Avatar universal

HSV 1/2 antibody tests - high HSV1 titer, low HSV 2 titer

I am a male in mid-20s. I had blood work done for HSV 1 and 2 (type-specific) antibody testing. I had no reason to do so. I just wanted to get checked out to soothe my conscious. My HSV 1 test came back strongly positive with a titer level of around 5. I have had cold sores for as long as i can remember, and I was expecting to test positive for HSV 1 antibodies.  However, I never thought I had HSV 2. I have never exhibited any symptoms of genital herpes, or symptoms for any STD or genital irritation for that matter. Thus, I was expecting a negative result from my HSV 2 antibody testing. However, my results came back positive, yielding a very low 1.23 titer. From what my physician has told me, I have nothing to worry about. He said the threshold for positive HSV 2 antibodies is a titer of 1.1, and mine is just hardly above that. He said that, had we performed the test on any other day, I might even test negative for HSV 2 antibodies (i.e. below the 1.1 threshold).

So my question is twofold: 1) Could this be a false positive result for HSV 2? I read that there is sometimes a false positive relationship in men who test for a high titer of HSV 1 antibodies but a very low titer of HSV 2 antibodies. Is this true? And is this a possibility in my case?

My second question: I have never exhibited any symptoms of genital herpes, but is it possible that I may exhibit them in the future due to the presence of HSV 2 antibodies in my blood (assuming that I do not expose myself to anyone else with the HSV 2 virus hereafter)?

Also, do I need to inform my sexual partner? We use birth control so we do not use protection. Should I be legitimately worried about spreading the HSV 2 virus to my partner? Am I contagious even with such a low HSV 2 titer and no genital symptoms? I am well aware of the dangers of HSV 1 infection due to oral sex but I am only inquiring about HSV 2 genital contact.

Thanks for all the help!
4 Responses
101028 tn?1419603004
yes indeed this is probably a false positive but you'll need further testing to confirm that.  

has your regular partner ever been tested for herpes to know their status? this is well worth discussing together so you can find out. if your partner tests negative for hsv2, get a herpes WB at any point. if they test +, then wait a few months and repeat the test you just had done again to see what it shows.

Avatar universal
Hi Grace,

I took your advice and ordered the Western Blot HSV I & II test from U. Washington, and the HSV II results came back negative!!!  My HSV I was positive, but I was expecting that, as I have gotten cold sores since I was a young kid.  

I just want to thank you and Dr. Handsfield for taking the time to address peoples' concerns over this forum. I could have gone a lifetime believing my false positive results from the antibody test, and I only have the two of you to thank for giving me advice on how to further investigate my test results.  

I have learned an invaluable lesson about sexual responsibility. These have been some of the most nerve-racking and psychologically painful months of my entire life (wondering whether I was truly HSV II positive and awaiting my test results), and I never want to experience that kind of uncertainty and helplessness again. I hope others will read posts like this on this forum and feel compelled, as I do now and will forever, to practice safe sex at all times.

Thank you again for all of your help, Grace. Words cannot express my gratitude.
101028 tn?1419603004
glad you got answers :)

did your partner ever get tested too?

Avatar universal
How do you go about ordering the western blot test? I was tested and was positive for hsv1 and 2. First hsv1 titer was 18.8 and hsv2 was 3.14.

I got restested and got the results back this week. Both still positive but my hsv 1 titer went down to 11.6 and my hsv2 titer went down to 2.16.... not really sure why they’d vary so much. I was told my values would probably increase over time, and they’re goin down which leads me to believe hsv2 is a false positive.

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