Medical

Have medical questions? Ask a doctor online!

Ask a Doctor,
Get an Answer ASAP!

I was recently given the following test results and when I…

Customer Question
I was recently given the...
I was recently given the following test results and when I talked to my doctor she said that there is nothing to worry about since I have never had an outbreak or any signs and that the only thing I have ever had is a cold sore. I was told that I could not pass it on to my partner and that my life does not change.
Please let me know if this information is correct or if there is any further testing I can do?
Report-HSV TYPE 2 AB, IGG
Result-Positive
Ref. Range-NEGATIVE
Units
ABNORMAL
Status Final
Lab
HSV TYPE 2 AB, IGG Positive NEGATIVE Abnormal Final MDF
MDF
med fusion
2501 South State Highway 121,Suite 1100
Lewisville TX 75067 (###) ###-####
Benton R Middleman, MD
Submitted: 2 years ago.Category: Medical
Show More
Show Less
Ask Your Own Medical Question
Answered in 6 minutes by:
3/4/2016
Doctor: Dr. D. Love, Doctor replied 2 years ago
Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 19,548
Experience: Family Physician for 10 years; Hospital Medical Director for 10 years.
Verified

Since you did not include any numeric value index as part of the report, I assume that it was not present, correct?

Have you had the oral cold sores since childhood?

Was an HSV type 1 IgG level also checked?

Ask Your Own Medical Question
Customer reply replied 2 years ago
No, HSV-1 was not tested. You are correct the index levels were not indicated. I have had maybe one or two cold sores in my life.My doctor is acting like this is no big deal.
Customer reply replied 2 years ago
What does Ref Range negative mean?
Doctor: Dr. D. Love, Doctor replied 2 years ago

This is a complex issue, so it will take some time to type an answer. Please be patient and I will post the discussion shortly.

Ask Your Own Medical Question
Customer reply replied 2 years ago
Okay, I will wait for your reply. I guess this is why they say blood tests should not be done for this. Should only do if there are symptoms.
Doctor: Dr. D. Love, Doctor replied 2 years ago

This is complex because there are several issues to consider in this situation.

There are several issues to discuss with herpes blood tests and I do not completely agree with the statements by your doctor, so will quote studies in the literature where I disagree, because you obviously do not know me.

First, is that there is a chance that the test is wrong, i.e., a false positive. When measuring antibodies, they actually generate a numeric number reflecting the activity of the antibodies. In anyone, there is some background cross-reactivity with the antibody, so they will compare the individuals numeric value to the maximum possible background value and calculate an index. An index of 1.0 means that the individual is at the maximal background level. An index that is <0.9 is considered negative, while an index >1.1 is considered positive, and an index between 0.9 and 1.1 is considered inconclusive. However, even with a positive result, it is possible that the result is a false positive. The test is very sensitive, so can generate a fair amount of false positives, and the likelihood of false positives is greater if the result is only mildly positive. For example, in this study, if you look at Figure 1, only 15% of people with an index between 1.1 and 1.5 are truly positive when a more accurate test is done. It is only with an index that is >3.5 that there is a >90% likelihood that it is a true positive. In someone having typical symptoms, there is less reason to think that there could be a false positive, but in someone with no symptoms, the first step when there is a positive HSV2 IgG test is a review of the index and consideration whether a second more accurate test should be done, such as a Western Blot test.

If there is confirmation that you are truly positive, then the meaning of the positive result is the next issue.

Herpes Simplex Virus type 2, or HSV2, will usually cause genital herpes, while HSV1 will usually cause oral herpes. However, there is some crossover, with HSV2 causing oral herpes or HSV1 causing genital herpes. A blood test cannot determine the site of infection. The antibodies that are formed from the common HSV2 genital infection are identical to the antibodies that are formed from the uncommon HSV2 oral infection. If the oral cold sores first started as a child, it is even more likely that it is HSV1, but if the cold sores developed in adulthood, then while still uncommon, there is a slightly greater chance that it is HSV2 that caused the oral cold sores. The vast majority that have a true positive HSV2 IgG test have a genital infection, but if there are no symptoms, it cannot be definitely stated from a blood test. If there is a positive HSV1 IgG, then that would support that the oral cold sores were from HSV1, while if there is a negative HSV1 IgG, then that would raise the likelihood that your oral cold sores were caused by HSV2. However, the only way to prove whether someone is having oral HSV2 or genital HSV1 is to perform a culture of a sore from the respective area. This is frequently impractical, so doctors will frequently assume that a positive HSV2 IgG indicates a prior genital infection, and they will be correct the vast majority of the time, but there will be exceptions.

