Possible False Positive?

[False Positive]

Hi Terri,

First of all, you provide an amazing service here and it is greatly appreciated!

My last sexual encounter (un-protected) was late April 2014 w/ HSV-1 and HSV-2 Positive BF.

Beginning of May 2014 (1 week or less from date of last encounter) I started experiencing some bladder pain, and back-ache, and this painful paper cut lesion in crease between thigh and labia. The paper-cut/fissure type lesion I’ve had in the past (not as severe) and each time went to the doctors discovered I had a severe yeast infection. (I’ve been on Diflucan 150mgs 1x a week for the past 6 months).

I also have an Autoimmune Disease, Mixed Connective Tissue disease, Interstitial Cystitis, and hypogammaglobulinemia (depleted iGg Levels), depleted estrogen levels (<20) and elevated FSH Levels/perimenopausal.

I went to my Gyn 1 day after above said symptoms. Discovered that I had a severe UTI, Bacterial Vaginosis, and a Severe Yeast Infection. She looked @ the fissure in leg crease & didn’t think it looked suspicious & indicated that it was most likely due to the yeast. Fissure wasn’t swabbed. A pelvic was performed & she thought she saw possible budding HSV lesion. But said it did not look a 100% so she swabbed it.

Then ran an HSV IGM 1/2 and IgG Specific Blood Test(results below). I was given Cipro for UTI, Flagyl for BV, Diflucan for the Yeast and Valtrex (500mg 2x day) for possible HSV.

Swab came back negative for HSV. (Do not recall what type of swab)

TEST RESULTS:

1st Test May 6, 2014:
Solstas Labs
HSV I/II Combined AB, IGM: 3.93 (positive >=1.10
HSV 1 Glycoprotein G AB : 0.24 (Negative = <0.90)
HSV 2 Glycoprotein G AB: 0.45 (Negative)

2 days on Cipro & Flagyl, I felt a lot better. The fissure did take some time to heal about 2 weeks and i did have pain urinating & internal vaginal tissue very red and irritated, Don’t recall seeing any blisters internally or externally.

2nd Test Sept 22, 2014 (was on 1000mg of Valtrex Daily since June 2014)
HSV IgM I/II Combination: 2.21 (Positive = >1.09)
HSV I IgG, Type Specific <0.91 (Negative)
HSV 2 IgG, Type Specific <0.91 (Negative)

3rd Test Dec 16, 2014 (8 Mos frm last exposure)
LabCorp
HSV IgM I/II Combination: 1.55 (Positive = >1.09)
HSV 1 IgG, Type Specific <0.91 (Negative)
HSV 2 IgG, Type Specific 1.26 (Positive = >1.09)

*FSH and Estradiol levels were run (due to vaginal discomfort assoc. w/ declining hormone levels. I’m 47 and peri-menopausal.
FSH: 147 (HIGH)
ESTRADIOL: <20 (So low it would not even register)

BOyfriend HSV TEST: October 2014
Quest Labs
AB HerpeSelect
HSV 1 IgG Type Specific: 1.29 H (Positive = >1.10)
HSV 2 IgG Type Specific: >5.00 H (Positive = >1.10)

Symptoms: I’ve had no evidence of any overt HSV Outbreak in my genital area since May event. Each time i felt something even remotely awry in the genital area I had it swabbed. 3 Swabs all negative for HSV. I’ve had a tingling (almost like when your arm or leg falls asleep) in the genital area and down my legs almost every day. I’ve had Itching in the genital area which is alleviated w/ Oral & Topical yeast trtmnt.

Question
1. Could December’s test be a false positive? Since it’s in that questionable low range below 3.5?

2. What could be causing the long term elevated IgM?i I get my IgM levels run (not hsv) & my IgM’s are always elevated around 391. Is there any correlation here?

3.Would the higher dose of Valtrex (1G) since June cause an extended delay in sero-conversion?

4. Could my IgG deficiency be the reason for the possible delay in Sero-Conversion?
I’ve tested + for Epstein Bar, + low range RF Factors & have had Shingles. I’ve ordered the Western Blot blood draw sched for Mar 19.

I have met someone new and I am trying to sort all oft his out, so I know what to tell him. I would love to hear your insight on this scenario. Thank you!

[Terri Warren]

Question
1. Could December’s test be a false positive? Since it’s in that questionable low range below 3.5?
Yes, it could be a false positive. In fact, there is an 85% chance it is a false positive. I would strongly suggest a herpes western blot for confirmation.

2. What could be causing the long term elevated IgM?i I get my IgM levels run (not hsv) & my IgM’s are always elevated around 391. Is there any correlation here?

The IgM test for herpes is notoriously bad and inaccurate and has many false positives (the IgM is positive but the person never becomes IgG positive ) I would ignore it completely

3.Would the higher dose of Valtrex (1G) since June cause an extended delay in sero-conversion?

You’ve been taking Valtrex since June every day, I gram? That could definitely interfere with serconversion yes. I would recommend stopping that.

4. Could my IgG deficiency be the reason for the possible delay in Sero-Conversion?
I’ve tested + for Epstein Bar, + low range RF Factors & have had Shingles. I’ve ordered the Western Blot blood draw sched for Mar 19.

I don’t know anything about the IgG deficiency and how it would affect your testing, honestly. Guess I should but I just don’t.

[False Positive]

Hi Terri,

Thank you so very much for your prompt reply. I will be having the blood draw for the Western Blot on March 19th, I will keep you posted. In regards to stopping the Valtrex, the only concern from my Doctors was if I was a true positive and had an outbreak it most likely will be fairly uncomfortable for me since I have this chronic autoimmune issue as well as, chronic pain condition where any assault on my body registers with more intensity than normal, unfortunately.

1) If I stop the Valtrex now (Today) is March 19th, too soon for Western Blot blood draw? I am out of state and having the blood drawn at my internist’s office? Would be ok to stay on 500mgs a day vs 1000?.

2) I’ve read some of your posts on Cellular protein issues causing false positives, could this be what is going on? Thank you once again, for all of your help!

Thank you.

[Terri Warren]

I think you should be off the Valtrex for longer than that, given your immune disorders and the fact that you’ve been on meds this long. I would wait until mid April. And no, I think you should be totally off. If you have an outbreak off meds, then you can have that swab tested and if positive, you won’t need a western blot. You could have a low positive due to cellular proteins tripping the test, yes.

I’m not clear that you can get a herpes western blot through your internist’s office. Are you certain that’s what they are going to do there?

Terri

[False Positive]

Thank you again Terri, for all the good info here. I ordered the Herpes Western Blot kit directly from the University of Washington. My doctor’s office is only performing the actual blood draw and then i will ship back to University of Washington for processing. I will go ahead and stop the Valtrex and postpone the blood draw until mid April. I will keep you posted on the end results! Keeping my fingers crossed for good news.

[Terri Warren]

aaaah, yes, of course. Sounds good. The issue with taking the Valtrex is that if the drug is effective, it reduces the copy number of virus in your body, thus the immune system doesn’t see it and doesn’t make an antibody response. This is probably obvious, but just thought I would explain it a bit more.

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Terri

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