Herpes and Pregnancy

[Jim197]

In October my wife had a rash on her butt.  She went to see her OBGYN and he said it was definitely herpes.  He also took a culture and bloodwork.  Both the culture and bloodwork came back negative.

Just to play it safe I went and got my bloodwork done.  My Igm came back positive, but Igg is negative.

My wife is now pregnant and she is very concerned.  The doctor said that if she developes another outbreak she may need to abort the pregnancy if she does not have the antibodies.

So my question is, is there any chance that my wife has herpes, but did not develop any antibodies?  Is there any cause for concern here, or is the possibility higher that the original diagnoses was incorrect?

Thanks for your help!

[stillHurting]

There's about a 5% chance that a long standing HSV-2 infection will not result in any detectable antibodies using HerpesSelect IgG test.  If the infection is recent, then the odds are much, much higher of a negative result.  But since you're both married, I'm assuming the odds there are pretty low?

IgM is a pretty unreliable test, but then again so is culture.  Have you ever had symptoms?  Or have you had any exposures lately?

And were you both tested for HSV-1 and HSV-2 or was it just HSV-2?  Since genital HSV-1 is a possibility.  That might also explain your positive IgM with a negative IgG for HSV-2, if you are having asymptomatic shedding of HSV-1.

PCR is a better test than culture, you could try that the next time she has an outbreak, if any.  Culture provides a lot of false negatives.

Right now, I'd say odds are pretty good that the rash was not any sort of HSV.  But I wouldn't be confident enough to say no chance at all, especially if the doctor thought for sure that's what it looked like.  If it were me, I'd take another IgG test in a couple of months.  

You could also take a different test, such as the Western Blot, which can pick up some cases which were negative with HerpesSelect (and vice versa).

[Jim197]

Thanks for the answer.  To answer your questions, I have not had any symptoms and yes we were tested for HSV 1 and 2.

[stillHurting]

Well that's interesting.  So I'd say the two most likely things are either it's a recent infection, or it's not HSV at all.  And my money would still be against HSV since IgM is not a reliable test.

I guess I'd still just either wait for another outbreak, or just take another IgG test a little while later.  But I still think most likely it will be negative.

[DidisMirage]

I agree! The IgM can come back positive for the other herpes viruses such as chickenpox, CMV, EBV, etc. I know because it happened to me! My IgG was negative.

I freaked out a little even though I know IgM is flimsy. I re-tested at 12, 16, and 24 weeks and again at 8 months post exposure and continue to test negative for HSV-1 and HSV-2 IgG. You can never retest too many times, so next time ignore the IgM. There's a lot of ignorant doctors out there who don't know or refuse to learn how to read results.

[DidisMirage]

Oh yeah and then with the results after, my IgM was coming back negative too!! So don't worry until you are definitely sure :}