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Baffled by negatives and high positives

Hey everybody, I have a set of results from IGG tests over the course of this year which have confused me to no end and I was hoping some other might be able to shed some light.

So, like many others, I was tested for HSV without asking during a routine panel at a walk-in clinic at the beginning of this year that came back positive for HSV2.

Then I retested that week at a different clinic and it came back negative.

Then I retested again (to make sure) at a different lab again a month later and that came back negative too.

Then, to make even more sure, I retested five months later and came back solid positive.

Then I retested and came back even more positive.

Here's my timeline including partners:

Unprotected sex June 2019, partner status unknown.

Protected sex October 30th 2019, partner tested negative.

Unprotected sex over Xmas and New Year's, partner tested negative.

Test timeline (all IGG)

1st test: HSV2 1.6 (brand unknown) Jan 28, 2020
2nd test: HSV2 0.34, HSV1 0.10 (Euroimmun) Feb 2, 2020
3rd test: HSV2 <0.91, HSV1 <0.91 (Labcorp) Mar 10, 2020
4th test: HSV2 3.8, HSV1 1.25 (brand unknown, same walk-in as 1st test)
5th test: HSV2 4.9, HSV1 Neg (Herpeselect)

Ordinarily, I understand that these last two numbers are high, but the two negatives sandwiched in between are making me very skeptical about the positive results.

Assuming the two most recent partners are indeed negative (most recent partner took another test this Oct and came back negative again), that would mean I would have had two false negatives for HSV2 from two different brands of test.

The first false negative would've been about 8 months after exposure with a person who's status I don't know, and the second negative would've been 9 months after.

I'm skeptical for this reason, and I'm also skeptical because I haven't had any symptoms, even though I find myself examining my area any panicking at even the slightest change in pigmentation on my skin.

As far as I can deduce, either those two negative tests were simply both wrong, which would be strange as they were well past the recommended 4-month seroconversion period.

Or, the 1st and 4th tests from the same walk-in clinic used the herpeselect test, and there's something in me that's causing it to go awry.

I know for sure I can get false positives one way or another because of the HSV1 diagnosis on the 4th test, which I do not have.

Anyways, if anyone can offer any advice or share an experience that might help me understand this a little better, I'd appreciate it.

And as a further note, I've read virtually every report, forum, and article on the internet and I'm aware about the famed 80% asymptomatic stat and the probability of low positives and all that stuff.

Thank you and once again I appreciate all the help!
2 Responses
Avatar universal
Forgot to add, the 4th test was Aug 1 and the 5th was two days later.
207091 tn?1337709493
COMMUNITY LEADER
I'm sorry you're going through this. I really hope you're in the US, because figuring this out otherwise is going to be tricky, and next to impossible otherwise.

First, let me say that we know now that some people get false positives on the hsv2 IgG, which it sounds like you know already. Most of the time, it's results under a 3.5. However, even those with results over a 3.5 who have no symptoms can have false positives, and yours aren't that far over that. If your results were like 11.8 or something, I wouldn't be mentioning this, but it could still be a false positive.

So, what now? You need to get a Western Blot test. This is where it gets tricky, or it could. It will likely get expensive. There is no right or wrong answer here, okay?

The Western Blot test is different because it looks for different proteins, and is considered the gold standard in herpes testing. Your doctor can order it, though many (most) don't understand this process, and most I've talked to here in these forums really struggle to get their doctors on board. If you have a good doctor, and good insurance, give it a try.

If that's not the case, you can get it from Terri Warren, who is a nurse practitioner, and one of the world's leading experts in herpes. You will have to self-pay, though, and it will easily run into the several hundred dollars.

https://westoverheights.com/getting-a-herpes-western-blot/

I don't say this to discourage you at all - if you can do it, I think you should - I just want you to be prepared for what it will entail.

I can't tell you if you have hsv2, or even the odds. A test result under a 3.5 has a 50% chance of being a false positive, and a 1.6 has probably an 85% chance. We don't really know the chances over a 3.5, and yours are really not that much over.

I would suggest setting up an appt with Terri Warren, and if you can, get the Western Blot. I'm not a doctor, but I'm not convinced you have hsv2.

The hsv1 IgG misses about 30% of infections, so it's more likely that you have that, but about half the adult population has that, and it's probably an oral infection for you, and that's not a big deal.

You can read more about all of this in the Herpes Handbook at https://westoverheights.com/herpes/the-updated-herpes-handbook/ It's free, and you can read it right on your phone or computer.

Please let me know what you decide to do, and if you have any questions. Hang in there, okay?





9 Comments
Thanks for your response, this whole thing has been a bit of a nightmare. I think were I someone else I might be able to trust the negative tests that were 8 months after my risky contact, but I just can't get the positives out of my head!

I think you're right, the only way to know for sure is doing the WB. I can't afford that right now, so I might get another Labcorp test and if that's negative I think that might be a good sign, whereas if it's positive it would indicate a real infection.

Gotta say though, if I got it from that one encounter, I'll be upset, but that's what you get for taking your sexual health for granted I suppose.
If another IgG test comes back positive, it doesn't really indicate anything. Some people have a protein in their blood that causes false positives - it has nothing to do with actually being positive.

Your last 2 tests - when were those? Was your last sexual activity with anyone last New Years?

I can't imagine you got it from the June guy. Your test would have been more definitely positive by January. It takes up to 12 weeks to develop antibodies. My guess is that your 1.6 is a false positive there.

