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HSV-2 diagnostic, false positive?
I have never had (or never noticed) physical signs of genital herpes unless a possible ingrown hair would indicate herpes, but never a blister and nothing ever lasted more than a couple days
I dont recall ever having cold sores as a child but i assumed HSV-1 would be positive due to the high prevalence
I receive a phone call from the urgent care clinic. He said I was positive for both HSV's I asked to have the results sent to me so i could have a hand copy for various reasons.
Through research online of HSV blood samples and I came to the conclusion though they are a great in conjunction with symptoms but they do pose the possibility of error.
Today; I received the hand copy of the results and was confused to the reading of the IgM screening because from my understanding this test is unable to determine whether it is HSV-1 or HSV-2 the results read as;
HSV 1-2 IgG & IgM antibodies
HSV 1 IGM - NEGATIVE
HSV 2 IGM - POSITIVE
HSV 2 IgM Ab Titer 1:20 AB 5.00 H <.90
HSV-2 IgG antibodies .16 1.10. or should i assume ive been infected resently
Im already inclined to get retested in 2 months as that will provide the most accuracy as my last sexual encounter was 4 weeks ago.
I dont recall ever having cold sores as a child but i assumed HSV-1 would be positive due to the high prevalence
I receive a phone call from the urgent care clinic. He said I was positive for both HSV's I asked to have the results sent to me so i could have a hand copy for various reasons.
Through research online of HSV blood samples and I came to the conclusion though they are a great in conjunction with symptoms but they do pose the possibility of error.
Today; I received the hand copy of the results and was confused to the reading of the IgM screening because from my understanding this test is unable to determine whether it is HSV-1 or HSV-2 the results read as;
HSV 1-2 IgG & IgM antibodies
HSV 1 IGM - NEGATIVE
HSV 2 IGM - POSITIVE
HSV 2 IgM Ab Titer 1:20 AB 5.00 H <.90
HSV-2 IgG antibodies .16 1.10. or should i assume ive been infected resently
Im already inclined to get retested in 2 months as that will provide the most accuracy as my last sexual encounter was 4 weeks ago.
Best Answer
Hi it is believed that igM appears first then dissapears so a positive igM and a negative igG could mean a recent infection. However we dont use igM do to the high prevelance of false positive. You can retest at 8 week as a good indicator
To elaborate,my wife's igm for hsv 2 came back at 1:40 after 3-5 weeks post exposure. The igg was negative. It said the igm was confirmed by a second method (IFA). Is there still a chance this is false postive and she doesn't have it or does the IFA method confirm it''s not false?
If an IGM came back positive and they confirmed with IFA, does that mean it really is positive?
Many doctors will just follow the text book response without have a deep knowledge of the implications of HSV testing. I'm sorry that you appear to have been caught up in one of these circumstances.
Best to retest 12 weeks post last possible exposure.
Best to retest 12 weeks post last possible exposure.
So i shouldnt be too concerned of the HSV-2 IgM titer of 1:20? I apologize for the repeated questions as i have general anxiety disorder and having a phone call telling me i have HSV2 has been very concerning
I'm sorry you did mention you are HSV-1 positive but just didn't show the result explicitly in your listing. A result over 5 would be a confirmed infection.
That also changes things more to the erratic. Once you have a HSV type, all IgM antibody production becomes more erratic. Not sure why but probably to do with the presence of effective IgG antibodies already.
As for the IgG HSV2 reading, that is a clear negative. Every test has a control minimum value, it is never zero. A value of 0.16 to me looks exactly like a control minimum. This means not a trace of IgG HSV2 antibody to be found.
That also changes things more to the erratic. Once you have a HSV type, all IgM antibody production becomes more erratic. Not sure why but probably to do with the presence of effective IgG antibodies already.
As for the IgG HSV2 reading, that is a clear negative. Every test has a control minimum value, it is never zero. A value of 0.16 to me looks exactly like a control minimum. This means not a trace of IgG HSV2 antibody to be found.
Thanks for replying first and foremost. Im not sure if i misunderstood the end of it or not tho, you mentioned i dont have HSV-1 as the symptoms wouldnt randomly appear, the IgG numbers however said 5.00> H(high) for hsv-1, i thought that wouldnt essentially guarantee an HSV-1 diagnosis.
however, the HSV-2 IgG .16 makes me question the HSV-2 IgM positivity
however, the HSV-2 IgG .16 makes me question the HSV-2 IgM positivity
The tests can distinguish between HSV1 and HSV2 IgM antibodies. There are two major problems with such a test though.
First, the production of IgM antibodies is erratic. Not everyone reliably produces IgM antibodies upon infection, or subsequently for that matter. Even if they do it may be for only a matter of days.
Second, false positives are enormously common for this test.
So a positive tells you very little as it could be false, and a negative tells you nothing as you may not produce IgM antibodies or not at the time of the test. Not a useful test at all!!
You do not have HSV1 such that a primary infection with HSV wouldn't suddenly show up. You'd have had symptoms.
First, the production of IgM antibodies is erratic. Not everyone reliably produces IgM antibodies upon infection, or subsequently for that matter. Even if they do it may be for only a matter of days.
Second, false positives are enormously common for this test.
So a positive tells you very little as it could be false, and a negative tells you nothing as you may not produce IgM antibodies or not at the time of the test. Not a useful test at all!!
You do not have HSV1 such that a primary infection with HSV wouldn't suddenly show up. You'd have had symptoms.
I do plan on getting retested. But, what is the HSV-2 IgM titer of 1:20 represent, i thought IgM tests couldnt differentiate between HSV1 and HSV2
HSV 1 IgG antibodies >5.00 H <.90
HSV-2 IgG antibodies .16 <.90
Index Values for HSV-1 and HSV-2 antibodies
1.10 positive
HSV-2 IgG antibodies .16 <.90
Index Values for HSV-1 and HSV-2 antibodies
1.10 positive
HSV 2 IgM Ab Titer 1:20 AB 5.00 H <.90
HSV-2 IgG antibodies .16 <.90
Index Values for HSV-1 and HSV-2 antibodies
1.10 positive
So should I assume that the IGM test was a false positive for HSV-2 being that i have had chicken pox before and the fact I am HSV-1 positive for the antibodies both which can cause cross re activity for the IgM test. Along with having extremely low HSV-2 IgG antibodies. ".16 compared to positive being >1.10. or should i assume ive been infected resently
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Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
