Sexually Transmitted Diseases Community

we no longer recommend herpes igm testing to be done. it's inaccurate.

your hsv1 is negative.

your hsv2 is evidently positive but since there is no numeric values, we recommend additional confirmatory testing to confirm that it's not a false positive. We recommend the herpes WB as the testing to be done if you are in the US.

if you have a history of cold sores, then you know you have hsv1 even though your hsv1 is returning negative. even the best blood tests still miss 1 out of every 10 hsv1 infections

grace

Thank you for getting back to me. I am going to be calling my doctors again on Monday and ask why nobody has ever seen an index value. I want to know what my index value is.That is important isn't it? I haven't had a cold sore since I was about10 years old. I am now 32. I know I can get one at any time but I just wonder if that's why the HSV1 came back negative. Do you think that could be why it came back negative? I don't know if my doctors can get the index value of the results but I would assume they can if they look into it. From what I read on the CDC website under the Herpes Testing Information for Healthcare Providers there should be a numerical index level on my results and I don't have any. It also said:HSV IgG antibody tests. Serology testing for both HSV 1 and 2, or for HSV 2 only, is
acceptable. Don't order a combined HSV 1/2 test (i.e. a test that does not look for HSV1 and HSV 2 separately), and IgM tests' usefulness is very controversial. None of the FDA-cleared IgM tests are type-specific, so HSV IgM testing can give false positive results and is often not appropriate for diagnosing herpes. Why? There is crossreactivity
between HSV 1 and HSV 2 (you could tell someone with cold sores that they have genital herpes — in fact, new genital herpes!). In addition, there may be crossreaction with other viruses; and finally, people with well-established herpes can periodically generate IgM antibodies so you can't reliably sort out new from old infection with HSV IgM. Basing a diagnosis of genital herpes on IgM results alone can mean a wrong — and very distressing - diagnosis for your patients. Then what I read goes on to say this:


When you get the test results back, you'll see a numeric value called an index value, along with an interpretation of positive or negative. By package insert, any index value greater than 1.1 in considered positive. However, recent research has shown it not to be quite that simple. The sensitivity of the type specific IgG tests for HSV 2 in an STD
clinic population is about 98% and for HSV 1, 91% (it misses about one out of 10). The specificity of the HSV 2 test is about 97%. Basically, that means there could be 3 false positives out of 100 positive tests. Studies indicate that most of the false positives occur with index values between 1.1 and 3.5 (low positives); it rarely happens with index
values over 3.5. For those with low positive results, it is recommended to confirm testing by a second kind of test, perhaps herpes Western blot from the University of Washington.


if you recall my lab was tested for that HSV IgG/IgM and the results had a HSV1/2 AB so do you think that could have an effect on why the HSV1 didn't show up and maybe it really isn't HSV2? I'm sorry to ask so many questions but you and others on here seem to know more than my doctors at this point and I hate to say that because I really like my doctor but this has really devastated me. Thank you in advance to you and anyone else that may have a answer.

it depends on the test they use as to if you get a numeric result or not. some don't have numeric results. I don't think you had a herpes WB done so probably an immunoblot - since there are false positive issues with the tests, confirming your status with a 2nd test is the best course of action at this point since you've had no lesions to culture. the WB is also more likely to pick up on your hsv1 infection too though it still misses hsv1 1 out of every 10 times too.

Thank you kindly for all of your knowledgeable information. I truly appreciate it.

If you are in Canada then it is quite common not to get a value with your blood tests. You need to have your Doc call the lab and specifically ask them to provide the values.