Re-test?

[inneedofexpertise]

Hi Terri. Thanks for this amazing resource!
My questions is whether or not I need to be re-tested after my initial positive HSV-1 blood test. This blood test was performed May 20, immediately after my noticing a labial lesion, 2 weeks after sex with a new partner. The results were as follows:

HSV 1 Glycoprotein G-Specific, IgG: <0.2 (negative)
HSV 2 Glycoprotein G-Specific, IgG: <0.2 (negative)
HSV 1\T\2 IgM: 1.11 (positive)
(No swab test was performed)

The clinic explained that since I was negative for IgG but positive for IgM, it had been a recent and/or current infection with no indication of a previous infection. However, the nurse practitioner didn’t instill confidence regarding her knowledge of herpes or how to interpret the results, and made a comment that my results indicated that I had been exposed to HSV2 but wasn’t infected. Though this makes little sense to me (as you either have antibodies or not), it continues to haunt me 3 months later. I know it’s best to wait 3-4 months before getting a blood test, so would you recommend I get re-tested to clarify what I have is actually HSV-1?

Other potentially helpful information: I had no previous knowledge of any HSV infection (though this was my first blood test), my initial genital outbreak was quite severe (lasting a full month), I have been on suppressive therapy since June, and am currently having my first recurrent outbreak. Thank you!

[Terri Warren]

The IgM test that was ordered has many false positives. I would only pay attention to the IgG test. However, you were tested too soon after the potential exposure. So yes, I would recommend repeating it again soon. Do remember that the HSV 1 antibody test, compared to the best test, western blot, only picks up 75% of cases. The western blot is not readily available but if you decided to do it, our clinic can order it for you to be drawn at a lab near you. The only test you want to pay attention to is the IgG, never the IgM. And if you had a sore, why was a swab test not performed? I’m confused.

Since you are taking daily antiviral therapy it will likely interfere with the IgG test.

If you are currently experiencing a recurrences, please, go and get a PCR swab test of the lesion right away to get confirmation of this diagnosis.

terri

[inneedofexpertise]

Thank you! Will the daily antiviral also interfere with the PCR swab test?

[Terri Warren]

Yes, the daily medicine could interfere with the PCR in that you could still have infection, but the medicine could reduce the amount of virus present and make the PCR inaccurate.

Terri

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