The next issue is whether someone with a true positive blood test has any viral shedding. In the typical genital herpes infection, there are occasional sores and large amounts of viral shedding when there are sores. In between the episodes of sores, there is usually no viral shedding, but there are some days of shedding of the virus on days when there are no sores, called asymptomatic shedding. In someone with no symptoms and a positive blood test, the question becomes whether there is any shedding of the virus. There is a common misconception that someone with no symptoms is not infectious, but a study from a few years ago showed that people with no history of infection in whom there was a positive test frequently had viral shedding when genital swabs were tested for the virus - see Figure 1 in http://jama.jamanetwork.com/article.aspx?articleid=896698. Even in the worst case, there is no shedding on most days, as is also true in someone with a symptomatic infection, but shedding could be detected. There were also many patients in whom shedding was not detected, but since the study was only for a limited period of time, it is not sufficient to prove that these people never have shedding. So, from this study, it can be said that some people with no symptoms and a positive blood test can have asymptomatic shedding, although there are also some that may not.

It is also worth noting, as I tell everyone that gets infected with genital herpes, that the greatest impact of a genital herpes infection is the psychologic and social impact of the infection, since it cannot be cured. The physical consequences of this infection is minor, in the same way that the physical consequences of an oral herpes infection is minor. But the psychologic and social impact is much greater.

So, there is a chance that you are not truly positive, and the index should be requested from the lab. But if you are truly positive, there is a chance that you are having asymptomatic shedding, so it cannot be said that you cannot pas it to your partner.

If I can provide any clarification, please let me know.

Ask Your Own Medical Question
Doctor: Dr. D. Love, Doctor replied 2 years ago

I realize that this is a long answer and the issue is complicated. If it would help to have a phone conversation at an additional cost, then let me know and I can send an offer for additional services.

Ask Your Own Medical Question
Was this answer helpful?
Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 19,548
19,548 Satisfied Customers
Experience: Family Physician for 10 years; Hospital Medical Director for 10 years.

Dr. D. Love is online now

A new question is answered every 9 seconds

How JustAnswer works:

  • Ask an ExpertExperts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional AnswerVia email, text message, or notification as you wait on our site. Ask follow up questions if you need to.
  • 100% Satisfaction GuaranteeRate the answer you receive.

JustAnswer in the News:

Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.

What Customers are Saying:

I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me from a serious, even life threatening situation. I am very grateful to the experts who answered me.

Susan O.USA

I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much

Corrie MollPretoria, South Africa

I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well!

ClaudiaAlbuquerque, NM

Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion.

KevinBeaverton, OR

Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
I feel better already! Thank you.

ElanorTracy, CA

Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem.

JulieLockesburg, AR

You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions.

John and StefanieTucson, AZ

< Previous | Next >

Meet the Experts:

Family Physician

Family Physician

Doctor

2,592 satisfied customers

Emergency Medicine and Family Practice for over 26 years

Dr. Ketch

Dr. Ketch

Board Certified Physician

76 satisfied customers

Medical Degree, Former Assistant Professor at School of Medicine at Yale University

DrRussMD

DrRussMD

Board Certified Physician

51,786 satisfied customers

Internal Medicine--practice all of internal medicine, all ages, family, health, prevention, complementary medicine, etc.

Dr. David

Dr. David

Board Certified Physician

224 satisfied customers

Treat children/young adults, former chief resident, multiple publications

Dr. D. Love

Dr. D. Love

Doctor

19,548 satisfied customers

Family Physician for 10 years; Hospital Medical Director for 10 years.

Dr Chip (M.D.)

Dr Chip (M.D.)

Doctor

15,787 satisfied customers

20 yrs. in practice, including surgery, general medicine, addiction medicine and pain.

Dr. Arun Phophalia

Dr. Arun Phophalia

Doctor

13,764 satisfied customers

MBBS MS. Post doctoral fellowship in Sports Medicine. General surgeon and sports medicine specialist

