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Test Results at 9 Weeks - Equivocal


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    • I am a male, 24 years old.

      I had a 1 sexual encounter on 5/28 and engaged in unprotected oral and vaginal sex. (She told me she was STD free) To be safe, I got a full STD panel (I have no symptoms) included I was tested for HSV1/2 on 8/2 (66 days after exposure) The test was through Quest and was a type specific IgG test with index values as followed:

      <.90 negative
      .90 – 1.09 equivocal
      >1.09 positive 

      My results:

      HSV1 .93 H equivocal
      HSV2 .90 negative 

      My questions:

      1.) Is 9+ weeks enough time to get an IgG test for HSV1? 

      2.) Is this result most likely negative?

      3.) I’m getting the Western Blot, how accurate is that at determining a true negative/positive at 12 weeks post exposure? I guess I’m just scared of getting a “indeterminate” result in the event 12 weeks isn’t enough time.  
       

      4.) is there anyone who personally tested equivocal and resulted in a negative with WB?

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Hello! 

First, it is awesome that you are proactive about your sexual health. Getting tested regularly is so important, and yet so underrated! So, way to go! 

Second, here are answers to your questions! 

1) Typically, it is recommended to wait 12+ weeks from the latest date of possible exposure. You waited 9 weeks, and the results were .90 (just at the end of the negative range) and .93 (just entering the equivocal range), if you waited another 3 or more weeks, your antibody rates could increase into the positive range. 

2) Because it's been only 9 weeks, I honestly cannot say that the result is most likely negative. 12 weeks is the minimum to wait for, so maybe waiting about 13 or 14 weeks would show a more accurate result. I'm not a doctor or healthcare professional, but there's no harm in waiting a few extra weeks after week 12 before getting a second test.

3) The Western Blot test is utilized by the University of Washington Virology Division. Read about the test, how it works, and more using this link: https://testguide.labmed.uw.edu/public/view/HSWB?tabs=no

The Western Blot has great sensitivity and specificity rates. I am unfamiliar with exactly how the testing works, but I did find a lot of scholarly research on the test. I am going to keep researching and provide you with some helpful and easy to interpret information. Also, I recommend calling the University of Washington's Medical site where they do the testing to find out more information and answers to your questions. They would have much better answers and they'd be able to provide guidance as well. Here are some contacts I found:

Herpes Resistance

Director: David Koelle, MD

(206) 616-1940

 

Virology Research Clinic (VRC)

Director: Anna Wald, MD, MPH

(206) 520-4340

I hope that this helps!! 

4) I personally have never received those results. However, if anyone o ln the forum has, I'm sure they will comment and or reach out to you ☺️

I hope the above answers your questions. If they didn't, I am so sorry! Feel free to ask more questions, we are her to help! Stay well.

Sending blessings your way 🌻☀️,

Grace

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Hello!

 

thank you for taking the time to reply to this post. I will admit, your response has me hopeful but anxious at the same time. I have been dealing with this since May and the wait is killing me. 
 

I plan on taking the western blot at 12 weeks. I hope that is enough time to yield a correct result. Do you think that is correct? 
 

In your experience, how often do you see equivocal as a “true” equivocal. As in: there is a protein that is similar to hsv reacting with the antibody in essence making this a negative result? 

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Hi!! 🙂 

I know, waiting is hard! I am so sorry you are anxious!!

The Western Blot is a very accurate test, from what I have read, so the 12 weeks marker should be an appropriate amount of time. However, I would still call the testing center and see if they could offer a more trustworthy answer!!

Your second questions is a great question, and I have often wondered the same thing! An IgG antibody test tests for specific antibodies that the body produces in response to the HSV, so I don't know if another virus or foreign agent would result in the production of the same antibodies that the test looks for in regards to the HSV.  Awesome question, and I wish I could offer an answer 😞!

I am going to tag @Ebelskiver, who has just joined the Community forum, and is a nurse practitioner who has so much experience helping patients with HSV! 🙂 Perhaps they would be able to provide some guidance for your questions!

Blessings! 🙂❤️ 

Grace 

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Hi!! 

Of course, we are all here to help one another!! 

Yes, information overload can be so overwhelming. If you can, avoid going down the google rabbit hole. It feeds stress, and half the time the resources aren't accurate or verified. I totally reccomend checking out the CDC, WHO, and other medical platforms for information ☺️.

Hang in there!!! I'm sending you positive energy!! 🌄

Blessings! 🌼

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Hi,

I may be able to help a bit with the questions surrounding your results. I would consider you potentially positive  for 1 and negative for 2 based on the results you shared. But also based on the fact that HSV1 is so common and is acquired in childhood for most people. There are sometimes false positives for 2 if you are positive for 1 when the numbers are below 3.5. This is because the antibodies are very similar and testing is not specific enough at lower numbers to differentiate. 
 

Antibodies also wax and wane over time. I’ve see equivocal results turn both negative and positive with repeat testing. I would retest at 12 weeks and if you are in the positive range at that point I would forego Western Blot and assume positivity with 1. I’ve also not seen definitively positive results turn negative.
 

I use Western Blot to confirm equivocal or “low-positive” 2 numbers in the presence of a positive 1 without confirmatory outbreaks. I do not confirm positive 1 results with Western blot in the absence of an outbreak because no blood test can tell you whether it is genital or oral and 1 is so common it is not cost effective for the patient to order an expensive test that they are 80% likely to have. 

I understand you are likely anxious and that there’s not much I can say to alleviate that but I hope you can relax and retest in a few weeks to get the answers you need. 
 

 

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What I understood from Terri Warren on a podcast, when she made a study of IGM-IGG test vs Western Blot:

- IGM:

  • It is worthless. It is not recommended.

- IGG for HSV-1 and HSV-2:

  • 12-16 weeks after exposure, an IGG test is higly reliable.
  • The antibody tests for HSV 2 have a sensitivity of about 92% (out of every 100 cases of herpes, the test will pick up 92 of them).
  • If a test is positive between 0.9 and 3.5, the chances of being a false positive are 50%.
  • The closer the index value of 1.1, the more likely to be a false positive.
  • She mentioned she had found a false positive as high as 5.07, but it was rare. Numbers above 3.5 are positive.
  • In these cases of low positive (0.9-3.5), she highly recommends a Western Blot. 

- In the case of HSV-1: 

  • The IGG test misses 30% of the positive cases; but for HSV-2, it is different, the false positives are most likely in these frame numbers (0.9 - 3.5).
  • However, all the people tested positive for HSV-1 in IGG was 100% positive in western blot.

Terri Warren is not against the IGG blood test; in fact, she doesn't agree with doctors that don't test their they patients with the excuse "there are a lot of false positives". Most false positives are more likely to happen within the range (1.1-3.5); and false negatives in people who get tested too fast and don't wait the window time (12-16 weeks).

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