Deep HSV questtions continued

[Jliv4]

Hi Terri,

I’ve replied to the old questions about 10 and 5 days ago, have not gotten a response from you and don’t know if you see them.

I came to you about having index of
During oral outbreak 2021 summer:
Hsv-1:50.80 igg
Hsv-2:2.14 igg

After outbreak:
Hsv-2: 1.93 igg
You have told me it is a low positive and a hugh chance of false positive. A few months ago I got the WB confirmatory test and it was negative.

It’s been months since and my doctor and I agreed on no more tests unless I have an out break genitally and we will go off of if my hsv-2 results ever gets high. A month ago I had sex unprotected sex with no lube and it caused friction. A week or few days later I noticed a bump but didn’t got to the doctor nor added aquaphor to it till another week after, then the redness went down and it was hurting. Once that went down 3 more bumps came along with bumps all over my hand I get a fee times a year which dint hurt but, then I started to get tingles where I’d need to rub, and below my shaft was red and parts of the foreskin would tingle, but it was getting dry. I was freaking out, but the bumps on the penile gland didn’t itch hut was sensitive I applied aquaphor and it barely helped then my doc sent a full std panel along with me using fungal cream on it which didn’t help. Almost a week went by then I used aquaphor and it’s just settling down after 1.5-2 weeks. Now my onis is fine. I received my std results coming to be all negative except hsv as expected for what I though would be only igg, she order igm as well.

RESULTS:
HSV-1: 44.90 Igg
HSV-2: 2.21 Igg

HSV-2: 1.12 IgM

I would have been fine with and take the Igg as no change, but the IgM through me off and giving me anxiety. My doc says it can be a recurrent infection but not to worry. I do not have a current outbreak, though it is summer and typically have outbreak at this time hence the high hsv1 number.

[Jliv4]

Also, I went to the derm finally and he could not do anything with bumps on penile gland since they’ve healed but based on pictures he doesn’t think it was herpes, but he said based on what been happening with bumps all over my body he thinks I have ‘lichen nitidus’, which he thinks could have been on my penile gland, but he took a biopsy in another location.

Questions:

I’ve seen you say that IgM is inaccurate and CDC recommends to not use, which I have looked up, but I believe they are primarily false negatives than false positives, can’t remember, but what if it is a new infection hsv2 and not reccurrent based off of the high hsv1 index since I don’t have a current outbreak?

Should I just ignore the IgM and just go by my igg results, and to not get tested again until if I ever have an outbreak and my doctor deems it may be herpes? Or should I take another Igg and/or IgM test next week, which would make it 2 weeks from the last?

Why does Hsv-1 index effect my hsv2 index?

Lastly, if im only going based of my hsv2 index since it’s been 1.93, 2.14,and 2.21. In case I ever get another at what number should I be concerned I might be positive for hsv-2?

Most of this is due to myself having anxiety and been thinking I had Hsv-2 for 7 years, and limiting myself from encounters because if it and last year I’ve been more casual but dealt with disclosing and rejection. So even the slightest doubt, or something going om with my body u instant think herpes and just wonder over and over.

[Jliv4]

I just have been comfortable with not need to disclose anymore and get anxiety even if my doc says not to worry since igg has been closely same, I’m slowly getting there and getting used to not feeling like I’m holding something from someone I may get serious with, but for now it’s just casual encounters until pieces align for a relationship.

Please feel free to add any additional advice personally/and professionally. Thank you.

[Terri Warren]

The problem with the IgM test is false positives. The test picks up antibodies from a range of other things.

Since your western blot is negative and the IgM is very bad, I don’t see the need to disclose anything – there is nothing to disclose!

The HSV 1 antibody can sometimes cross-react with the HSV 2 test and cause a false positive. The test is supposed to be type-specific, but sometimes, it isn’t fully so.

Terri

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