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Antibody titers
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Antibody titers

I have a patient who has been diagnosed with Mollaret Meningitis.  She has also tested + for Herpes type 2.  We are proceeding with immune support, antivirals and TAAT.  I was wondering if the viral panel( IgG IgM) testing  would be useful in tracking the viral count of this disease to see if the regimine I have designed for her is making a difference over the next several months.  If so, what time frame would you recommend for testing and retesting?

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101028_tn?1348750963
First off we don't recommend the herpes igm test EVER. It's not a very worthwhile test for when it comes to herpes.  “common use of inaccurate antibody assays to identify infection status with herpes simplex virus type 2”  Rhoda Ashley morrow, Zane Brown  American journal of obstetrics and gynecology ( 2005), 193, p.361-362   is a good article to read for more info on that.  It's not consistantly + due to hsv being active either which also doesn't make it useful for what I assume you wanted to use it for.  

What was your patients hsv2 igg?  was it over 3.5? Was hsv2 detected in the csf too?  As long as your pt really is hsv2+, there's no reason to continue checking hsv2 igg levels.  They aren't going to get lower based on treatment.  I'm not aware of any reason to do anything but treat with antivirals  and assume they worked. If your pt continues to have reccurences of meningitis then suppressive therapy would be the best course of action.

Hope that was the info you were looking for.

grace
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Thanks
Does this mean that even though my patients is on antivirals and immune support her antibodies will not go away. what did antivirals do then if not remove or reduce antibodies or treat the disease??
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101028_tn?1348750963
correct - the igg will always be positive for hsv2 regardless if you treat it or not.  

Antivirals help to disrupt the viral replication process so that it goes back into dormancy again faster so that the pt feels better faster.  

grace
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207091_tn?1337713093
Hi there -

I'm not sure what you "do" that you have patients, but one of the most frustrating things about herpes is that there is no cure.  None.

Boosting the immune system might help prevent outbreaks, but its not going to cure her.

We have no cure for any virus at this time, herpes included.

Aj
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207091_tn?1337713093
Oh and Mollaret Meningitis is self limiting.  She will probably be feeling a lot better in a couple of weeks, even if you did nothing for her.

Aj
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