Question about recent low positive for HSV 2

[acillatem]

Hi Terri. You helped me a long time ago with a western blot, which came back negative.
Had a couple full panels since, all negative.
About three months ago, performed oral sex on someone, and for piece of mind, did a full std panel 90 days after, and the IgG for HSV 2 came back positive, with a 1.35. The recommendation from them was to test again in 4-6 weeks, and see if that number goes up.
I know from previous research, that the IgG test has a fairly high percentage of false positives/negatives. I also seem to remember that it’s fairly difficult to contract HSV 2 from oral sex, and correct me if I’m wrong, that 1.35 is very low, and wouldn’t it be higher after 90 days, if positive?
All that said, I know the western blot would end the debate, but it’s not as easy as just ordering it through Quest, like it used to be. Off hand, I don’t know if I have a lab in or near my zip code(95482, Calif.) that would spin the blood and all that.
I remember my original justification for the western blot, was because of a positive, but can’t remember if it was 1 or 2

Curious what your opinion is on that low number, and my likelihood, and also, would taking another IgG test in a month or so, be trustworthy?

I might also add……I’ve had no symptoms, that I can tell.

Thank you

• This topic was modified 3 years, 7 months ago by acillatem.

[Terri Warren]

At 1.35, there is at least an 85% chance that this is a false positive. I suspect your western blot previously was triggered by a low positive HSV 2 – rarely do people do a blot due to HSV 1 low positives. If that is indeed the case, I think you will probably always have a low positive result on the IgG test. You are correct that there is a low chance of contracting HSV 2 orally by giving oral sex. Not zero, but low indeed.

There are no ANylabtestnow offices in your area, you are correct, and I don’t know of a lab in your area that would draw and spin your blood but often, with the kit from UW, a hospital lab will do this for you if you decide to do it again. I would guess that another test, taken 6 weeks later, might be very close in value if indeed this is a false positive. Would the person to whom you gave oral sex be willing to test?

Terri

[acillatem]

Thanks for the reply Terry. Yes, I do believe the previous Western Blot was due to a low positive HSV 2 result. I seem to remember 1.40 something.

I could check with the person, and see if they’re willing to test.

I know I got a couple full std panels since the Western Blot, and previous to this last panel, which prompted me to come here, and didn’t have a positive at all for HSV 2, but I guess that doesn’t mean this one is accurate, like you said.
I will consider the Western Blot, but sure wish it was as easy as last time. Oh well…..it is what it is.
All that said, if I do another IgG at 6 weeks, and say it’s very close to the same low number, or perhaps even equivocal or negative, would kit be fairly safe to assume I’m negative? And by the same token, if the number has gone up a fair amount, would it mean I’m more likely positive, or would it still be just as likely a false positive. Unless the number was much higher, or?? I know there’s no definitive answer, but guess just wondering the likelihood. I know you get where I’m going with this. With the lack of simplicity of doing the western blot, the “low” risk activity I engaged in, and no symptoms, and that 1.35, could I do one or two more IgG tests, and come to a reasonable conclusion? I’m over explaining, you get it. And of course, it would be your professional opinion, that I respect, and nothing I’d hold you to, haha.

Thanks!

• This reply was modified 3 years, 7 months ago by acillatem.

[Terri Warren]

Yes I think if you do another IgG and it is still a very low positive, it is very likely a false positive. Sometimes we have to just accept what is the most likely thing.

Terri

[acillatem]

Hi Terri. So, I did another IgG HSV2 test, 6 weeks after the first test, and it came back 1.44. Although slightly higher, and correct me if I’m wrong, still very low, especially now that it’s just about 19 weeks.So, 90 days after encounter in question, 1.35. 6 weeks after that, 1.44. No symptoms. I feel this is like you said, a second very low positive, and very likely another false positive, curious what you think. Wouldn’t that number be significantly higher by now, if a true positive?

[Terri Warren]

I think it is highly likely that this is simply another false positive. The difference between the two scores is not at all significant. If you continue to do IgG tests, you are going to continue to get low positives. You could do another western blot but I honestly don’t think that’s altogether necessary. My suggestion about finding a place to have another western blot drawn, if you are going to do that, would be to contact your local hospital and ask them if they would do it. But honestly, I don’t think it’s necessary.

This is your final post on this subscription. If you have more questions, feel free to renew

Terri

• This reply was modified 3 years, 6 months ago by Terri Warren.

[acillatem]

Hello again Terri,
So….just for the heck of it, I did another HSV 2 IGG test, almost 2 years since my last one, that the consensus was most likely false positive. Since I don’t have easy access to the Western Blot test in or near zip code 95482, I went with that, and might add, no symptoms either.

That said, this new HSV 2 IGG test was 1.37, so now it’s
4/7/2020 – 1.35
5/19/2020 – 1.44
3/1/2022 – 1.37

In your opinion, does that put an exclamation point on what you said previously, in that this is most likely a false positive? And, correct me if I’m wrong, if 2 years ago, it really was positive, wouldn’t that number have gone up by now?

Oh, and is Quest still not drawing the blood, or doing the tests? Just checking.
Thanks in advance!

