1. I know IgM is bad, but I haven’t seen an IgM as high as mine. A 3.4 followed by a steady decrease to equivocal, then to negative over 2 months seems consistent with a new infection, especially given the exposure time. Would you still consider that obsolete?
I have seen IgM as high as yours and they are almost always false positives which is indicated by a follow up negative IgG.
2. I’m curious about the 30% false negative with HSV1. Low positive index values are a significant predictor of discordant results between Elisa and WB. Does the same concept apply to high negatives with an HSV1 test? In other words, assuming all other factors (lab, timing, lack of symptoms, etc) were the same, would you expect a person with an HSV1 IGG of 0.1 to share the same 30% chance of a false negative as someone with an HSV1 IGG of 0.7?
We know less about the IgG for HSV 1 and its predictive value for a true positive. I would say, from anecdotal experience, that higher negatives do present a bit more of a risk of being false negatives than low negatives, yes.
3. We are in Europe. The WB is out of price-range, and doesn’t seem reasonable in my case. But, I do still worry about that 30% false-neg for HSV1. After 3 months of stress, I don’t want to give her GHSV1 thanks to a false test. Would you feel confident in a negative result if we both tested negative after 3 months with each other? Especially as my most likely time of transmission has already passed and we weren’t using protection?
I honestly can’t say. With a test that misses 1/3 of infections, I’m not clear how to guide people who get a negative. I would say if you have no symptoms and you think you might have genital HSV 1, the risk is already low because HSV 1 genital infection is rarely transmitted through intercourse.
4. HSV2 increases your risk for HIV. Is the same true with GHSV1?
NO, because genital HSV 1 is rarely active.
5. Your research was compared to American ESLIA tests, whereas in Spain we are using CLIA. Though similar in procedure, the research that I have found suggests that CLIA is be more sensitive. Do you have any knowledge of this?
We also use CLIA based testing. I don’t see a difference between the routine ELISA and the newer CLIA tests in terms of sensitivity for HSV 1.
6. My doctor seemed to believe that the IgM was likely a false pos caused by the full body rash (urticaria) three weeks prior. I have had full body hives before due to allergy, though in this instance there was no obvious allergen to explain it. This rash did not cause any ulceration, the only lasting effect was constant peeling of the fingertips for 2 to 3 weeks afterwards. Very strange.
Have you seen IgM positives be skewed by other factors such as this? More importantly, in all your years have you ever seen anyone whose first symptom (or any symptom) of HSV be full body hives?
nope
Terri