Aa
False Positive HSV-2 Igg test and Western Blot
Hi everyone,
I wanted to share my story in case it's helpful to others. Although I have not posted before, I benefited from many of the other posts. The short version is that I had a low-positive 2.5 Elisa HSV-2 Igg test from Labcorp, and like many other people I later got a negative Western blot HSV-2 test from the U. of Washington, proving that the initial Labcorp result was a false positive. If you keep reading, you'll get details of the story as well as information about how to get the Western Blot test (which was not easy!). :)
In August 2013 during a routine annual exam my obgyn tested me for a variety of STDs. Please note that this was just routine since I had ended my previous relationship 8 months prior and I was starting to date someone new and wanted a "clean slate." I've never had an STD in my life, I am a healthy and responsible woman in my early 30s. As a lesbian, I am less at risk than heterosexual women. I did not have any symptoms of any kind.
It was devastating and shocking to hear from my doctor that my HSV-2 Igg Elisa antibody test performed at Labcorp turned out to be a 2.5, which is positive according to their official range of values (>1.1). For the record, my HSV-1 Igg was negative (and indeed I've never had a cold sore in my life, unlike most people). That's the only herpes test I had ever had, since routine STD screenings don't typically check for herpes, so I had no prior results to compare it to.
I work in academia, I have a Ph.D., and I have access to medical journals and publications, so I began to research everything published on the subject. Here's what I found out:
1) In low-risk populations, any Elisa HSV-2 Igg "positive" value under 3.5 should be considered suspect. According to published studies, it is estimated that 65% of those low positive Igg values (under 3.5) in the Elisa test are in fact false positives. That is why the the CDC does not recommend routine screening for herpes in low-risk populations. What you should realize is that MOST DOCTORS ARE NOT AWARE OF THIS FACT.
2) The reasons for the low-positives are not clear. According to many researchers, a positive HSV-1 (cold sore) might lead to a false positive HSV-2 value because of cross-reactivity among those different strands of the herpes virus. That has been shown in the literature. In my case, however, this is not a relevant explanation since my HSV-1 values were negative. A working hypothesis is that other strands of herpes (chickenpox and shingles) might cause the test to falsely report HSV-2 antibodies, but to date that is speculation based on clinical findings only that has not been proven conclusively. Personally, I believe in the latter theory because I myself had shingles a couple of years ago (when I was 30 years old).
3) The scientific literature on the subject has found 2 tests to be accurate confirmatory tests to ascertain if a low-positive Elisa HSV-2 Igg value is indeed a real positive or not. Those are the Biokit (also marketed under SureVue) and the Western Blot.
The Biokit is a finger prick test done in a doctor's office. It takes about 10 minutes for the result. Articles published in medical journals have found the biokit to be highly accurate. The problem I encountered is that it was virtually impossible to find it. I called the manufacturer (http://www.biokitusa.com/) and they were able to give me the contact information of just 2 clinics in my state that carry it. If you have a supportive doctor, you can convince them to order the kit and administer the test in their office. Most doctors, however, would be unlikely to bother with it because they are not informed enough about the statistics on low-positive HSV-2 Igg results. I gave up on the biokit because it was too difficult to get to it for me. Instead, I went for the Western Blot.
The Western Blot HSV-1 and HSV-2 Igg antibody test is absolutely the gold standard herpes antibody test. The validity and reliability of all other tests are measured against this one. This is the test you want. The catch is that it is only performed at the University of Washington in Seattle. I had found older posts on this forum and on other fora explaining that you could get the Western Blot done and ordered through your local Quest Diagnostics lab. That used to be the case, but it is NO LONGER TRUE. Quest Diagnostics does their own HSV-2 Elisa Igg test, and if the result is a low positive (under 3.5) then they also do an immunoassay test to confirm the result. Their immunoassay is better than nothing (certainly better than Labcorp), but it is not accurate enough. You could have a low positive HSV-2 Elisa Igg and a positive immunoassay at Quest, and you might still be a false positive. The only way to know for sure is a Western Blot.
So, how do you get the Western Blot HSV-2 Igg test nowadays? Here's what you do step by step.
1) Call the University of Washington Virology Dept. at 800.713.5198
(http://depts.washington.edu/rspvirus/documents/hsv_western_blot.pdf
and http://depts.washington.edu/herpes/faq.php).
2) They are very nice and helpful. They will mail you a kit (free of charge) with instructions, a vial, a requisition form, and an appropriate box with ice pack and biohazard sticker that you will need to use to mail your vial back to U of WA.
3) Go to your doctor with the forms. Your doctor has to give you 2 things: the requisition form for the U. of WA, and a lab order for a local lab to draw your blood.
4) Go to a local lab with your doctor's order, have them draw your blood and spin it, and then give you back the vial with serum.
