Blood test for herpes 1/2

[Mandala76]

I had a horrid sexual experience in 2017 and have refrained from any sexual encounters siince as fear I have herpes now both genitally and orally after a range of strange symptoms and pain in both areas. I took a blood test In 2019 and was found to be negative for hsv2 and 1

Forward to this year I did another test for both ang got negative again for hsv 2 but the hsv result had jumped from a 0.5 to 1.05 which is equivocol. I’m now so scared that I have it

Has anyone has similar experiences with igg blood tests ?

[Galen70]

Equivocal does not mean positive. I am unsure why you are focussed on herpes simplex , your tests previously were negative, so you dont have herpes simplex. It sounds like you need specialist counselling around your previous experience.

[Mandala76 in reply to Galen70]

Yes but don’t blood tests in the uk miss 30 percent of hsv 1infections??? Currrntly saving for western blot and yes I have requested counselling

X

[Galen70 in reply to Mandala76]

Great that you have requested counselling for this area of concern for you.

Up to 50% of adults in the UK will have HSV 1 antibodies by the age of 50. This does not mean however that it explains your symptoms, or that you acquired it sexually.

I refer you to the BASHH guidelines, which although technical , explain why blood tests are not usually done in a sexual health clinic setting for HSV.

Testing for HSV type-specific antibodies can be used to diagnose HSV infection. The detection of HSV-1 IgG or HSV-2 IgG or both in a single serum sample represents HSV infection with HSV at some time. It is difficult to say whether the infection is recent as IgM detection is unreliable and avidity studies are not commonly available. Collection of serum samples a few weeks apart can be used to show seroconversion and, hence, recent primary infection. HSV-2 antibodies are indicative of genital herpes. HSV-1 antibodies do not differentiate between genital and oropharyngeal infection. Many commercial tests for HSV antibodies are not type-specific and are of no value in the management of genital herpes. Urine tests are inappropriate for the diagnosis of herpes. Assays should be used that detect antibodies against the antigenically unique components of glycoproteins gG1 and gG2 (III, B).

Western blot is the diagnostic gold-standard, but it is not commercially available. Several commercial assays, as well as validated in-house methods, are available which show 91–99% sensitivity and 92–98% specificity relative to Western blot in sexually active adults. For some widely available commercial assays sensitivity is very different for HSV-2 and HSV-1, and test performance may be markedly different for samples from some ethnic groups.

Caution is needed in interpreting serology results because even highly sensitive and specific assays have poor predictive values in low prevalence populations (Table 1). Local epidemiological data and patient demographic characteristics should guide testing and result interpretation