Herpes is a common condition, with 50-80% of American adults infected with oral herpes (HSV-1) and 11.9% infected with genital herpes (HSV-2). This is a condition that is often associated with discomfort and stigma, so accurate testing is critical.
But what happens when your herpes test results are false positive? The mental turmoil you feel when you believe you have herpes only to find out later that your diagnosis was incorrect. Just imagine. This situation is more common than you think.
So what causes a false positive herpes test? Let’s take a look at why and how to deal with such a scenario.
What causes false positive herpes tests? 5 common reasons
Even if you do not have herpes simplex virus (HSV), several potential factors can contribute to inaccurate herpes test results. They include:
1. Type of exam
Herpes tests, such as blood tests (serology), check for immune system markers, making the results difficult to understand. These tests tend to give false-positive results in people who are at low risk of infection. Blood tests such as IgM tests cannot accurately distinguish between HSV-1 and HSV-2 antibodies, resulting in false-positive results.
2. Initial infection
If the herpes infection is in its early stages (no noticeable outbreaks have occurred), an individual’s body may not yet have released enough antibodies to be detectable. This means that although there is a possibility of infection, very few antibodies are present, resulting in a false positive result.
3. Inspection error
In some cases, laboratory errors may be the cause. These failures can occur during testing procedures, such as mistakes during sample handling and processing, contamination, and incorrect evaluations. These factors can cause a false positive test result.
4. Cross-reactivity
In some cases, the test may react with proteins or antibodies from other bacteria, viruses, or conditions similar to HSV. For example, people infected with Epstein-Barr virus or varicella-zoster virus through viral infections may develop antibodies that cross-react with herpes simplex virus (HSV). This can lead to misinterpretation of herpes test results.
5. Underlying health issues
In some cases, certain medical conditions, such as autoimmune diseases, can also contribute to false-positive results from herpes tests. These conditions can affect the immune system and cause the production of antibodies. This can compromise the accuracy of the test.
What to do if your herpes test result is false positive
If you receive a false positive result, first try to remain calm and not panic. Here’s what you can do:
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Request additional testing: Get additional confirmatory testing, such as a polymerase chain reaction (PCR) test or a secondary antibody test. This will help you see the results accurately.
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Talk to your doctor: Talk to your doctor about your test results and any symptoms. Appropriate guidance for proper diagnosis can be provided more effectively.
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Consider your risk factors: Talk to your doctor about any sexual history or risk factors that might increase your risk of actual exposure to HSV.
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Seek a second opinion: If you are still unsure or not completely satisfied with the explanation you have been given regarding your results, get a second opinion for more clarity.
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Understand test limitations: Remember that false-positive results are common, especially with antibody blood tests. Therefore, always discuss different tests before making a decision.
Please also read Understand STD online testing
FDA recommendations
US Food and Drug Administration (FDA) recommends that all healthcare providers and laboratory staff keep the following in mind to reduce the likelihood of false reaction results:
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Check the CDC guidelines before recommending an HSV-2 blood test.
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Please note that false positive results may occur.
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Educate people about the shortcomings of available tests before undergoing HSV-2 serology testing.
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For false positive results, we perform additional confirmatory tests, such as biokits or Western blot tests, as stated on the test label and according to professional guidelines.
Why do false positives occur so often?
False positives occur more often because the blood test is done earlier and the risk of herpes infection is lower. Test results are common, half of them give inaccurate results. Serology (antibodies) that can be produced by tests such as the HerpeSelect test Approximately 50% False false positive. Therefore, it can further help detect past herpes infections even if there are no symptoms.
The inaccuracy is primarily due to “borderline positive” measurements, which are close to the cutoff for a positive diagnosis for standard tests. This can lead to misleading results.
Comparison of genital herpes tests based on the presence or absence of symptoms
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scenario
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Testing with symptoms
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Asymptomatic testing
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Type of test
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Commonly used are PCR, serology (antibody testing), and viral culture.
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Serology is often used to identify past herpes infections.
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reliability
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Accuracy is high because symptoms such as pain can be clearly seen.
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It is less reliable because there is no active herpes outbreak, and detectable antibodies may not yet be available.
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Purpose of the test
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Confirm the presence of active herpes infection and detect specific HSV types.
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To learn about past herpes infections.
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timing
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Accurate diagnosis of herpes immediately or during outbreak.
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It can be done at any time, even after you’ve had herpes for years.
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Risk of incorrect results
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The risk is lower because the herpes virus actively disappears.
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The risk is higher because there is no active virus present.
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Symptoms to check for
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Painful ulcers, blisters, or itching in the genital area.
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There are no symptoms, and it is unknown whether he has been exposed to herpes in the past.
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When should you consider a herpes test?
Please get tested for herpes if:
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Experiencing genital symptoms that may be related to herpes.
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Have genital herpes or have had a sex partner who has genital herpes.
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If your doctor has tested you for symptoms of herpes, but you still need a confirmatory test.
Testing allows the doctor to understand what may happen in the future and what treatment plan may be helpful. Medications can help reduce symptoms. Additionally, your doctor can advise you on how to prevent the risk of transmitting herpes to your partner.
Additionally, herpes testing is not recommended for people without symptoms in certain circumstances. This is because blood tests have limitations and can give inaccurate results. Herpes test results are more likely to be false in people who are at low risk of infection.
Please also read Step-by-step guide: How to get tested for herpes
Can herpes actually be misdiagnosed?
Yes, misdiagnosis of herpes can occur due to the following reasons:
Symptoms such as genital warts, fungal infections, and ingrown hairs can be similar to those of herpes and can cause confusion.
Testing errors, cross-reactivity with other currently existing viral infections, or improper sample collection can contribute to false-positive herpes test results.
Some people don’t have noticeable herpes symptoms, so the diagnosis may go undiagnosed and those symptoms may be associated with other problems.
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Early outbreak confusion
The first outbreak of herpes can be mistaken for other symptoms, since the appearance of the sores in the early stages is different or less extreme.
People with other infections, such as sexually transmitted infections (STIs), may have overlapping symptoms, complicating diagnosis.
Testing too early or too late during the herpes infection cycle can affect the accuracy of results, especially for antibody blood tests.
final thoughts
For those wondering what can cause a false positive herpes test result, factors such as the type of test, test errors, cross-reactivity, and other health issues can be to blame. There is a gender. It’s not common, but it’s possible. Therefore, it is important to understand the potential reasons behind such misconceptions and seek confirmatory testing if you are unsure.
Remember, don’t panic if you get a positive result. Please see a doctor to ensure an accurate diagnosis. Stay informed and take proactive steps for your health.
Please also read How is herpes transmitted other than through sexual intercourse? 4 unknown ways
FAQ
Can a yeast infection cause a false positive herpes test?
No, that’s not possible. Although both have the same symptoms in the genital area, yeast infections will not affect test results.
What can be mistaken for herpes in a blood test?
Symptoms similar to herpes include genital warts (HPV), syphilis, bacterial vaginosis, insect bites, ingrown hairs, shaving irritation, and hemorrhoids.
Can bacterial vaginosis (BV) cause a positive herpes culture test?
Yes, BV can alter the cytokine environment within the reproductive tract, increasing the likelihood of herpes infection with BV.
Can HPV contribute to false-positive herpes test results?
No, you can’t because herpes is caused by the herpes simplex virus (HSV) and HPV is caused by over 200 human papillomavirus (HPV) viruses.