*Here's the problem: most labs will REFUSE to give you back your vial with serum. Labcorp and Quest both turned me down citing their corporate policy. I had to find a small independent laboratory in my city that was willing to do it. So, be prepared to call around. The lab I found charged me $25 for drawing fee*
5) Pack the vial of serum, the requisition form, and a check payable to the Univ. of Washington (currently the cost is approx. $162) and send it fedex overnight in the box provided by U. of WA. You'll have to pay for overnight shipping. Also, U. of WA does not bill insurance for anyone outside of WA state, so you'll have to pay upfront and then you can try later to get your insurance to reimburse you (highly unlikely though!).
6) Not all Fedex offices will accept a "clinical specimen" shipment. Call ahead of time the general fedex national number and ask them which Fedex office in your area is designated to accept dangerous goods and clinical specimens. They will make you place the box inside one of their fedex "clinical paks." I did not have to fill out a dangerous goods form, but be prepared to describe in detail how you packed it. Here's a post I found on another website that helped me a lot with step by step instructions: http://www.racoon.com/herpes/WB_test.htm
7) Your doctor will call you with the result. It takes about 2 weeks. That was the best part: hearing that indeed it was negative!
8) I am going to try to submit receipts (for the drawing fee, the Western blot test, and fedex shipping) to my insurance company, but I am not holding my breath. All in all, it was about $230 for me.
I hope this will help someone. Good luck!
I wanted to share my story in case it's helpful to others. Although I have not posted before, I benefited from many of the other posts. The short version is that I had a low-positive 2.5 Elisa HSV-2 Igg test from Labcorp, and like many other people I later got a negative Western blot HSV-2 test from the U. of Washington, proving that the initial Labcorp result was a false positive. If you keep reading, you'll get details of the story as well as information about how to get the Western Blot test (which was not easy!). :)
In August 2013 during a routine annual exam my obgyn tested me for a variety of STDs. Please note that this was just routine since I had ended my previous relationship 8 months prior and I was starting to date someone new and wanted a "clean slate." I've never had an STD in my life, I am a healthy and responsible woman in my early 30s. As a lesbian, I am less at risk than heterosexual women. I did not have any symptoms of any kind.
It was devastating and shocking to hear from my doctor that my HSV-2 Igg Elisa antibody test performed at Labcorp turned out to be a 2.5, which is positive according to their official range of values (>1.1). For the record, my HSV-1 Igg was negative (and indeed I've never had a cold sore in my life, unlike most people). That's the only herpes test I had ever had, since routine STD screenings don't typically check for herpes, so I had no prior results to compare it to.
I work in academia, I have a Ph.D., and I have access to medical journals and publications, so I began to research everything published on the subject. Here's what I found out:
1) In low-risk populations, any Elisa HSV-2 Igg "positive" value under 3.5 should be considered suspect. According to published studies, it is estimated that 65% of those low positive Igg values (under 3.5) in the Elisa test are in fact false positives. That is why the the CDC does not recommend routine screening for herpes in low-risk populations. What you should realize is that MOST DOCTORS ARE NOT AWARE OF THIS FACT.
2) The reasons for the low-positives are not clear. According to many researchers, a positive HSV-1 (cold sore) might lead to a false positive HSV-2 value because of cross-reactivity among those different strands of the herpes virus. That has been shown in the literature. In my case, however, this is not a relevant explanation since my HSV-1 values were negative. A working hypothesis is that other strands of herpes (chickenpox and shingles) might cause the test to falsely report HSV-2 antibodies, but to date that is speculation based on clinical findings only that has not been proven conclusively. Personally, I believe in the latter theory because I myself had shingles a couple of years ago (when I was 30 years old).
3) The scientific literature on the subject has found 2 tests to be accurate confirmatory tests to ascertain if a low-positive Elisa HSV-2 Igg value is indeed a real positive or not. Those are the Biokit (also marketed under SureVue) and the Western Blot.
The Biokit is a finger prick test done in a doctor's office. It takes about 10 minutes for the result. Articles published in medical journals have found the biokit to be highly accurate. The problem I encountered is that it was virtually impossible to find it. I called the manufacturer (http://www.biokitusa.com/) and they were able to give me the contact information of just 2 clinics in my state that carry it. If you have a supportive doctor, you can convince them to order the kit and administer the test in their office. Most doctors, however, would be unlikely to bother with it because they are not informed enough about the statistics on low-positive HSV-2 Igg results. I gave up on the biokit because it was too difficult to get to it for me. Instead, I went for the Western Blot.
The Western Blot HSV-1 and HSV-2 Igg antibody test is absolutely the gold standard herpes antibody test. The validity and reliability of all other tests are measured against this one. This is the test you want. The catch is that it is only performed at the University of Washington in Seattle. I had found older posts on this forum and on other fora explaining that you could get the Western Blot done and ordered through your local Quest Diagnostics lab. That used to be the case, but it is NO LONGER TRUE. Quest Diagnostics does their own HSV-2 Elisa Igg test, and if the result is a low positive (under 3.5) then they also do an immunoassay test to confirm the result. Their immunoassay is better than nothing (certainly better than Labcorp), but it is not accurate enough. You could have a low positive HSV-2 Elisa Igg and a positive immunoassay at Quest, and you might still be a false positive. The only way to know for sure is a Western Blot.
