Conflicting Herpes Test Results: Seeking Guidance from Dr. Hsu

Dr. Hsu, thank you for your assistance?

Hello Dr.
Hsu, I have been tested for HIV, herpes, and syphilis.
The results for HIV and syphilis are confirmed negative, but I have tested for herpes six times with conflicting results: three reports indicate positive results from one lab, while another clinic and another lab report negative results.
The report from Kaohsiung Medical University also states negative (I am unsure if both IgM and IgG were tested).
In total, there are three reports indicating positive results and three indicating negative results.
Recently, I tested again, and one lab reported positive while another reported negative.
Now I have four reports saying positive and four saying negative.
I am at a loss about what to do.
Although the doctors I have consulted all say my clinical symptoms do not resemble herpes, should I rely on the doctors' opinions or the test results? (Note: I have only been tested for type 2 herpes.) Dr.
Hsu, I would appreciate your advice.
Thank you for taking the time to answer my question.

qq, 50~59 year old female. Ask Date: 2012/02/19

Dr. Xu Weikai reply Urology

Hello, it is possible that your test results are right on the edge, close to the limits of normal values.
For example, if the normal range is between 1.3 and 5.6, but your result is 5.59 or slightly higher, the clinical interpretation may classify it as normal or abnormal depending on the sensitivity or accuracy of the testing facility.
It is recommended to seek a laboratory that has international accreditation, such as ISO 17025.

Reply Date: 2012/02/19

More Info

Conflicting herpes test results can be quite confusing and distressing, especially when multiple tests yield different outcomes. It is essential to understand the nature of herpes testing, the types of tests available, and the implications of the results.

Herpes Simplex Virus (HSV) testing typically involves two types of antibodies: IgM and IgG. IgM antibodies indicate a recent infection, while IgG antibodies suggest a past infection. The presence of IgG antibodies can help determine if you have been exposed to the virus at some point in your life, but it does not indicate whether you currently have an active infection. The two types of herpes viruses, HSV-1 and HSV-2, can be tested separately, and it is crucial to know which type you are being tested for, as they can affect the results and interpretation.

Given that you have received conflicting results from multiple testing facilities, it is important to consider a few factors:
1. Testing Methodology: Different laboratories may use different testing methods, which can lead to variations in results. Some tests are more sensitive and specific than others. For example, type-specific serological tests for HSV-1 and HSV-2 are generally more reliable than non-type-specific tests.

2. Timing of the Test: If you were tested shortly after potential exposure, it is possible that the antibodies had not yet developed, leading to false-negative results. It typically takes several weeks for antibodies to become detectable after infection.

3. Clinical Symptoms: You mentioned that the physicians you consulted indicated that your clinical symptoms do not align with herpes. This is an important consideration. Clinical evaluation, including a thorough history and physical examination, is crucial in diagnosing herpes. If you do not exhibit typical symptoms, this may suggest that the positive test results could be false positives.

4. Consultation with a Specialist: Given the complexity of your situation, it may be beneficial to consult with a specialist in infectious diseases or a dermatologist who has experience with herpes infections. They can provide a more comprehensive evaluation and may recommend additional testing or a different approach to interpreting your results.

5. Follow-Up Testing: If the conflicting results persist, consider discussing the possibility of retesting with a more reliable laboratory or using a different testing method. Some healthcare providers may recommend a viral culture or PCR test, which can directly detect the virus rather than relying on antibody presence.

In conclusion, while laboratory results are important, they should be interpreted in the context of your clinical symptoms and history. It is advisable to follow the guidance of healthcare professionals who have assessed your condition rather than relying solely on laboratory reports. If you continue to have concerns, seeking a second opinion or further evaluation may provide clarity and peace of mind. Remember, managing health concerns is a collaborative process between you and your healthcare providers, and open communication is key to achieving the best outcomes.

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