The two partners who tested negative - you can trust them, or you've seen their results?

If you haven't been with anyone else, I can't see how this is anything but a false positive.

If you do the Labcorp test, I'll be interested to see what those numbers are. They now do a supplemental reflex test automatically if it's positive, but it's basically worthless, because that might have as many false positives as the regular IgG test does.

Keep us posted. It's very frustrating, I know.

Well I took another Labcorp test and it came back with 4.2 for HSV2, but for supplemental test was negative. I hope you're wrong about it being worthless because I feel like taking this result and running with it frankly.
@auntiejessie
I don't know that it's helped you, because it hasn't cleared it up for you at all - that's what I mean by worthless. The negative supplemental lends itself to you being negative, but your 4.2 may contradict that, and I can't tell you with any kind of certainty either way if you have herpes or not. I really wish I could.

Are you in the US? I'm assuming you are because you mention LabCorp. This is good news because that means it's easier for you to get a Western Blot. It doesn't make it any less expensive, but it does make it easier to access.

It's up to you entirely what you choose to do now. There are no right or wrong answers here.

You can assume you are negative with the negative supplemental, and carry on. The con to that is if you do have it and transmit it someday.

You can assume you have it, and carry on. You can take precautions and suppressive meds to reduce the risk of transmission. Obviously, the cons to this are taking meds you might not need, having conversations about it that you don't need, perhaps dating someone with it assuming you have it and then getting it.

You can get the Western Blot and find out for sure. The cons are the cost, obviously. You can always set up a video call with Terri Warren and get her opinion on it. https://westoverheights.com/getting-a-herpes-western-blot/ It's all explained here. You could also post a question on her forum for $20 and ask. She's one of the world's leading experts on herpes, and I'd trust her judgement over mine.

I wish I could wrap this up nicely for you, but I can't. Keep me posted on what you decide. I'm sorry this happened this way.
@auntijessi Thanks for the quick response! In all honestly, I'm comfortable with the negative supplementary. Given my history, negative partners, lack of symptoms, and now a negative biokit, I should just accept the confirmatory result and move on with my life.

My worrying encounter was 8 months before two negatives IGGs, positive IGGs are all over the place and now a negative confirmatory result.

In a way it has cleared it up, because there's no plausible way a supplemental would test negative at this point, just as there's no plausible way I could get two false-negatives that far out initially. It's all so implausible. As far as I'm concerned, I've done a latest test, the confirmation says negative, so I'm negative and I'm putting this whole thing behind me.

Thank you so much for your input! You have been an extremely valuable source of information and you really know your stuff, you're a credit to this online community and everyone who comes here for help.
You got a negative biokit? That's good enough for me. (And good for you for getting a biokit - those aren't that easy to get.)

I think given your history, your parters' testing, and the biokit, it's fair to say you are negative. If you do herpes testing in the future, I'd just skip to the biokit. Some people just get false positives on the IgG, and you appear to be one of them. Starting with the biokit can save you the heartache and stress.

You're welcome, and best of luck to you. We're here if you ever need us. :)
@auntiejessi I apologize, it wasn't a Biokit, it was whatever Labcorp uses as its supplemental test, but it was negative in any case.

If I'm able to use logical deduction here:

People who test falsely negative on IGGs (after the appropriate time) tend to always test negative -- well obviously I'm not one of those.

People who test falsely positive also tend to repeat testing positive -- I'm probably one of those.

The only thing that bugs me is my high index values, but a large part of me just has to step back and use common sense. The negative supplemental I think just adds to my sense that there's something in me that's seriously messing around with these tests.

I mean, how rare is it for someone to test negative twice 8 and 9 months after exposure? Very.

How rare is it for someone to test falsely positive with numbers over 3.5? Very

How likely is it that someone who's positive would test negative on a supplemental 17 months after exposure? I don't know but I'd imagine that too is unlikely.

It's clear that cases like mine are the reason the medical community is reluctant to have widespread use of blood testing for herpes.

See how many people are on this forum like me who got tested without symptoms (and without asking I might add) and get a positive result, many! Imagine how many more there would be if we had routine testing for it in every STD clinic in the country! I'd wager there would be so many that they'd have to stop because the tests aren't frankly aren't good enough.

I suppose the most frustrating thing about my case is there will always be that lingering doubt in the back of my mind, questioning whether the supplemental is wrong, or the initial test was wrong.

I may get a WB if I really can't get past this. I must admit however that this whole thing has been an eye-opener in terms of the accuracy of antibody testing.

If I am negative, then four of my tests are just flat out wrong. If I'm positive, then three of my tests (including the most recent supplemental) are just flat out wrong.

Either way it's a minefield.

In any case, enough of my blabbering, thank you very much for your help.
"How rare is it for someone to test falsely positive with numbers over 3.5? Very"

Actually, we don't know this, at least in people without symptoms. We have assumed that people over 3.5 were positive, and it was accurate, but as Terri Warren posts on her Western Blot page, "Also, a research study that came out in early 2020 found that even some people with higher index values who have no symptoms have false-positive IgG tests." (I haven't seen the study so I don't know the numbers on this yet.)

So we don't know how rare it is. It might not be.

It is a minefield. I used to be someone who recommended herpes testing to everyone, routinely. I have firmly changed my mind about that.

In your case, I'd probably go with negative, but again, I might end up with a WB to make sure because I would want to know for sure. There's no right or wrong here.

Take care. :)
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