Confusing IgG results

[mallory]

7 yrs ago I was diagnosed with hsv1 genital. I recently had an encounter where I was positive I’d been exposed to hsv2. I had sex with someone who has hsv2 and immediately the next day I started feeling strange. I had all the typical herpes symptoms – leg pain, etc & they were much stronger than I’d ever had with my type 1.

I did not have many sores though despite the increased symptoms. The only 1 or 2 I had were in the same place I used to get my hsv1 sores. The only other visible symptom has been a rash that comes & goes. The symptoms were bothering me so much that I went on a high daily dose of Valtrex (1000 mg) about a month after this incident. I have been on them since and the symptoms have continued to bother me a lot despite being on the medication.

I finally reached the 3 month mark so decided to have the IgG done. The results came back negative for hsv2 but very strangely high for hsv1 (52). I read in other posts that the antivirals can mess up the results. Do you think this is what has happened?

I guess I’m confused whether I should be working with my gynecologist on determining if it is something else or go off the antivirals & try redoing the IgG in a bit.

[Terri Warren]

Your daily antiviral therapy could definitely be interfering with your antibody test results! However, if you got newly infected with HSV 2, it would be highly unlikely to get symptoms so fast. Also, your symptoms don’t sound typical for HSV 2 at all and also the Valtrex not improving it makes it seem less likely to be HSV 2. I also don’t think that 52 (I’m guessing on a LabCorp test) is that high with someone with well established genital HSV 1 infection. If you really want to know your HSV 2 status, I would suggest that you come off suppression for about 3-4 months and retest and see what you get.

Terri

[mallory]

Hi, Terri, thanks so much for your thoughtful response. I didn’t mean to say the Valtrex doesn’t help at all. It definitely does but nowhere near what I would expect. I thought on suppressive therapy you might expect to have symptoms a few times a year. I would estimate I’m having low level (or more) symptoms at least 1/2 the time per month. So I’d prefer not to go off the Valtrex definitely for 3-4 mos since I’m fairly miserable now & assume it will just get worse. (Someone even suggested if I have been exposed to something else, it may be making the hsv1 flare up much more than usual).

If I were to remain on it, do you have any idea of what might be a reasonable time it would show up in a blood test? Maybe 6 mos – 1 yr? (I’m sure that is tough to guesstimate). Also, in your experience what percent of patients continue to have bad symptoms despite being on 1000 mg/day of Valtrex?

Thanks very much.

[Terri Warren]

Honestly, if you don’t have HSV 2, I would not imagine that your HSV 1 is causing you to have symptoms 1/2 the time. That just isn’t how HSV 1 behaves in the genital area. And if you are still on suppression, you may never have a full blown outbreak that could be swabbed and your antibody levels will not go up. We had a patient who wanted to go on suppression right away with new infection and she had still not seroconverted 9 months later. She was involved in a legal case about her herpes so we had to pull her off suppression to prove that she had HSV 2. She seroconverted a month later. Who knows how long she would have gone on being negative on meds. You call. Just letting you know the situation.

Terri

[mallory]

Hi, Terri, thanks again. Yea the unfortunate reality is that it probably is hsv2 just with atypical symptoms.

Well I think I have one more question with the paid membership I selected. Please let me know if not. If so I guess my last question would be do you have any advice about where I can go to research alternate therapies, etc. I am pretty miserable and some days just don’t know what I’m going to do with myself.

Thank you.

[Terri Warren]

You have put yourself is a rather difficult position. You are unwilling to do the things that you need to do to come up with an accurate diagnostic picture. If you come off suppression and have an outbreak that can be swabbed and it is positive, then you have your answer. If you don’t have an outbreak and wait the time necessary for an accurate test, then you have your answer. You’ve jumped to a big conclusion here and you could be correct, but before searching out alternative therapies, etc, don’t you think it would be best to find out what is really going on here?

Even if you had HSV 2, I would not expect the symptoms that you are having – it just isn’t reasonable.

You have reached the final post on your subscription. If you wish to ask more questions, please feel free to renew.

Terri

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