Lab results all Negative!! Now what?

I had my IgG HSV2 test positive on April 21st this year. I just got retested for everything last Friday (September 12th). Everything came back negative including HIV (whew!).

They used something called HIV 1/O/2 Abs-Index Value for the HIV test. I looked it up on the testing lab's website, and it referred to Immunochemiluminometric assay (ICAM). I've read several sites where people comment this is accurate within 3 months. Still other sites say to get tested again in 6 months, but I don't know if that is only for certain HIV tests. My doctor says this is conclusive, and that I don't need to be tested again, but I don't know if I trust him sadly.

So the IgG HSV2 test also came back negative. I didn't even register a measurable level apparently. The nurse said that just meant it is dormant since I tested IgG HSV2 positive back in April when this all started. So my understanding is I have HSV2 (somewhere), but I have not had any conclusive outbreaks, so not sure where it is. Is she correct or should I get some other kind of test?

Thank you for your help as always friends!

Sounds like you need to do the Western Blot ... it looks at something like 14 proteins (instead of 1) associated with the Herpes antibodies. Call Nurse Terri Warren and see what she believes you need to do - she's one of the top Herpes specialists in the country and she can get you the script for the Western Blot (most Dr's can't/won't) if she feels you need it.

You can become a phone patient of Terri Warren's at the Westover Heights Clinic,http://westoverheights.com/ (503) 226-6678 ... she can order the test for you through Quest Labs.

Do you know what the numbers were that they used to determine that you were H+ in the earlier test???

Thank you Dancer. My number from the earlier test was:

HSV 2 Glycoprotein G Ab 2.78 IV H

I think the H was for "high" perhaps. IV stands for "Index Value". The range is listed as:

< 0.90 IV NEGATIVE

0.90-1.10 IV EQUIVOCAL

> 1.10 IV POSITIVE

This time around, my level was just reported as "<0.91 index". Also, the doctor switched labs they use; I know that shouldn't matter, but made me a little suspicious.

2.78 is within the range where false-positives occur about 40% of the time. The first positive test may have been due to cross-reactive antibodies, although it is incorrect as your nurse said that you have it and that "it's just not registering." When IGG antibodies rise to a detectable level, they stay very close to that level for the rest of your life. They do not simply vanish. Like Dancer says, the Western Blot will go a long way toward clearing this up. By now, if you have herpes, the Western Blot should be positive, and/or many of the necessary viral proteins should fall into place. If only one, or at most two, proteins are present, I believe you can be confident this is due to cross-reactivity, and not a sign of the formation of antibodies to HSV-2. Good luck.

Wow, 40%?!? Why didn't the nurses and doctors bother to tell me that? Or suggest a Western Blot since this last test was so different?

Yes - @riverstyx is right... I got this from a NYT article with Dr Peter Leone, one of the experts on Herpes (he's the one in Adrials support group video)

One of the most common brands of type-specific serology is the HerpesSelect brand. It is a very good test, but there are issues with false positive results with one form called the HerpesSelect ELISA. (Other forms are the HerpesSelect Immunoblot and the HerpesSelect Express.) That is, some people who have a positive test result for the virus are not actually infected.

The Herpes Select ELISA is reported back as an index value. A value greater than 1.1 is considered positive. If you have no history of genital herpes outbreaks, did not have a positive culture or PCR test for HSV, or have no risk factors for genital herpes, you should know the index value. False positives have been reported with values less than 3.5. If your value is less than 3.5, ask to be tested again with a different test, preferably with another antibody test called the Western blot.

And they don't suggest Western Blot because you can only get it through the University of Washington and/or the Westover Heights clinic I gave you info on. And BTW, just learned Nurse Warren charges $5/min for consults ... I'm guessing you will need 15 min to give her your info, and she will tell you if she thinks you should do the WB or not. Whatever SHE says, I'd take it as being as close to the "truth" as any person can give you with the present knowledge of Herpes as we know it.

I tested positive with herpesselect igg for hsv2 with 2.43 on 7/15. I got the WB thru Terri's clinic (westover height clinic) and went to quest lab to get the blood test (the lab fedex the blood to UW overnight) on 8/25. I got my results over a week ago and I am hsv2 neg!!!!

Please do look into this and confirm your status. Good luck and God bless, S

This past Monday, 10/20, I had the blood drawn for the HSV2 Western Blot test and sent to the Westover Heights clinic. The doctor I spoke with at Westover said it could take up to three weeks to get the results back, but she said she would call me and let me know. So I'm hopeful this will confirm I don't have it, but I'm trying to look on the bright side either way. Thank you all for your guidance and kindness. I will let you know what happens and hopefully I'll have some very good news for you soon!

@myfiercecalm

I agree with all of the other comments on here.

Unfortunately, the original nurse you spoke to was profoundly uneducated. I am studying to be a geneticist, and I took many, many courses on disease pathology, so I do know a few things about disease. Certain diseases can and do go into remission. While this is theoretically possible for any disease, it would be an extremely rare event for something like HSV-2. Also, from a medical standpoint it is completely unclear what "remission" would amount to here. Does it mean the virus has completely left the body? To date, I have not heard of that in the medical literature. Does it mean it is still present within the body, although now dormant? That of course is what commonly happens, but antibodies basically always form as the body's way of "fighting" the infection. This is an automatic immune response. Indeed, if no antibodies were present at any time, and the infection was still present, then you would be experiencing quite frequent and severe outbreaks. Yet that is not the case here.

To put it simply and crudely, HSV in either of its manifestations does not simply "go away." By far the most likely scenario is that your first test was a false-positive, and that your second test more accurately registered no antibody response because you have no antibodies. Moreover, you have no antibodies because you likely do not have HSV-2.

I believe the odds that the Western Blot will come back negative are firmly in your favor.

Agree. Impossible

Thank you both for your input. I feel more encouraged now :) I have not heard an update yet, but I will let you know when I do.

Looking forward to hearing from you. I am having a similar issue with hsv1. Have a negative blood test as of last week and a positive one 2 months ago but they are from different test methods to add confusion. I need to do a western blot. Waiting Til I see my infectious disease specialist though.

I got the negative Western Blot for HSV1 and HSV2 call on Halloween. I'm sorry I didn't update everyone sooner. I've been under the weather the past few days. While I was very relieved, I had come to a point where I really didn't think I had H. I'm glad I got the test done all the same. The doctor I spoke with was very nice by the way (at $5 a minute, they should be). It was totally worth it, and I cannot encourage you enough to get a Western Blot test performed if you have not actually experienced an outbreak. I would also argue you should get one anyway since we can mistake other things for H outbreaks. Anyway, I am truly blessed and have learned so much about myself and H of course in the past 6 months. Thank you all again for your support during this trying time.

@WCSDancer2010 can we put this thread under a Important Info section if there isn't this info already? I realize I'm in the minority of people who get a false positive, but it would have helped me early on if I knew there was a real chance I had a false positive. None of the medical "professionals" I dealt with knew about it. Everyone said I had H and I would always have it regardless of future tests. Damn it feels good to know they were wrong!

Well, I can't do that but I will suggest to Adrial that it goes under the FAQ section... and I will refer/link to it as well in the future. You are about the 3rd or 4th that we have had on here this year that came back negative with WB after a "positive" Elissa test.

You may want to go back to the Dr's who were clueless and tell them that they need to get up to date with their info and give them the U of Washington and Westover Heights contacts so that they can get better informed :p

Thanks for the update... :)