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Ghsv1 antibodies fluctuate Positive to Negative back and forth frequently

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I am a F. 25 and was diagnosed with HSV1 genital in Oct 2014 via swab test. I get tested twice a year and since then I have gotten positive and negative HSV1 antibodies test results. My most recent results of May this year was positive for HSV1 with a viral load of 1.92 and my test this August HSV1 came out negative (<.091) Does this happen to anyone else out of curiosity? If so would you happen to know why? My doctors are kind of clueless of to why my results fluctuate this way? Attached are the specific tests, the 2 negative results attachments are from August and the 1 positive results are from May.


Thank you in advance.

May 1.png

Aug 2.png

Aug 1.png

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On 10/6/2018 at 11:19 AM, acd820 said:

yeah, that pretty much what happened. I don't know why my blood work keeps going back and forth. would you happen to have any insight?

I'm going through the same thing. every swab I get is negative... 

bloodwork was positive 51.80 

then weeks later it's was 34.40

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The IgG test for HSV-1 is known to do this, it's not as reliable for catching HSV-1(even when it's established) as it is for catching HSV-2.  IgG tests miss 30% of HSV-1, and it's a flaw that I can't find a good explanation for, it's just known that this happens. This is a part of the reason why testing for antibodies in the absences of symptoms isn't advised, the tests present these issues for us and create confusion. The CDC's web page simply says: "The HerpeSelect HSV-1 Elisa is insensitive for detection of HSV-1 antibody," but if your doctors are feeling confused about this result, it might be worthwhile to print out the CDC's page to show them that (I did that to show my doctor why I was still concerned about my status despite a negative test result after previous low positive results--most doctors are not experts about herpes despite being fabulous doctors in all other ways!) Here is the link to the page I referenced: https://www.cdc.gov/std/tg2015/herpes.htm and there are other sources out there, too.

A positive swab is definitive, although a negative swab is not. A positive swab confirms that a certain sore was caused by HSV. A negative swab means only that no virus was caught on the swab; either it wasn't a herpes sore OR no virus was present in the sore at the time of the swab (because the sore had begun to heal) OR the swab wasn't collected or handled properly. In cases like this, where swab testing was "negative" it really just means it was "inconclusive," follow-up tests are then used to try to determine if antibodies develop. Then, of course, you have to start dealing with the chance that the blood test will miss it. But when the IgG test DOES show a high number (anything over 3.5, I think) it's reliable.

So, acd820, your positive swab diagnosis is something you can trust, despite the antibody tests not adding any information, and the good news about that is that you know *where* you have acquired it--wherever you got the swab indicates the location. That's good to know. I know I have HSV-1 by taking a Western Blot test because IgG testing was back and forth, like you describe, and I am assuming it is genital due to having a few things that seemed like outbreaks, but they haven't been swabbed for confirmation.

Loyalloulou, your IgG results indicate an established infection, but can't tell you where you have it, only that you have the antibodies, so you have the virus. Your swabs *might* be coming up negative simply because they are in the healing mode by the time you are able to collect the swab sample, or maybe because the clinician taking the sample failed to do it thoroughly enough, or maybe something else went wrong with the test. But basically, a negative swab doesn't mean it's not herpes, just that the sample taken didn't catch anything testable. Or perhaps the areas you are swabbing aren't related to HSV-1, but you had coldsores as a child and so your IgG tests are showing that.

Hope this helps!

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