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Suggest A Confirmation Test To Get Accurate Result Of STD
Question: Hi Doctor,
I recently took "comprehensive" STD test through tSTD.org, which uses QUEST Labs Diagonistics for their blood testing. My test included Herpes Simplex Virus 1 and 2 and chlamydia. My Chlamydia test came back positive, and my HSV 2 test came back "positive" at "2.02 H" on the index. The "normal" or "negative" range is anything below 0.9 according to the lab results sheet. I have read numerous articles and research papers on the Internet indicating that a score of under 3.5 is not conclusive, and that in many cases anything under a 3 may be a false negative. I went ahead and proceeded with having another Herpes I and II test performed a week later, and I am still awaiting those results. What is your opinion on my results? I have never had any symptoms of Herpes II, as I have never had irritation at all in my genitalia. I have also learned that the CDC does not even recommend Herpes II testing unless you show symptoms, as apparently the test has not been proven to be that accurate. Do you know the current state of Herpes II testing and what I should do under these circumstances?
I recently took "comprehensive" STD test through tSTD.org, which uses QUEST Labs Diagonistics for their blood testing. My test included Herpes Simplex Virus 1 and 2 and chlamydia. My Chlamydia test came back positive, and my HSV 2 test came back "positive" at "2.02 H" on the index. The "normal" or "negative" range is anything below 0.9 according to the lab results sheet. I have read numerous articles and research papers on the Internet indicating that a score of under 3.5 is not conclusive, and that in many cases anything under a 3 may be a false negative. I went ahead and proceeded with having another Herpes I and II test performed a week later, and I am still awaiting those results. What is your opinion on my results? I have never had any symptoms of Herpes II, as I have never had irritation at all in my genitalia. I have also learned that the CDC does not even recommend Herpes II testing unless you show symptoms, as apparently the test has not been proven to be that accurate. Do you know the current state of Herpes II testing and what I should do under these circumstances?
Brief Answer:
Can go for western blot for confirmation
Detailed Answer:
Hi
Thank you for query.I am Dr Bharatesh D Basti answering your query.
Yes you are correct that CDC does not recommend hsv2 testing if asymptomatic. They will subject people to unnecessary anxiety.Moreover usually it does not lead to severe complications .
There are two antibodies IGM and IGG.
IgM tests are not reliable.
IgG tests have sensitivity and specificity well above 90%.The titre value above 1 is considered positive.
Hope the test values given is for IGG.
People with Titre above 3.5 are considered more infectious.
There is 5-10% chances of false positive by this test.
Repeating test also helps you to rule out positivity due to technical errors .
So you can go for confirmatory test like Western blot.
In asymptomatic individuals Hsv2 positivity does not always indicate anogenital infection.It can occur even around oral cavity.
Hsv1&2 ,both can occur in both areas( genital and oral).
So wait for repeat test results. You can go for western blot for confirmation.
You can get back for any clarification.
Thank you
Dr Bharatesh D Basti
Dermatologist and venereologist
Can go for western blot for confirmation
Detailed Answer:
Hi
Thank you for query.I am Dr Bharatesh D Basti answering your query.
Yes you are correct that CDC does not recommend hsv2 testing if asymptomatic. They will subject people to unnecessary anxiety.Moreover usually it does not lead to severe complications .
There are two antibodies IGM and IGG.
IgM tests are not reliable.
IgG tests have sensitivity and specificity well above 90%.The titre value above 1 is considered positive.
Hope the test values given is for IGG.
People with Titre above 3.5 are considered more infectious.
There is 5-10% chances of false positive by this test.
Repeating test also helps you to rule out positivity due to technical errors .
So you can go for confirmatory test like Western blot.
In asymptomatic individuals Hsv2 positivity does not always indicate anogenital infection.It can occur even around oral cavity.
Hsv1&2 ,both can occur in both areas( genital and oral).
So wait for repeat test results. You can go for western blot for confirmation.
You can get back for any clarification.
Thank you
Dr Bharatesh D Basti
Dermatologist and venereologist
Above answer was peer-reviewed by :
Dr. Raju A.T
Dr. XXXXXXX Basti,
I have done a lot of research and it appears test results below 3.5 are very unreliable (up to 50% false positives). Can you confirm this or have you heard of this? My understanding is that the Western Blot is the most accurate test, and that in up to 68% of 3.5 or below positive results the Western Blot proves the test to be a false positive. I would like as much input as you can offer, as I am obviously having a great deal of anxiety at this moment.
Thanks,
XXXX
I have done a lot of research and it appears test results below 3.5 are very unreliable (up to 50% false positives). Can you confirm this or have you heard of this? My understanding is that the Western Blot is the most accurate test, and that in up to 68% of 3.5 or below positive results the Western Blot proves the test to be a false positive. I would like as much input as you can offer, as I am obviously having a great deal of anxiety at this moment.
Thanks,
XXXX
Brief Answer:
Go for Western blot test for confirmation.
Detailed Answer:
Hi
Thank you for follow up query.
As I have earlier mentioned the false positivity rate is between 5 to 10%.
It is found that nearly 6% tested in US is known to have titre values between 1 to 3.5. Of them 50% may have false positivity I.e 3%.
So all in the range need not be considered negative too.
Another fact is there can be cross reactivity (to HSV1 ir other viruses) giving false positives too.
These are screening tests .
So repeat test would give some more light to the results.
Better would be to go for western blot which is a confirmatory test to relive your anxiety.
Western blot is a specific test with > 99%.
You can get back for any clarification
Thank you
Dr Bharatesh D Basti
Go for Western blot test for confirmation.
Detailed Answer:
Hi
Thank you for follow up query.
As I have earlier mentioned the false positivity rate is between 5 to 10%.
It is found that nearly 6% tested in US is known to have titre values between 1 to 3.5. Of them 50% may have false positivity I.e 3%.
So all in the range need not be considered negative too.
Another fact is there can be cross reactivity (to HSV1 ir other viruses) giving false positives too.
These are screening tests .
So repeat test would give some more light to the results.
Better would be to go for western blot which is a confirmatory test to relive your anxiety.
Western blot is a specific test with > 99%.
You can get back for any clarification
Thank you
Dr Bharatesh D Basti
Note: Consult a Sexual Diseases Specialist online for further follow up- Click here.
Above answer was peer-reviewed by :
Dr. Shanthi.E
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