< Previous | Next >

Related Medical Questions
I had a western blot test run March 5 and may 17 exposure
I had a western blot test run March 5 and may 17 exposure was sometime in February I believe. Both negative. When should I get another test run to be accurate?… read more
Dr. Muneeb Ali
Dr. Muneeb Ali
Senior Registrar Critical Care Medicine
Doctoral Degree
8,217 satisfied customers
With hpv is it necessary to continuesly produce antibodies
With hpv is it necessary to continuesly produce antibodies to avoid infection reoccurrence?… read more
Dr. D. Love
Dr. D. Love
Doctor
19,548 satisfied customers
Do you have any information about srp positive antibody?
do you have any information about srp positive antibody? … read more
Dr. Greg
Dr. Greg
Residency
254 satisfied customers
My wife had hs1 viral encephalitis. After 5 weeks in the
Second opinion] My wife had hs1 viral encephalitis. After 5 weeks in the hospital she was recovering slowly but surely. She has suffered a relapse. She no longer eats or talks or responds in any way. … read more
Dr. Phil, MD
Dr. Phil, MD
Internal Medicine Physician
Doctoral Degree
2,773 satisfied customers
I recently had a positive antibody to P/Q voltage calcium
I recently had a positive antibody to P/Q voltage calcium channel ab. Or VGCC .Even while on immune suppression drugs. . It's associated with Lambert Eaton syndrome . My question is: can you have posi… read more
Dr. Phil, MD
Dr. Phil, MD
Internal Medicine Physician
Doctoral Degree
2,773 satisfied customers
Smooth muscle antibody lgG titer is positive. what is the
smooth muscle antibody lgG titer is positive. what is the next step … read more
Dr. Jon
Dr. Jon
Attending Physician
MD
145 satisfied customers
How can one tell if their bronchitis is viral vs. bacterial?
How can one tell if their bronchitis is viral vs. bacterial? Also, is it common for the center of the chest to hurt with bronchitist?… read more
Dr Uzair
Dr Uzair
FCPS (R) General Surgery
M.B.,B.S. FCPS
3,806 satisfied customers
My western blot showed all absent except IgG P41 Ab. present
My western blot showed all absent except IgG P41 Ab. present Abnormal what does this mean. … read more
Sumanth Amperayani
Sumanth Amperayani
Consultant Paediatrician
Master\u0027s Degree
769 satisfied customers
What is hepatitis surface antibody. My doctor is sending me
My doctor is sending me to get my blood test for the following: hepatitis B surface antibody, hepatitis a antibody, ana with reflex to titer, hepatitis c antibody, Iron TIBC AND %sat … read more
Richard Han
Richard Han
Pediatrician
Post-Doctoral Degree
1,058 satisfied customers
I am recovering from viral bronchitis and due to fly to
I am recovering from viral bronchitis and due to fly to India on Friday - no fever- cough is productive and it is clear- should I be fine? … read more
Dr SS
Dr SS
Doctoral Degree
12,327 satisfied customers
A patient has had high EBV acute infection antibodies on 3
A patient has had high EBV acute infection antibodies on 3 consecutive LabCorp tests, spaced about 6 months apart. Main symptoms are disabling physical and mental fatigue.Is it possible that the patie… read more
Sumanth Amperayani
Sumanth Amperayani
Consultant Paediatrician
Master\u0027s Degree
769 satisfied customers
What is a viral infection? Dr prescribed cough syrup. The
The syrup has helped reduce the cough but the other symptoms are still here. It feels like a cold/sinus but my mouth burns and feels raw and my gums are inflamed. … read more
Dr. Mark
Dr. Mark
M.D. in Neurosurgery
Doctoral Degree
5,370 satisfied customers
I got the result of my western blot test. It came out 0.6
Hi sir I got the result of my western blot test . It came out 0.6 negative . The test was conducted on 6 th February 2018 is it to high after 10 days of exposure . I wasn't provided with any range det… read more
Dr Stan
Dr Stan
DO
3,179 satisfied customers
I have positive intrinsic factor blocking antibody, with the
I have positive intrinsic factor blocking antibody, with the hx of RDW's being their highest at 18 over the last year and half. 8-2015 was anemic, but hg came back up. Researchers have stated that the… read more
Dr Ted Manos
Dr Ted Manos
Self Employed
MD
925 satisfied customers
Trying to determine if this is a viral or bacterial
Trying to determine if this is a viral or bacterial infection. … read more
Dr. Muneeb Ali
Dr. Muneeb Ali
Senior Registrar Critical Care Medicine
Doctoral Degree
8,217 satisfied customers
Just received Western Blot test for Lyme results. Everything
Just received Western Blot test for Lyme results. Everything negative except: IgG P41 - Present abnormal and Igm P23 - Present abnormal. What does that mean? … read more
Vakul Aren
Vakul Aren
Consultant Physician
Post graduation (Liverpool, U.K.)
4,124 satisfied customers
Results for Lyme C6 Peptide AB W/RFX to Western Blot are
Results for Lyme C6 Peptide AB W/RFX to Western Blot are 0.15 - is this within the normal range?… read more
Medicaldoctor
Medicaldoctor
postgraduate resident,MD
Master\u0027s Degree
121 satisfied customers
What is a western blot herpes test? That's the crazy
That's the crazy part...I DON'T HAVE ANY! I went to my doctors office for a check up on 3-23-17 and was tested for everything … read more
Dr. D. Love
Dr. D. Love
Doctor
19,548 satisfied customers
Disclaimer: Information in questions, answers, and other posts on this site ("Posts") comes from individual users, not JustAnswer; JustAnswer is not responsible for Posts. Posts are for general information, are not intended to substitute for informed professional advice (medical, legal, veterinary, financial, etc.), or to establish a professional-client relationship. The site and services are provided "as is" with no warranty or representations by JustAnswer regarding the qualifications of Experts. To see what credentials have been verified by a third-party service, please click on the "Verified" symbol in some Experts' profiles. JustAnswer is not intended or designed for EMERGENCY questions which should be directed immediately by telephone or in-person to qualified professionals.

Disclaimer: Information in questions, answers, and other posts on this site ("Posts") comes from individual users, not JustAnswer; JustAnswer is not responsible for Posts. Posts are for general information, are not intended to substitute for informed professional advice (medical, legal, veterinary, financial, etc.), or to establish a professional-client relationship. The site and services are provided "as is" with no warranty or representations by JustAnswer regarding the qualifications of Experts. To see what credentials have been verified by a third-party service, please click on the "Verified" symbol in some Experts' profiles. JustAnswer is not intended or designed for EMERGENCY questions which should be directed immediately by telephone or in-person to qualified professionals.

Show MoreShow Less

Ask Your Question

x