Probably false positive hsv1/2 IGM

[hereshoping]

I had protected sex 5 weeks ago with a girl who claimed to have been recently tested. By happenstance I happened to get a full std panel 5 days later. The results came back as follows:

HSV1 IGG: 2.9
HSV2 IGG: 0.2

HSV1/2 IGM: 1.2

My doctor at that time diagnosed recent hsv2 infection. After a very panicked week and a lot of xanax-fueled google med school, I found that the IGM is almost totally unreliably (mostly thanks to your work).

I went and got another IGG at 4 weeks post exposure and both remained negative, the IGM still showed 1.2 (which is odd because the paperwork I gave to Quest Diagnostics didn’t even ask for IGM, just IGG – suspect they may have just resent the original results for IGM.

I have had no symptoms (I’ve never even had a cold sore). I am pretty comfortable with the idea that this IGM was either totally false positive, or cross reacting with HSV1, but I wanted to get your expert opinion before potentially exposing any future partners.

Thanks.

[Terri Warren]

I’m totally with you that a positive IgM is virtually meaningless. I can’t tell you how many people I have seen who have positive IgM tests, erroneously ordered, who negative have a positive IgG test. The IgM is not wrong every single time but it is wrong most of the time, based on my clinic experience. The problem is that when it is drawn, it is hard to know when it might be positive. However, your value is incredibly low and I’m assuming that you have no symptoms to be concerned about or you would have mentioned that. In addition, it is a combined HSV 1 and 2, and we know that IgM’s intermittently go up and down with HSV 1 and 2 infection so who knows what the heck this means???
If you were my patient, I would do a final IgG at 12 weeks and forget it. Really

Terri

[hereshoping]

Thank you for the prompt response. Would it be ethical given the current state to have protected intercourse? The IGG was negative at 4 weeks no change in the IGM, if they even redid it at all (I have my doubts since it wasn’t ordered and the number was exactly the same). I feel that since the hsv1 IGG was positive, that the IGM 1/2 would almost be expected to be positive.

In response to your assumption, I have had no genital symptoms or seroconversion type symptoms that I am aware of.

[Terri Warren]

I think the most likely situation is that this is a false positive IgM but I can’t tell you that with 100% certainty. But I seriously doubt that this has any credibility.

Terri

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