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?
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.
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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