How Do HSV2 False Positives Occur

[concernedmale65]

I had two low positives for HSV 2 after an unprotected sexual encounter.  5 months post sexual encounter with no sex in between, I confirmed with the WB and came back negative for HSV 2.  

What causes some of us to be falsely positive?  

Some online sources seem to indicate the potential for the chicken pox virus to possibly cause false positives, but of course, the manufacturers of the standard HSV 2 tests claim that is not possible.  When I was a child I had a second bout of chicken pox after my initial outbreak that was particularly severe...my mom had to take me back to the doctor after I was almost healed from the first bout of chicken pox.

Although I have confidence in the WB results at 5 months per this forum, my inquisitive mind still wants answers as to why I'm "blessed" with this false positive issue on the standard test.  Theoretically, I would need to get a WB done every time I'm with a new partner if I'm going to ask them to show me their paperwork.  

Any insight (even if it's educated speculation as opposed to a scientific study) would be appreciated.  I figure if anyone will have a possible answer on this, it will be you, Terri.  

It blows my mind that the CDC is aware of false positive issues with HSV 2 testing and doesn't promote testing in the general population.  I mean, how many people out there go get tested and come back falsely positive and live out the rest of their life thinking they have HSV2...taking antivirals and dealing with the social stigma.  Also makes me wonder how much the manufacturers of the standard HSV 2 tests as well as the antiviral pharma companies know and what they are hiding [said the conspiracy theorist:)].

Thanks.

[Terri Warren, RN, Adult Nurse Practitioner]

I have been out of internet range in the Canadian boundary waters and the board managers were to let people know, I'm so sorry your post slipped through the cracks.  

As to why there are false positives:  We know that in the person who has HSV 1, the test sometimes picks up some HSV 1 antibody and calls it HSV 2.  This is called cross reaction between the two viruses.  But we also see false positives for HSV 2 in people who are negative for HSV 1 and for that situation, I think there are some cellular proteins (your own proteins) that look enough like the HSV 2 proteins that they trip up the test.  And in people who have low positives with no HSV 1, the western blot sometimes can't help sort that out.  I am happy it could sort it out for you, but yes, that has to feel very annoying.  

It would be my preference for the test makers to disclose the possibility of a false positive on every test with an index value of 3.5 or lower.  That's up to the FDA, not the CDC, and they don't appear to think it is necessary.  Perhaps because there isn't an easily obtainable confirmatory test.  

We will be conducting a study on a new test this summer, particularly on people who have indetermintates.  

Terri

[Terri Warren, RN, Adult Nurse Practitioner]

Thanks for your kind words.  We come in from the woods in a week and back to real life where I can be sure every day we have a good connection to the internet.

Terri

[concernedmale65]

Thanks so much, Terri.  Well, I think your husband is probably right in a sense, but you are very passionate about what you do, which is great in general.  You help so many people and we do truly appreciate it.  But you also definitely earn some care free vacation time (probably more than you take in general).  Thanks again and have a good rest of your week!

[Terri Warren, RN, Adult Nurse Practitioner]

yes, I believe you can believe the western blot.  They would have definitely told you if you were indeterminate.  That's kind of a personal hell for people who get that result because they just don't know what to believe about themselves. I personally think we will find, in the future, with a different test, that most of these low positive ELISAs and indeterminate western blots will actually be negatives.  

Yes, it was nice to detach from electronics but I worried that some people might think I was ignoring them. My husband just rolls his eyes when I worry about things like this on vacation.  LOL.

Terri

[concernedmale65]

Hi, Terri, thank you so much for your response!  I actually thought you may be on vacation (well, I'm assuming that's what it was) and knew you'd write when you were back.  I bet it felt great to detach from the electronic world for a bit!

So yes, I didn't specify in my original post, but I am one of those people who is definitively negative for HSV 1 but falsely positive for HSV 2 on the standard test.  The WB showed that I am negative for both.  I'm assuming they would have told me if I was indeterminate.  

So I know this is probably the paranoid in me still, but I should trust the WB at 5 months post encounter, correct?  I know 4 months is the minimum.  

