for Herpes Simplex Virus Type 1 and/or 2
Antibodies, IgG. ARUP test codes 0050292 and 0050294 will be
added. Additional charges apply.”

The IGM was negative. I’m assuming the line above about the additional test codes means after it was flagged positive it reflexed to two type specific IGGs (but that looks like what the above is?)

Next results:
-HSV TYPE 2 IGG, AB 0.14 IV <=0.89 IV
REFERENCE INTERVAL: HSV 2 Glycoprotein G Ab, IgG
(NOTE)
0.89 IV or less ……. Negative – No significant level of
detectable IgG antibody to HSV
type 2 glycoprotein G.

-HSV TYPE 1 IGG, AB 0.21 IV <=0.89 IV
(NOTE)
REFERENCE INTERVAL: HSV 1 Glycoprotein G Ab, IgG

0.89 IV or less …… Negative – No significant level of
detectable IgG antibody to HSV
type 1 glycoprotein G.

What do I make of this? Am I positive or negative? The second two tests are the type I’ve always had, and they’ve always been negative. And in this case, they are negative as well. Scared and confused.

[Terri Warren]

You are negative. Apparently, for reasons unclear, they first ran a combined IgG test for HSV 1 and 2 which I’ve not seen anyone use in many years. They they asked for the type specific tests, both of which were negative.

The combined test has been known to have false positives and most providers have totally stopped using it.

Terri

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