Equivocal, Negative, now Low Positive

[chazf]

Hello. I was hoping someone could help me understand my current situation. 

I was tested for HSV2 IGG on September 12th and recieved an equivocal score (0.95). I did an HSV2 confirmation test through Quest a week later and recieved a Negative <0.90 result. I believe this was called an inhibition test and the comments stated that the second part of the test was not conducted since the first part came back negative. 

Fast forward to two months later and my HSV2 came up positive on routine IGG test 1.15. I got another test from a different lab two days later and it says 1.19 positive. Am I to assume that I have the virus and the first confirmation was done too soon? I haven't been sexualy active since August. 

I have not had any symptoms and I did recieve a negative IGG in routine bloodwork in August before this all started. I'm wondering if I was exposed in August and got it at that time?

[mr_hopp]

Hi there @chazf,

Trying to make sense of your recent herpes simplex virus 2 (HSV-2) test results can understandably be a bit confusing. Let me see if I can help clarify things for you.

Initially, your HSV-2 IgG test gave an equivocal result of 0.95, which falls in a gray area; it’s not clearly positive or negative. The follow-up test you mentioned, likely a herpes inhibition assay, returned a negative result (<0.90). This type of test is quite specific and is often used to confirm equivocal or low positive IgG results. If the first part of the test is negative, the second part usually isn’t necessary.

However, your more recent tests from two different labs showed slightly positive results (1.15 and 1.19). These numbers are just above the threshold for a positive result, but they are still quite low. It’s important to note that IgG tests measure antibodies, which the body develops in response to the virus. These antibodies can take some time to reach detectable levels (up to 12 weeks in some cases), which might explain the initial negative or equivocal results followed by a low positive.

Given that you haven’t been sexually active since August and had a negative test around that time, it’s possible that you were exposed to the virus in August, and your body has since developed detectable levels of antibodies. However, without symptoms, it can be hard to determine the exact timing of infection.

Remember, a low positive result can sometimes be a false positive, especially with values just over the threshold. The CDC recommends confirmatory testing for low positive results. Given your recent results and the absence of symptoms, it might be worth discussing with your healthcare provider whether a confirmatory test like the Western Blot, which is considered the gold standard for herpes testing, would be appropriate in your case.

It’s also worth noting that many people with HSV-2 don’t experience symptoms (and about 20% never have symptoms), or they have very mild symptoms that go unnoticed. The absence of symptoms doesn’t necessarily mean the virus isn’t present.

I hope this was helpful to you! Keep us updated on what you find out, okay?

[chazf]

Thank you so much! I'm awaiting another confirmatory test. I will let you know the results. 

[chazf]

Hi everyone. I just wanted to provide an update. I got another confirmatory test done through the quest inhibition test and it came back normal. I guess I'm a little confused? I am pretty proactive about getting STD testing every 3 months and over the course of 4-5 years, I have never had a positive herpes igg score until recently. It's been 3 months since my last sexual encounter and the confirmation test is normal. Any thoughts as to why my igg results have been elevated in recent standard tests? Again, I have no symptoms. 

[chazf]

[mr_hopp]

Hey @chazf,

Thanks for the update! The Quest test coming back normal is a good sign. It might just be that the standard tests picked up something else that looked like HSV to the test. This happens sometimes, especially with those low positive numbers. Since you're not having any symptoms and you're testing regularly, these recent blips might just be a testing hiccup. It's been three months, so your body's response should be stable by now. I'd say keep chatting with your doc about it. They're the best bet for sorting out why those numbers are bouncing around.

Keep us in the loop, and take care!