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Really Confusing Herpes IgG Test Results


I tested for HSV1 & 2 as a routine std check. My results came back as follows:

March 2020 : HSV2 1.08 Equivocal
April 2020: HSV2 1.26
Perplexed I got another test several days later. Result <0.2
For good measure I got another one in June 2020. Result 1.23.

So; equivocal, positive, negative, positive. HSV1 has been continuously <.91 (no worries there). What on earth is going on with the HSV2?
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207091 tn?1337709493
The CDC and experts in the herpes field all believe that anything under a 3.5 on a hsv2 IgG test should be considered a possible false positive, and needs to be confirmed with a Western Blot test.

Since you keep testing with the same test, you may continue to get these really low positives, which are telling you nothing, really. At 1.23 or 1.26, you have at least an 85-90% chance of these being false positives.

You can get a Western Blot test from your doctor, or from Terri Warren on her site - https://westoverheights.com/getting-a-herpes-western-blot/ - but you'll have to self-pay.

You said this was routine - have you had any symptoms?

If you need info to show your doctor -

https://www.cdc.gov/std/tg2015/herpes.htm - info about the testing is about 1/4 of the way down.

Helpful - 0

I’ve had no symptoms. I keep getting tested out of disbelief. I found it even more shocking that I had a negative in there. I feel like these are all false positives like you stated.
It's a really, really good chance that they are false positives. Obviously, only testing can show that with certainty, but if you can't get a Western Blot right now because of Covid in your area, or you can't afford it, I don't think you have a big need to rush out and get it confirmed.
Hey AuntJessi,

Just following up. I got the WB and I am indeed negative!!

Thank you for your support!
Congrats! I'm really happy to hear this!

I hope you never need us, but if you do, we're here. Stay safe and healthy! :)
Hi Auntie Jessi,

So my PCP order one more batch of tests recently.

HSV 1 was negative
HSV2 came back at 1.17 igg positive.
There was a supplement confirmatory hsv 2 igg test that stated "negative" attached to it.

At this point I think i'm fine. What on earth could be causing these low positives?
No one really knows what is causing the false positives. Some say it's that the test guidelines need to be changed, and that they are just too low at 1.10 for a positive (I agree with that).

Some think it's a blood protein that hasn't been identified yet. That could also be true.

I think you're fine, too. Your WB was negative, and that's all you needed. That supersedes all your IgGs. Tell your PCP to stop wasting time and money and don't do any more testing. You know your status. :)

Take care of you, and if you need us, we're here.
I just had a similar experience. My partner had a sore in the genital region and made me get tested for Herpes. I had never shown symptoms in the past.

I went and got a blood test and the test results were both negative for IGM. IGG was negative for HSV - 1 but came back for HSV-2 at 1.18.

My partner came back with negative for Herpes 1 & 2 for both IGM and IGG. The sores were Shingles. We had been having unprotected sex for 18 months and she was pissed I could have exposed her. She had a lot of questions whether I had been honest with my sexual history, which was her and one other woman in the past 10yrs+. I went and got another test and HSV-2 IGG was 1.22. At that point the doctor told me I was positive and to deal with it. I didn’t hold out much hope but just wanted to be sure so did some real search and found out about the Western Blot test. By the time I managed to talk my doctor into it and get it done is was another 6 weeks. It just came back negative.

I was confused and called the University of Washington virology department to learn more. They said at my levels it was an 85% chance of a false positive before the WB test and they said that I was certainly negative but said this happens a lot.

I asked how they could be certain and learned that the WB Test checks for 16 different proteins for the HSV-2 antibodies versus just one with the regular test.

I almost lost my partner and suffered a lot of stress. When the labs come back with results in the 1.1-3.5 range they should put a note to get a confirmatory WB test. Instead I had to spend untold hours figuring this out.

Hope this helps someone avoid my anguish. If I was positive I was ready to deal with it, but knowing I may have infected my partner was one of the worst feelings in my life.

Thank you for sharing your story. It really highlights so much of what happens to so many with the IgG test.

First is that the cutoff for positives is probably too low. Second is that doctors who are doing these tests and diagnosing and treating herpes aren't aware of the false positives, and that the CDC guidelines calls for confirmation of anything below a 3.5.

They also aren't culturing sores to see what they are, or they'd have known your sore was shingles much faster.

In the meantime, it causes so much stress, issues in relationships, and costs so much money and time to straighten out. This forum is full of people in similar situations. It's terrible, and I'm sorry you went through it, but I'm happy you pushed for answers.

Thank you again for sharing your story. It will help many others.

Thank you Cowboy911, I'm glad you were able to get the test and find peace.

Auntiejessi, my PCP is actually somewhat invested now. They ordered another igg! This time my results were:

HSV1 : negative
HSv2: 1.00 equivocal

I'm somewhat relieved that my pcp cares now, perhaps they will change the way they have been diagnosing people.  
Is there a reason they did another IgG and not a Western Blot?

The good news is that your numbers on the IgG dropped, meaning that is highly unlikely that you don't have hsv2, not that I thought you ever did. However, once you have a false positive on an IgG, you likely always will. Continuing to test with the same test isn't going to do much.

I have no idea why this is so hard for doctors. It's very clearly stated by the CDC. I'm sorry you are still dealing with it. What are you going to do now?
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