HSV Results

I received results from my doctor this week, and am trying to remain level headed about this, but it's not easy.  My doctor said I have HSV, and that it shouldn't matter whether I have Type 1 or 2.  I am not in a monogamous relationship. I have had unprotected vaginal sex twice in the last year with the same man. I have given and received oral sex with two different men in the last year. I feel stupid, angry, and like I'm being punished for my promiscuity.

The test results were as follows:

HSV Ab Screen IgM Detected
HSV Ab Titer IgM 10 H

HSV1 Ab IgG 4.2 H Positive
HSV2 Ab IgG  0.00 Negative

My doctor focused on IgM result and told me I probably contracted HSV within the last 12 months. She said HSV1 can be transferred to the genital area. I have had a minor irritation/sore in the genital area off and on for the past 6 months.  I kept trying to understand the results and asked her questions about which type I have, as it looks like I have type 1, which I've always had, and had not been concerning to me previously. She gave me an Rx for Acyclovir 800 mg 3xday for a week then 400 mg maintenance, which I began yesterday. I've always tested positive for HSV1 and get cold sores about 1-2 times per year. I've never had any symptoms in my genital area until about 6 months ago.

Questions for you:

1.  Was my doctor correct in her interpretation of the results?
2.  Do I need to be concerned with an HSV1 positive result and/or the IgM result?
3.  Was my doctor's treatment correct?  If not, what would you recommend?
4.  Should I get a different, more specific test?  If so, what would be the value and are they covered by insurance?
5.  What is the difference in Type 1 vs Type 2 in regards to spreading it.

I so appreciate your advice!!
  

[petal130]

Dear, you already KNOW you have oral HSV1!!! This is a no-brainer! Your IgG test was in fact positive for HSV1, confirming what you already knew. 70% of the adult population have oral herpes, it's incredibly common!

You are negative for HSV2.

She is wrong about autoinoculation - it is in fact rare to transfer an existing HSV infection to another body part. People who have it orally and genitally almost always get it at the same time during sexual encounter (say you have intercourse and give oral sex to the person who has herpes).

An IgM blood test is not considered a valid test for herpes - disregard it. The IgG type specific test is what you want to go by.

As to your genital "symptoms", the ONLY way you would know if it was herpes was by a swab/culture of an active lesion. Having a symptom "off and on" for six months - especially were it HSV1 genitally, is most likely not herpes.

I don't know too many folks who take suppressive therapy for oral herpes. I have genital HSV1, and even I don't take it suppressively, I only take it for outbreaks.

Your doctor is incorrect as to it not being important which type you have. It can make a difference on the frequency of outbreaks, and also if your partner has the same "type", you don't have to worry about transmitting it to him/her.

[MaryJo44]

Kathy,

I just posted a long message a few minutes ago.  Read my post.
We are the same.  I have had HSV1 since childhood.  My IgM
was high positive too and I was convinced by counselors and doctors
that I had HSV1 too long to produce such a high IgM.  WRONG!

100+ days later, was HSV2 negative.  Your results will likely
be the same as mine.  

MaryJo

[anne1211]

Hi Kathy,

I just posted updated results on a similar situation.  Igm tested positive for Type 2, but Igg was negative.  One doctor said I had it, another said I did not.  To calm my nerves and be sure I was retested at 3 months after initial tests.  100% negative for Type 2.  Igm tests were wrong, just as I was told here.

Hope this helps.  

[anne1211]

(I made an error on the name, sorry)

Hi Kathy,

I just posted updated results on a similar situation.  Igm tested positive for Type 2, but Igg was negative.  One doctor said I had it, another said I did not.  To calm my nerves and be sure I was retested at 3 months after initial tests.  100% negative for Type 2.  Igm tests were wrong, just as I was told here.

Hope this helps.