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Borderline HSV PCR, ELISA tests. Sholud I be concerned?

Resolved Question:

Confused with HSV Test Result.

I had protected sex with a girl of unknown status 3 months ago.
I was concerned with my HIV status and underwent STD testing. All the test results were negative except for HSV (the result was borderline).

To validate the result i tested for HSV (blood test) using PCR and ELISA methods and test results are contradicting.

I have attached the test results for your review.

Can you please advice.

Category: Infectious Disease Specialist

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Category: HIV- AIDS Specialist
 27 Doctors Online

Thank you for your query at
I understand your concern.
Yes your results are borderline which indicate that you may have had a past infection and that is not really significant until and unless you manifest any herpes symptoms such as cold sores, or rash around the genitalia.
So if you do not have symptoms, you do not need to worry about the report.
Hope this was helpful,
Feel free to discuss further,

Patient replied :

Thanks for your reply.
The first report shows that my values are on the borderline. To confirm this i tested twice once with PCR method and other with ELISA method.
PCR method is negetive , but with ELISA method the HSV 1 IgG is positive (report attached Page 2 and Page 3).
1. So should i retest to confirm the status ?
2. Which test is reliable ?
I dont have any symptoms

As I mentioned, HSV-1 infection can be acquired during childhood, even without any sexual activities. A lot of children acquire it during their childhood, and never manifest any symptoms. IgG only indicates a past infection, so please do not worry about it.
Since you have no cold sores or open mucosal lesions, you have nothing to worry about.
You do not need re testing unless you have any symptoms.

Patient replied :

Hello Doctor,
Please advice me on the following specific queries
1. Why is my HSV test result using Real time PCR method negetive and with Elisa method positive ?
2. Based on the test results should i assume that i am HSV 1 Positive ?
3. Can i lead a normal sex life , or would i infect my wife and kids ?
4. Should i tell my wife about my HSV 1 infection ?
5. I read that there is no cure for HSV infection is that true ?
6. How detrimental is this infection to health , is it like HIV ?
Thanks for your advice and patience.

1) ELISA is a slightly more sensitive test. The issue with HSV-1 infection is, the virus is so common, we can even acquire the infection during periods of weakened immunity such as our childhood even in the absence of any active disease or sexual contact. ELISA can pick up traces of previous infection. However, as I have already mentioned, in absence of any cold sores you do not need to worry. It can even be a false positive.
2) If you never had any symptoms, this test is insignificant.
3) Yes, you can have a normal sex life.
4) You do not need to tell her. However, if you do get cold sores, please avoid any intimate contact with her.
5) No, there is no cure for HSV infections, medicines can just prevent recurrences and severity.
6) It is not detrimental, just the fact that, outbreaks can happen anytime and are painful. 30 % of US adult population has hepres 1 infection.

Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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