So, how do you get the Western Blot HSV-2 Igg test nowadays? Here's what you do step by step.
1) Call the University of Washington Virology Dept. at 800.713.5198
(http://depts.washington.edu/rspvirus/documents/hsv_western_blot.pdf
and http://depts.washington.edu/herpes/faq.php).
2) They are very nice and helpful. They will mail you a kit (free of charge) with instructions, a vial, a requisition form, and an appropriate box with ice pack and biohazard sticker that you will need to use to mail your vial back to U of WA.
3) Go to your doctor with the forms. Your doctor has to give you 2 things: the requisition form for the U. of WA, and a lab order for a local lab to draw your blood.
4) Go to a local lab with your doctor's order, have them draw your blood and spin it, and then give you back the vial with serum.
*Here's the problem: most labs will REFUSE to give you back your vial with serum. Labcorp and Quest both turned me down citing their corporate policy. I had to find a small independent laboratory in my city that was willing to do it. So, be prepared to call around. The lab I found charged me $25 for drawing fee*
5) Pack the vial of serum, the requisition form, and a check payable to the Univ. of Washington (currently the cost is approx. $162) and send it fedex overnight in the box provided by U. of WA. You'll have to pay for overnight shipping. Also, U. of WA does not bill insurance for anyone outside of WA state, so you'll have to pay upfront and then you can try later to get your insurance to reimburse you (highly unlikely though!).
6) Not all Fedex offices will accept a "clinical specimen" shipment. Call ahead of time the general fedex national number and ask them which Fedex office in your area is designated to accept dangerous goods and clinical specimens. They will make you place the box inside one of their fedex "clinical paks." I did not have to fill out a dangerous goods form, but be prepared to describe in detail how you packed it. Here's a post I found on another website that helped me a lot with step by step instructions: http://www.racoon.com/herpes/WB_test.htm
7) Your doctor will call you with the result. It takes about 2 weeks. That was the best part: hearing that indeed it was negative!
8) I am going to try to submit receipts (for the drawing fee, the Western blot test, and fedex shipping) to my insurance company, but I am not holding my breath. All in all, it was about $230 for me.
I hope this will help someone. Good luck!
Most insurance company's won't.
4 Comments
Gey! I have tested postive for 1 and 2. My range is like 4 for 1 and 5 for 2. What do yall think?
Pretty high numbers for a possibility for a false positive. Have you tested again ton verify?
I went into LabCorp last Friday and it came back the next day strange. It was even higher. I payed online cite called std and they found labCorp in my city and I went in had it done.
The values will change a little between tests. Think of the result value number as a confidence number. The higher the number the more confident the test is it saw the antibodies it's looking for
Congrats on your good news.
Current partner tested over 5.00 for HSVI and 3.66 for HSV II. I don't know what are my chances for contracting this.
Good news! Your advice is very wise indeed, thank you for reporting back.
I just got my results back and It was negative for both. I would of went the rest of my life thinking i had hsv2 if i hadn't come across all the info Terri Warren has out there. When my doctor called with the results they were just going to give me a valtrex prescription and send me on my way. Luckily I already knew my result and had done research. It was until I BROUGHT UP the high false positive rates for someone with a number low as mine that they said yes there is a high rate and that confirmation testing is a good way to go. I'm just glad Terrie Warren has made the western blot available to more people. If you can spare the $250 and youre between 1.1-3.5 i suggest getting the WB. If you're over 3.5 and have never had symptoms and can spare the $250 i would suggest getting it done just for the peace of mind.
3 Comments
I am in the same boat as you were right now. I just got tested in 09/2016 and the test came back positive for hsv1. I'm single and not sexually active. I'm so devastated by this and I cry almost every day. I want to get the western blot test. When my Dr called to give me the news they wanted to give me antivirals and send me on my way. I was so devastated that I didn't ask what my numbers were. I'm so stressed right now.
This is an old thread. Please start a new thread if you need help.
Thank you
Thank you
Please tell me how to get this test
It was 250.00 flat rate. That included the phone consultation and the Western Blot. When I was at Quest labs, I gave my insurance card. I am not 100% sure if insurance will cover the blood draw, so there could be an extra blood draw charge if my insurance bills me. You can also order a kit free of charge from UofW, take it to your doctor or a med-stop and have them fill out the order and then go to a blood draw place. When the result is sent in, you'd need to include a check for approximately 206. I found it easier to just go through Westover Heights. The 250 included a 10 minute appointment phone call with Terri Warren. I found it was better to do the blood draw on a monday than a friday because it gets overnight shipped on dry ice. Quest labs handled all of this. You don't want your sample sitting around on a weekend.
You are reading content posted in the Herpes Community
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
