Concerned HSV2 IGG and IGM test results reversed?

[mcogburn]

In 2001 I was tested for HSV2 after I found out my boyfriend had herpes and did not tell me. I did enough research at the time to know I wanted a type specific HSV2 antibody test. I went to my nurse practitioner who ordered an IGG and IGM test performed by a local lab. I was told over the phone, that I came back positive for both Herpes 1 and 2 and in a follow up visit she explained there was no confirmatory testing needed, that I had to accept it, etc. I never had a breakout. I married the boyfriend. When I got divorced however in 2008, I did consider myself to have herpes and chose to try dating through “positive singles” a website that caters to people with herpes and other stds – thus exposing myself to yet more people with herpes or even hvp (!). In 2014 – I switch to a new obgyn who orders a new IGG test and I come back positive for HSV1 but NEGATIVE for HSV2. This doctor and his nurse both tell me that “I must have cleared the herpes HSV2 from my system…” That did not make sense to me. It still doesn’t. I ordered my original records to look at the first test. The original test shows the indices for the IGG and IGM. The test say “herpes simplex virus IGG and IGM Herpes AB Panel.” It reports that my “Herpes Simplex 1 IGG is 1:1000 and my Herpes Simplex 2 IGG is 1:100 (with normal range expected both at less that 1:10). It states my Herpes Simplex IGM and 2 IGM are both “none detected.” This did not make sense to me because I think that is the titer or index is actually for the IGM test – and that the IGG index should be ranged between 0-5 – am I right? I am essentially trying to find out if I was ever HSV2 positive or if I should go ahead and take the Western Blot. I do get cold sores every few years so being HSV1 positive is no surprise. I called the virology department at University of Washington and they told me that it sounds like the results got reversed somehow, that the test was not reporting the right index for the IGG test. I want to know if my doctor and nurse should have realized this for all these years (they always discussed my herpes status with me because we talked at various points about having a baby and needing suppression therapy in that event, and discussed it again after I got divorced and started dating) but maybe I am really HSV2 positive? Current doctor said the HSV2 IGG came back negative so in his mind I don’t have it and that is the end of the story. Or should I just get tested with the Western Blot? I am very confused. I can send you the lab page. Thanks.

[und3rpr3ssure]

I called the Drs office and they gave me my test results although not specific on numbers which weren’t given to them by quest.

HSV1 IGG is greater than 5
HSV2 IGG is greater than 1

Looking up on the ranges at Quest for HerpesSelect it says equivicol and that Im assuming is not 100% positive.

[Terri Warren]

This is a little confusing to me. Greater than 1 could be anything, either positive or negative or equivocal. You need specific numbers. I wonder if they are reading it correctly. You sure have had a rough go with test results, good heavens!
The western blot would certainly give you the answers that you seek, I believe.

Terri

[und3rpr3ssure]

For now, seeing as I have never had any symptoms regarding HSV2 and that the results from the DR say >1 but not greater than 1.1, I am going to assume everything is not at Defcon 5 for me just yet. I will post back when I get my labs directly from quest and what they say.

I think though that the NP is not up to speed on HSV2 and the results as I would prefer when providing them to a patient. She said the test either shows you have it or you dont as it tests for antibodies etc. I even asked about false positives etc and she didn’t have much information.

Ill post back in a day or so when I get my labs that I can see for myself.

[und3rpr3ssure]

Terri,

I got my results from the lab:

HSV 1/2 IGG, Type Specific AB Herpeselect:
HSV1: >5
HSV2: 1

HSV 1/2 AB (IGM), IFA W/RFL TO TITER:
HSV1 Negative
HSV2 Negative

I really appreciate your help. 🙂

[Terri Warren]

That is weird. The HSV 1 is normal but really, exactly 1.0 for HSV 2? That is equivocal, neither positive nor negative. But good news for you.

Terri

[mcogburn]

Terry these were two different posts – my question about the IGM titer showing up in the IGG report line on my lab report?

[Terri Warren]

Wow, I didn’t even see that. Not sure why that person posted on your thread. Weird and sorry I missed that.
The original test looks like it was a completely different one than is now used. If your IgG is negative now, then I would believe that. The old one used titers but we haven’t seen that one used in a very long time. Wow, you really put yourself at risk based on that old test result, didn’t you?
Likely, the first test was a false positive. You did not clear the virus from your system.
Given all of this craziness with testing, you may want a western blot, but I honestly think this one is probably good enough.

Terri

[mcogburn]

Thank you that helps a lot. I guess I was confused because I thought that specific titer was only used for IgM testing (just by googling the titer ranges I only came across information about that specific titer being used IgM testing) but in my report it was used for the IgG. So just to confirm – the titer was used in IgG testing back then as well? At this time I think I thought the Herpes Select ELISA test was available and I thought that was what I was getting but I guess it wasn’t. If it was simply a false positive though I can accept that I guess. I actually had thought that the IgG and IgM values were somehow reversed by the testing lab, and that was very upsetting. Although its all pretty upsetting.

[Terri Warren]

Some labs did use the old tests back then – not the big labs like Quest and LabCorp, I don’t think, but smaller ones, some did, and it looks like this one did. Have you actually seen your results on paper? If yes, I doubt that it said exactly 1.0 but maybe?

Terri

[mcogburn]

This is what the 2001 lab report says:

“Herpes Simplex Virus IGG and IGM Herpes AB Panel

TEST Results Expected Range
Herpes Simplex 1 IGG
1: 1000 (out of range) <1:10
Herpes Simplex 2 IGG
1:100 (out of range) <1:10

Herpes Simplex 1 IGM
None Detected None Detected

Herpes Simplex 2 IGM
None Detected None Detected

Testing performed at Esoterix Infectious Disease Center, San Antonio, Texas”

[mcogburn]

That really did not load properly I was trying to organize the text like it was on the actual lab report.

[Terri Warren]

interesting. I think you should rely on the most current results.

Terri

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