• This reply was modified 1 year, 9 months ago by acillatem.

[Terri Warren]

Yes, I still believe it is most likely a false positive. I don’t quite understand why you continue to do this very troubled and poor test when you have done the best one. Quest is still not drawing or sending western blots, no. Neither is LabCorp

Terri

[acillatem]

Well, on my original post in this thread, I had stated that since the WB,which was negative, back when you could just do it at Quest, I had a couple full panels, both all negative, then after this new sexual partner, whom I only performed oral sex on, my ocd told me to get another full panel, and it was that low positive, with another 6 weeks later, then this one. I know I had a false positive a long time ago, which prompted me to get the WB, which came back negative. Again, no symptoms. Had I not had a newer partner at some point, I wouldn’t have done it. Now it’s in my head.

Can I ask…..let’s say a person is truly negative, can they go back and forth with this IGG test, and have say, 2 negatives in a row, then 3 low positives, or whatever combo. Hope that made sense. I know you once said I will probably always test low positive with this test, but just wonder if a negative pops up once in a while.

Also, let’s say I wanted to cut to the chase, and try the WB again, would I simply call local labs outside of Quest and Labcorp, and tell them I want to do the WB, and I need blood drawn, spun up, and essentially handed back to me?

Thanks in advance!

[Terri Warren]

Yes, for people who get repeated low positive, they can definitely dip into the negative range as well. I think you can expect this over the years if you continue to do IgG tests.

We are using ARC point labs to draw blood now for the western blots as well as others. There is one very very close to you that we use all the time, if your zip code is the same. This is not a test you can order yourself. You need to contact UW and get the kit, 206-685-6066 and then either work with your own provider or do a telehealth consult with me and I will get you the required lab requisition to get the test done. You will pick up a prepaid shipping label prior to having your blood drawn and they will ship it for you.

Terri

[acillatem]

Hello again Terri. I just did another full std panel, which obviously includes the HSV 2 IGG test. Positive again, with 1.31, so now it’s
4/7/2020 – 1.35
5/19/2020 – 1.44
3/1/2022 – 1.37
10/7/2023 – 1.31
I pretty much expected a positive again, and still feel it’s a false positive, like you said, so not super worried. BUT, this time, the online service I used, recommended what they call a confirmatory test, to ‘end the debate’, or so they say. I asked them, and turns out is the ELISA test. I got locked out here, as couldn’t remember my password, and made too many attempts before using the lost password option, because I was going to ask your opinion. Anyway, I just went ahead and did it, and now I obviously have the password thing resolved, so my question is, did I just pretty much waste my time with that ‘confirmatory’ test, because when I did a little research, it seems like it’s not considered super reliable. I know they wanted to sell another test, but they must have some reason to believe this ends the debate, but super curious what your opinion is. If it come back negative, I’ll call it a day, because my IFF results point to a false positive, but if it comes back positive, I won’t be sure what to think. Almost seems like I’d be back in that same ‘false positive’ neighborhood. If positive, maybe just for the piece of mind, I will figure out some way to get the WB test. Zip codes is 95482, but probably nothing has changed. The woman at this place said the ELISA is the next best thing to the WB, maybe that’s true.

[acillatem]

Just to add, the code( I believe) for this one, is 37529 and on the order it says: HSV-2 IgG Inhibition IA (Serum)

[acillatem]

Guess I should have waited for the test results before the two previous posts, but it came back negative, and here’s what it says:
Test Name In Range Out Of Range Reference Range Lab
HSV 2 IGG INHIBITION, IA EZ
HSV 2 IGG SCREENING INDEX <0.90
INHIBITION INTERPRETATION
The HSV-2 IgG screening assay was repeated on a
different platform as part of the inhibition test,
and the result was negative; thus the Inhibition result
could not be determined. Most samples exhibiting this
type of discrepancy have initial HSV-2 IgG index values
of 1.10-3.00. If early HSV-2 infection is suspected,
submission of another sample collected 2-3 weeks after
this sample is recommended.
INTERPRETIVE CRITERIA:
% inhibition <60 NEGATIVE
% inhibition > or = 60 POSITIVE
This assay is intended only for samples giving a
positive index in the HSV-2 type-specific IgG
screening assay which is repeated as part of the
inhibition assay. A POSITIVE inhibition
interpretation indicates true HSV-2 specific
reactivity, whereas a NEGATIVE inhibition
interpretation suggests that the positive screening
index is falsely positive.

It’s not the WB, but with my previous low positives, and this, I’m going to assume I can call it a day on this, yes?

[acillatem]

Hi Terri,
I just now realized my subscription had to be renewed, and I had asked another question, sort of over the three previous posts. If you’d be so kind, could you just look at the three posts before this one, they all go together, and give me your opinion? And thank you!

[Terri Warren]

People who get negative inhibition assay IgG from Quest, who have done western blots as well, have all agreed, as I recall. I think with your repeated low positives and a negative IgG done with the inhibition assay, I think you can believe that you are not infected with HSV 2. At least that’s what our research shows so far. If someone tests positive on the IA, those results often don’t agree with the follow up western blot

Terri

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