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Test Results! - Question for Dr. Hunter

I am a single male in mid 30s. I am not in a monogamous relationship but extremely careful about using protection at all times (Never had sex without it). Below are my results verbatim this past Friday. I am a healthy individual and with no symptoms - rash/sores/worts.  My primary care physician said that I'm possibly positive but my results both show in the equivocal range. The analysis was done via blood and conducted by LabCorp.

Results below:

Herpes Simplex Virus I/II, IgG
HSV I/II    IgG                         0.9     High       index 0.0 - 0.8
Negative 1.0

HSV, IgM  I/II Combination       1.01  High
Negative 1.09

My questions are the following -
1) What does equivocal range mean ? What does Combination mean exactly in the 2nd result ? (my primary care physician frankly seemed lost)
2) I'm planning to do a Herpselect type specific iGG test from LabCorp. Would that be necessary and/or important given my index count ?
3) The above results don't seem to separately breakdown the HSV 1 and HSV 2. Is there a way to know that given my results above ?
4) I've been reading that for someone to be truly positive, the range has to be 3.5 or higher .. is that true ?
5) How safe are kids and babies in close proximity with me ?
6) How should I proceed moving forward with any sexual partners in future ? If positive, do I need to inform them or condom protection is sufficient ?

Any other advise or feedback would be highly regarded. I've been under extreme duress the past few days.

Thanks
3 Responses
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300980 tn?1194929400
MEDICAL PROFESSIONAL
Glad we could help. Take care. EWH
Helpful - 0
Avatar universal
Thank you Dr. Hook, your responses were fantastic. My Herpselect type scores came back today. Both are negative as per my primary care ( less than 0.91 for HSV I and HSV II). Feel like I am reborn!

This forum is a great service, always nice to have a professional opinion at fingertips before one jumps to conclusions. Thank you again.
Helpful - 0
300980 tn?1194929400
MEDICAL PROFESSIONAL

Welcome to the Forum.  I'll be happy to address your questions. Your experience is precisely the reason that we do not recommend blood tests for HSV unless a person is at substantial risk.  Having always practiced safe, condom protected sex, your risk for STD is miniscule and were you my patient I would not have advised testing.  You were however and now we need to deal with the results.  

Your doctor is exactly right- it appears that you were tested with a non-specific test which does not differentiate HSV-1 from HSV-2.  You need to be re-tested.  IgG tests in the equivocal range ( and even those classified as "low positive") are often falsely positive.  In the numerical range of your test, over 80% of results are false positive and given your history, your risk is probably lower still.  If your HerpeSelect test is also equivocal, you can sort this out by seeking what is called "confirmatory" testing with either a Biokit test (these are sometimes hard to find) or by having a specimen sent to the University of Washington (and only the Univ. of Washington) for testing with their Western Blot test.  If either of these tests are negative or, in the case of the UW Western Blot, equivocal, you can be confident you do not have HSV.  

In addition, I should add that the IgM test is of little value and have even more problem with its use than the IgG test. It has no meaningful role as a diagnostic test .

As for your specific questions:

1) What does equivocal range mean ? What does Combination mean exactly in the 2nd result ? (my primary care physician frankly seemed lost)

See above.  Some people with tests in the range of yours have HSV but most do not.

2) I'm planning to do a Herpselect type specific iGG test from LabCorp. Would that be necessary and/or important given my index count ?

Yes a HerpeSelect is a good idea.  If you do want to test again, the IgG test, not the IgM is the one to do.

3) The above results don't seem to separately breakdown the HSV 1 and HSV 2. Is there a way to know that given my results above ?

Yes, the HerpeSelect does break IgG results into HSV-1 (which causes cold sores and is present in over 60% of Americans) and HSV-2 (which causes primarily genital infection).

4) I've been reading that for someone to be truly positive, the range has to be 3.5 or higher .. is that true ?

Almost. If a person has a value of more than 3.5, they are infected.  If the value is lower, they may have a false positve test and need confirmatory testing as described above.

5) How safe are kids and babies in close proximity with me ?

Totally safe.

6) How should I proceed moving forward with any sexual partners in future ? If positive, do I need to inform them or condom protection is sufficient ?

At present you do not know you are infected.  I would suggest you continue to practice condom protected sex.  It would be premature to "disclose" to them at this time.  You do not know you have HSV.

I hope these comments are helpful.  EWH
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