Confusing Results HSV2

[LA1224]

I was recently tested for HSV 2 on a routine checkup and it came back positive 1.78. I went for a second test w/ reflex testing by labcorp and the index was 1.56 but the REFLEX supplemental test came back NEGATIVE. I’m confused on what then supplemental test is saying. Am i negative or need more testing? What is the reason for supplemental testing? I plan on getting the western blot tomorrow, but I’m looking for some clarification. Any information i would appreciate.

[Curious_95]

Would you know if quest diagnostics have this supplemental reflex test? Or where I can find the western blot test ? Can I just go to quest and ask for it ?

[auntiejessi]

I answered your other post. :)

[auntiejessi]

Do you know what the supplemental test was? The reflex test just means that they automatically run another test when you fall between a 1.0 and a 3.5, as these can be false positives.

If you can find out what that test was, I can help answer more. If it's a Biokit, and it's negative, you're definitely negative. If it's another IgG test (was your original test an IgG or IgM?), then you should maybe get the WB.

Do you have the actual test results?

[LA1224]

Thank you....
Yes i read the actual results. Here is the link to the actual labcorp info to the test I’m sure https://www.labcorp.com/tests/164922/herpes-simplex-virus-hsv-types-1-and-2-specific-antibodies-igg-with-reflex-to-supplemental-hsv-2-testing

Terri Warren’s forum said the supplemental test is like the WB. I read it in one of the forum questions. She said if the supp/reflex test is NEGATIVE, it’s most likely negative.

What is your take on it?

[LA1224]

My original test was IgG. The supplemental test only states Negative or positive for results. With it being negative it said unable to detect HSV2  antibodies.

[auntiejessi]

Can you find out what the supplemental test was? There are different types of tests, and it's important to know which one they did. According to the link you gave, the supplemental testing is also an IgG. That's the same kind of test you took the first time.

Reflex 1 163006 HSV-2 IgG Supplemental Test

Chances are really good that you're negative. The WB will clear it all up.

What made you test in the first place? Was it routine testing or did you have symptoms you were concerned with? Something else?

[LA1224]

Ok got it. It was a routine testing. No symptoms at all. Never had a breakout or anything. She just added it to the panel i guess.

If it was supp test was the same as the initial test, what would make it come back Negative if the first one was in the positive range? To my knowledge the reflex/supp test is to confirm/or rule out the first test.  Is that correct?

Below are the questions and answers that Terri Warren (Hsv Specialist) that you know wrote in her forum from her website:

1. I am assuming the supplementary test is the confirmation results as per their guideline – correct?
https://www.labcorp.com/test-menu/39916/herpes-simplex-virus-hsv-type-2-specific-antibodies-igg-with-reflex-to-supplemental-testing

Terri: Correct. I have found the LabCorp supplemental test to be more in agreement with the blot

6. What should be my next steps?

Terri: If you can feel at peace with the results of the supplemental test then you don’t need to do anything.

[auntiejessi]

She might be right - Terri is the best in the field, and I'd trust her implicitly.

There's a lot we don't know about what makes a person test with a false positive, then come back with a negative. We know it happens a lot, though, especially if the result on the positive is really low, like yours.

With your really low results, and then the negative, and no symptoms, I think you'd be safe to say you're negative. Any further testing would be for your peace of mind. Either way you go is - accepting the current results or wanting more confirmation -  logical and understandable.