HSV testing confusion

[Maggyfae]

After an unprotected sexual assault I went three days later to a clinic not because of symptoms but out of fear since I can't exactly ask this person their sexual history or status. I originally went in out of paranoia of bumps around my labia that the PA said was normal texture. I mentioned a single tearing around my vaginal opening which I wasn't concerned about and thought was from the trauma of the act but thought she'd like to look at. She stated it looked like herpes and swabbed it. Those cultures back negative but I was told false negatives are common. I dont know if it's worth mentioning that it healed relatively quick. They also had a HerpeSelect for HSV2 three days after the possible exposure which came back less than 0.9 (negative). 4 weeks later I had blood tests ordered my by primary doctor. She ordered an hsv igg 1/2 ELISA and hsv igm 1/2 ELISA. The results for the hsv igg 1/2 ELISA was 0.67 and for the hsv igm 1/2 ELISA was 1.32 with 1.10+ being considered antibodies detected for both tests and less than 0.89 being antibodies not detected. She told me that I had herpes and considering the timing she didn't want to give me hope about a false positive. She said we don't know the type or whether it is oral or genital and won't know without a positive culture of an outbreak. I asked to be retested at 16 weeks and she said while she wishes this was nothing the expected results are that the igm will go down and the igg will rise but she ordered it nonetheless as I wanted. I've been living my life in limbo considering how high 0.67 is and was wondering how reliable the combination test is at 4 weeks. I have hope about the igm being worthless as I often read, I suppose the high negative igg at just 4 weeks is what concerns me as I've been reading about seroconversion and such.

My sexual history is very limited to one partner who I no longer have contact with and this one time sexual assault. I have not experienced any outbreaks and abnormality I noticed has been written off as normal or nothing that can be swabbed everytime I rush to get checked. I guess I'm just wondering how to interpret these results and if there is any hope for the retest since it was only a single encounter and his status is not even known. I plan on ordering a Western Blot from the University of Washington at 6 months if necessary and I've read that Westover Heights clinic has closed which is disappointing and was wondering if anyone has information on if that is true. Sorry for the long explanation it's just very upsetting to think about being infected from an encounter like that as it just prolongs the feeling of violation.

[Maggyfae]

I just wanted to update you on my 12 week retest. I requested type specific IGG but apparently they did the IGG 1/2 Elisa again. For what it's worth though the IGG was 0.7 (negative). She ordered an IGM also which I disregarded as you suggested but thought I'd mention that was 0.81. My doctor messaged me "Your labs indicate a decline (as predicted) in your IGM but not a rise (as expected) in your IGG. It could be that this takes a little longer and we might consider retesting this in another two months."

I have a few questions for you.
1. Considering I haven't had any lesions can I just take this as a negative or is this something I'd have to disclose to future partners? I have felt some tingles which I'm gonna assume was me being hyperaware and anxious. And I did have some vulvar rawness and irritation on and off since the incident which I had numerous doctors look at and they didn't suggest herpes.
2. Is it significant that the IGG was 0.67 before but 0.7 now? And also that it's such a high negative? Majority of negative values I've seen on this site have been things like 0.08 and such.
3. Do you think it's necessary to repeat test in two months as my doctor suggests or can I take this and run?

I'm sorry for such a long post again. I just want to cover all my bases and move on from this, but I'd hate to walk away thinking I was negative and I put a future partner at risk for not disclosing.

[Maggyfae]

Sorry just to recap my testing.
3 days post exposure - negative swab
4 weeks - negative igg, positive igm
12 weeks - negative igg, negative igm
No outbreaks

[feelingundone]

No problem

[feelingundone]

12 weeks is sufficient for it ro be conclusive. All you need is a hsv2 igg test at that time. Like i said the odds are very low. If he had hsv2 the odds are roughly one in a thousand. I am sorry you're dealing with this.  

[Maggyfae]

Thank you so much for the advice I really appreciate it!

[feelingundone]

I'm very sorry to hear about the assault.
Igm tests are useless and far to unreliable to make a diagnosis off of. Most Dr's are clueless about hsv and testing. All you can do is test at 12 weeks with igg only. No need for a western blot yet.
I haven't heard the west overhieghts clinic closing and i know Teri Warren is at the asha website answering questions.

[Maggyfae]

is there a great significance between testing at 12 and 16 weeks? Or is 12 as sure as 16. The wait is driving me mad but I want to do this as right as possible. Thank you for the response.