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Need help understanding my herpes IgG results, please.

I had a hysterectomy in 2018 due to fibroids. Since my surgery, I have not had sex until November 2021. Prior to that, the last time was the end of 2017.  We only had vaginal and oral sex a few times. Forward to March 2022, we met up again and started having casual sex whenever our schedules allowed. The last time we had sex was 3 weeks ago.  About 13 days later I noticed small acne-type bumps that I assumed were ingrown hairs from shaving. 2 days later the area looked more like a cold sore. I have had cold sores in the past, but not very often. Since March, neither of us have had anything that resembled blisters or lesions. I was tested 6 days ago.

My results
HSV 1 IGG, TYPE SPECIFIC AB - 32.90
HSV 2 IGG, TYPE SPECIFIC AB - 8.22

Since receiving my results I have been a mess trying to comprehend what all this means. I have since started using acyclovir 5% cream on the area where the blisters were. Since I have had cold sores in the past, I would expect to see the HSV 1 IGG result positive, but why so high? What is freaking me out the most is the high number for my HSV 2 IGG. He was tested yesterday morning, so I am waiting on his test results

We ordered our tests through Ulta Lab Tests. I insisted on the basic STD panel, which included the Herpes Simplex Virus 1/2 (IgG), Type-Specific Antibodies. I am now wondering if we should have ordered the Herpes Simplex Virus 1/2 Antibody (IgM), IFA with Reflex to Titer. I am hoping that the IGG test was the correct one. Lastly, our oral and vaginal sex has been unprotected. I am more embarrassed by my lack of judgment when I should have known better. I am sure I will have a few more questions once his results are back.
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134578 tn?1642048000
So, what does your doctor say? Did you just get online and order some tests, or is this under a doctor's care?
Helpful - 0
5 Comments
I pretty much freaked out and got online and ordered some tests.  I have a telehealth with my nurse practitioner Tuesday.  As, for the cream, I am using a very old tube that was prescribed to me over 3 years ago for a cold sore.  
Can someone please explain these numbers to me please. His results came back and the results were HSV 1 IGG - >58.00
HSV 2 IGG - <0.90.
Your hsv1 isn't really all that high, it just means it's an established infection. That's not surprising, since you expected to have it.

The IgM test is unreliable and you don't need to take - you actually shouldn't.

So your hsv2 IgG test - it looks like it means you have hsv2. If the cream isn't working, it's hard to say that it's not working because the spots you're seeing aren't hsv2 spots, or because it's old.

Also, you can have hsv2 and have ingrown hairs or acne.

Not to give you false hope, but there are false positives on the hsv2 test. Typically, the false positive range is between 1.10 and 3.5, but Terri Warren, who offers the Western Blot confirmatory test, has seen false positives in the teens.

Your results don't have a high chance of being a false positive, but with vague symptoms, it's possible. Your provider can order the Western Blot, or you can go through Terri Warren - https://westoverheights.com/getting-a-herpes-western-blot/

Your provider will probably tell you to accept that you have herpes, so prepare for that. If you want the WB, you can get it through Terri, but you'll have to self pay.
Thank you for your response.  I had a telehealth and was prescribed a 10 day treatment of generic Valtrex.  My next question has to do with my partners results. Since his HSV 2 came back normal, should he retest? If so, when would be the best time to retest.  Also, his HSV 1 was >58.00. Looks like he has been exposed in the past, but why is his number much higher than mine?
So first, his hsv1 results - he wasn't "exposed" in the past, he was infected in the past. It means he has hsv1. He can infect someone with hsv1, even if he has no symptoms. Upwards of 90% of people with hsv1 orally never get symptoms. They still shed the virus, which means the virus is active on the skin without symptoms, and it can transmit at that time. (It doesn't always transmit with shedding, but can.)

The number on the test - your 32.90 and his 58.00 - doesn't mean a lot more than you definitely have it. The test looks for antibodies, and it does that by looking for things that are similar molecular weights to those antibodies. Sometimes it picks up on things - normal blood proteins - that are similar in weight.

It doesn't mean that he has a better chance of getting an outbreak, or that he is more infectious. It doesn't mean that he has had it longer, or that he gave it to you. You were both probably infected long before you met - many people are infected during childhood from well meaning adults who kiss you.

You could both test next week and get different results, too. You might get a 35, and he might get a 52. It just doesn't mean anything, other than it's not a brand new infection.

Your partner can test at 12 weeks on the hsv2 IgG for a conclusive result, if you aren't continuing your relationship.

If hsv2 is the only thing stopping that, though, I'll be sorry to hear it. If you are in a monogamous relationship with someone, have sex 2-3x a week, the chances that your male partner would get it, with you simply avoiding sex during outbreaks is 4% a year.

If you use daily valtrex (generic or brand name) OR condoms, it's 2%.

If you use valtrex AND condoms, it's 1%.

In any case, I hope that helps.

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