I asked Anna Wald, head of the Division of Infectious Disease at the University of Washington about your situation. Here is what she said to me:
“They could certainly reach out to me to discuss. I agree with you that given the situation, including the negative PCR’s x4, this is not HSV-2 infection. I am concerned about the use of the antibody assays in young children, since some of the assays have been shown to have high proportion of false positives in that age group – even higher than in adults. So in this setting, without exposure, with a pcr negative results, and a low positive, this is not a test result that should be relied upon. Altogether, I do not think that an HSV western blot is indicated here – just education of the providers about appropriate use of the tests.
Hope this is helpful
Terri