IgG Test Result Analysis

[gfnobelieveme]

I recently got STD screened.  I was last tested back in 2005 and got a clean bill of health.

Since then I have had three partners.  All three were tested (cleanly) immediately prior to us getting together.  

The HSV 2 test came back positive.  It yielded the following results:
Negative 120
Reading: 406H

I have had no symptoms, and neither have any of my partners.  The PA said that a reading that high indicates a recent exposure.  I am trying to find out "how recent." Is there a reference chart anywhere?  I am my partner's first relationship since having a child (that was not her husband), so there is a lot of consternation over this, and is why I am currently packing my bags.

Also, from reading the posts on here, it seems like this test is somewhat inaccurate? Is there any truth to this?

Thank you.

[Edward W Hook, MD]

Welcome to our Forum.  I'll try to help.  It sounds as though your risk for herpes may be low but more information will help.  For the type of HSV blood test done most widely, the HerpeSelect assay, the results typically are reported out as single digit numbers, not in the hundreds.  Thus a negative result is typically less than 0.90.  Which assay was used is important because, unfortunately there are some assays which still provide both false positive results and which tend to mix up antibodies due to HSV-1 which most commonly causes cold sores and oral infections and HSV-2 which most often causes genital herpes (although each virus can sometimes cause infection at the other site as well).  Can you check with your health care provider and let me know what assay was used?  It is also important to find out if this was a test for IgG antibodies or for IgM antibodies (which are also often falsely positive).  I note that the title of your question refers to an IgG test but there are also IgM tests which some peole erroneously think can identify recent infections.  

Further, it is not clear to me why you sought testing.  Because of problems related to the test, we do not recommend  these tests for routine screening- the results are all too often misleading.  Why did you get tested?  Does your partner has HSV?  Have you or your partner had sores or problems which lead you to worry about HSV?

Typically, unless you have been tested in the past, blood tests are not useful for determining whether or not an infection has been recently acquired.  
Sorry for all of the questions but this is a place where I can provide you with the most help if I have additional information., EWH

[Edward W Hook, MD]

Thanks for the additional information.  I wish we knew what the brand of test was and the numerical value (including decimal points) of your test result.  As  I said, a value of 406 is not a value I am used to seeing with type-specific tests and worries my about the test. on the other hand, a value of 4.06 (note the decimal point) is helpful and would be strong information that you indeed have HSV and making the question where did you get it.

As for the information on your partners, as I said, over 80% of persons with HSV are not aware of it until they are tested (typically because they have mistakenly attributed their HSV to something else, like a yeast infection or a recurring urinary tract infection). Thus you have one partner who clear does not have HSV and, in my mind, is better for know that. As for the other two, maybe they do and maybe they don't.  

As far as suppressive therapy, I think it is OK to not be taking it at this time as long as you are using condoms during intercourse while you await her test results. it would be unfortunate for her to get HSV while awaiting test results.  EWH

[gfnobelieveme]

The test results were screened using the Elisa method.

I have since gone a second time, and the results from that test also came back positive.  I am not sure what method was used for the second test, as it just came back with a straight yes or no.

Some other information...
one partner tested negative
the second partner's doctor did not want to administer the test because she had shown no signs of symptoms.  In fact, she was actually advised NOT to get tested, because of the stress it would cause either way.
the third partner's doctor did not want to administer the test because she had shown no signs of symptoms.  She did finally relent however, but is awaiting on the results.

My doctor did not recommend any suppressive treatment until I have an outbreak, or unless my partner's test comes back negative...

Thanks.

[Edward W Hook, MD]

We'll work to sort this out when you have a bit more data.  Most (80%) people who have HSV (either HSV-1 or HSV-2) do not know they are infected.  Knowing more about the test will help me to help you sort this out.  EWH

[gfnobelieveme]

Dr. Hook,

Thank you for the detailed reply.  I will need to consult with the doctor's office to confirm which assay was used.  I did doublecheck, and the listed results (and groupings) do not have decimal places.

I am confident it was an IgG test, as the line items are listed as HERPES 1 IGG and HERPES 2 IGG respectively.

None of the partners have ever had any symptoms or sores.  One of my partners and I simply agreed to the testing as a postscript to our relationship.  I did not anticipate there to be any issue, hence my surprise.

Thanks.

[gfnobelieveme]

I am not sure why the "reading" part got truncated.

It was supposed to say negative under 100, equivocal between 100-120, and positive greater than 120. The reading was 406.

I suppose I should get retested to validate as well...