Diagnosed soley on IgM

[annoyed18]

Hello Terri,

I was told by my GYN that I am positive for an acute (new) infection of HSV-1, having had no symptoms oral or genital in my life. My lab results were not posted on my patient portal, so I just picked them up in person today to actually see the #’s. I tested exactly 6wks after ending a relationship and I do plan on retesting @16wks (post last contact / roughly 4mos). I’m hoping that is ample time to determine if antibodies are present.

Here are my results for HSV Herpes Select IgM & IGG with types 42832:

Herpes Simplex Type 1 IGG = <.90
Herpes Simplex Type 2 IGG = <.90

HSV 1 IgM screen = POSITIVE
HSV 2 IgM screen = NEGATIVE

HSV 1 IGM TITER = 1.40 H

My 1st question is this: I had Roseola as a baby (per my Mom) which I understand is in the Herpes family, so could that be throwing off my IgM? Also, should I even care that the “titer” is HIGH or again could that be because the IgM test is inaccurate?

I am truly concerned and stressed with more weeks of waiting. Thank you.

[Terri Warren]

The IgM is terrible for false positives! It isn’t wrong 100% of the time but in my experience, it is wrong 85-90% of the time. The CDC in their STD treatment guidelines say never to use the IgM. The only test you want to pay attention to is the IgG. At 6 weeks from an exposure, 70% of those who are going to serconvert to positive will do so. The odds are definitely on your side. I would suggest that you get a copy of the CDC STD treatment guidelines for 2015 and show them to you doc. Perhaps they would freak out other patients.

Terri

[annoyed18]

Thank you, Terri.

I am now 14wks post last contact and 8 wks since my last HSV test. I had another IGG for both HSV-1 and HSV-2 and both were again negative. I hoped this was sufficient time for a definitive answer., however, my GYN still said she was concerned about the HSV-1 IgM showing high positive. She wants to retest both again next year. I asked if it could be cross-reactivity and she said maybe but that it can’t be ruled out.

I’m not sure really how to feel because if IGG is the standard and it was again negative, then why can’t I rule it out and be considered unequivocally to not be infected w/HSV-1 or 2? I told her about the CDC and she said the practice stands by these tests. I do not want to give something that I don’t think I have to a new partner, so I don’t know if I need additional testing or if I can presume that another IGG for both 1 & 2 is good enough?

Thanks!

[Terri Warren]

OMG, unbelievable. She just can’t let go of that terrible test. If her practice overrides the CDC guidelines, I feel badly for her patients.
The IgG test misses 30% of hSV 1 and 8% of HSV 2 infections compared to the gold standard western blot. If you want the best test, go for the western blot – my guess is she will tell you she’s never heard of it.

Terri

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