I'll be very interested to see the results of the indeterminate study.  My entire situation has really made me extremely interested in the related research you guys are doing!

[concernedmale65]

I would pursue the WB if I were you.  I am not one of the experts on this forum by any means, but based on what I've read from the experts on here, anything less than a 3.5 and you should get confirmed with WB.  With no symptoms and a low positive, you could quite possibly be negative via WB.  In my opinion better to know either way than to leave yourself wondering.  Good luck!

[Confusedlady2014]

Sorry it took me a bit to reply......I didn't ask that specific question but gave all my details and asked what twy felt the odds of it being a false positive were. Two people answered....one said I should get the western blot and the other said it was confirmed because they had ran the test twice (first was at an equivocal level--neither positive or negative and the second time, they got the 1.13). In my mind, that was an incredibly low number and the first time it was only equivocal. I've never had a symptom of anything, neither has my husband or his affair partner--who is allegedly negative. Everything on the expert forum was making me feel like this could possibly be a false positive but the guy on the community board dismissed it and said I was positive and I couldn't get anyone else to answer. I completely understand your anxiety. This has been such a terrible ordeal for me on top of the demise of a marriage I was 100% faithful in. Definitely not what I was expecting for my life. So so glad for you that you had a happy outcome. I guess I just need to get the nerve to have the western blot done but I am so scared of being positive.

[Confusedlady2014]

Sorry it took me a bit to reply......I didn't ask that specific question but gave all my details and asked what twy felt the odds of it being a false positive were. Two people answered....one said I should get the western blot and the other said it was confirmed because they had ran the test twice (first was at an equivocal level--neither positive or negative and the second time, they got the 1.13). In my mind, that was an incredibly low number and the first time it was only equivocal. I've never had a symptom of anything, neither has my husband or his affair partner--who is allegedly negative. Everything on the expert forum was making me feel like this could possibly be a false positive but the guy on the community board dismissed it and said I was positive and I couldn't get anyone else to answer. I completely understand your anxiety. This has been such a terrible ordeal for me on top of the demise of a marriage I was 100% faithful in. Definitely not what I was expecting for my life. So so glad for you that you had a happy outcome. I guess I just need to get the nerve to have the western blot done but I am so scared of being positive.

[concernedmale65]

My false positives were way higher than yours.  Here's the link to my story if you care to read it all: http://www.medhelp.org/posts/Herpes/Recently-Discovered-HSV-2-Exposure/show/1865071#post_8642735...definitely had a lot of anxiety as you will be able to tell.  My numbers were 3.96 and 1.75.  When I got the WB after 5 months, my doctor was astonished that the WB came back negative.  However, after all this, I'm actually much more open to dating someone who is HSV 2 positive, which I did not expect at all.  

So can I ask, did you specifically ask why people have false positives here int he expert forum and not receive a response...basically, did you pay to ask that question and no one responded?

Thanks

[Confusedlady2014]

I never really got an answer to my question either and have been watching your question in hopes of you getting an answer. There's a lot of info about false positives but the only person to really answer my question seemed to think it wasn't the case with me. (Never had any symptoms but tested positive for hsv 1--can't remember the number and low positive hsv 2-1.13 after I discovered my husbands affair. His affair partner was negative (allegedly) but I am so scared to get the western blot just because of how emotionally traumatic I know it will be if I am positive.   How long did it take you to get your results?  And what were your low positive numbers, if you don't mind me asking?

[concernedmale65]

And forgive me if I'm being impatient.  I realize you have obligations outside of this forum as well.  If that's all this is, then I'll patiently wait until you have some time to respond.  Thanks!

[concernedmale65]

Just curious what I can expect as far as a timeline for receiving an answer to my question.  It appears as though other questions that were posed after me have received responses, but I haven't received one yet.  Any response would be appreciated.  My credit card has been charged, so if for some reason an answer is not going to be provided, I'd like to pursue a refund as my credit card has already been charged.  I'd much rather get an answer, though, so just let me know what to expect.

Thanks.