I just had some confusing test results come back and no one (and I mean no one: multiple RNs, lab techs, and MDs at my primary care, planned parenthood, Med express clinic) could answer.
Thought maybe I could give you guys a shot?
Last week I had a non-primary first genital outbreak. I have been HSV1 (oral outbreaks only to my knowledge) since childhood. Planned parenthood ordered a culture. I left in a daze without requesting IgG, IgM, or PCR. The following day (Planned parenthood was closed), I went to a Med Express clinic and requested IgG, IgM, and PCR.
Med Express said I was IgG positive for HSV1 and negative for HSV2 within a day.
The rest of the results came back today (a week later) from both. Planned parenthood told me that I had a positive HSV2 culture.
Med express said I was (non specifically) negative for IgM and the culture and that they had cancelled the PCR because the lab no longer does them on anything other than CSF.
I had requested IgM with hopes that it would come back at the same time as the IgG and would give me some possible peace of mind during the wait. Now it's just a confusion.
What are the rates of a false negative IgM taken 3 days into an active infection?
What are the margins of error on culture swab testing?
I will be seeing IgG testing in 16 weeks. In the mean time Planned parenthood has informed me that I am HSV2 positive while med express has said that they are confident that I am not, and that it is an HSV1 genital outbreak.
What is the % of the population that has both HSV 1 & 2?
-----> My partner tested positive for HSV1 and negative for HSV2 a month ago. He had a small non-primary first outbreak on his knee 5 days after I had my initial outbreak. He had it swabbed by med express. They reported that it was (weakly) positive for HSV2. He has since started developing a small outbreak inside his mouth. He says has not had a cold sore since he was a small child. We have not had sexual contact since 5 days before my first break out.
If anyone has any insight into this viral ping-pong plague and the accuracy of these tests, it would be greatly appreciated,
C
http://www.ashasexualhealth.org/std-sti/Herpes/testing.html
A positive on a culture swab is virtually never wrong, unless the sample was contaminated. However PCR is a DNA test, not culture. In that case as well, however, a positive result is pretty definitive, except in cases of lab contamination. Whether one already has a prior infection is of no consequence, if the test is type-specific.
The HSV types (1&2) do not "cross the equator" from above to below the waist and vice versa. However, they can each infect either site - they are not limited to their site of preference.
According to your evidence, you are both experiencing a first infection of HSV-2, which does not seem possible, unless you've each had other partners in the last 4 months. However, if your IgG tests were the HerpeSelect IgG ELISA, they could have returned inaccurate results for either or both of you. The ELISA sometimes (a) misses HSV-1, (b) mistakes HSV-2 for HSV-1, and (c) returns false positives when the ab count is under 3.5 or so.
What I recommend: get the pricey but conclusive Western Blot - the gold standard of tests. You can wait until the 16-week mark to do this, and it will be conclusive. You can also re-test between now and then with the IgG, say at the 8-week mark, to see if the antibody count has changed, just to give yourself an idea of the virus' progression.
Dr. Anna Wald of the University of Washington told me that about 75% of the population has one or both types of HSV, about 65% has HSV-1, and about 16.9% has HSV-2. This would lead one to calculate that about 7% of us have both - that's over 22 million people.
Hope some of this helps.