High HerpeSelect 1 Elisa IgG, Negative 2 IgG

[bubsterino]

Hi All -

Been browsing the forum for a few days and very thankful for the good information from the team.  I have read a lot of information about IgM vs. IgG scores and have spoken to my doctor about them.  I regularly test for STDs as part of annual physicals, but realized they never tested me for HSV.  I have been aware through testing in the past that I had HSV 1.  I got the 1 and 2 test last week out of curiosity and I received the following results:

HerpeSelect 1 Elisa IgG = H 24.50 (positive >=1.10)
HerpeSelect 2 Elisa IgG = .12 (negative <=.9)

HSV 1 IgM, IFA = H Positive
HSV 2 IgM, IFA = H Positive
HSV 1 IgM Titer = H 1:40
HSV 2 IgM Titer = H 1:20

I have a few questions (and appreciate any additional comments on the test results):

1)  The HSV 1 IgG score seems very high compared to what I've seen from other posts - what's to make of that?
2)  I was told that I may have an early infection and to come back in a month for additional testing - I'm really not sure whether or not I have HSV 2 at this point, but have already spoken to my partner about this.  Any insights on whether or not these tests are indicative of an early HSV 2 infection?

Many thanks for the support.

[bubsterino]

thanks so much for your emails/support.  received a negative result from the most recent IgG test.  For purposes of being thorough, I will retest in a few months, but Dr. felt strongly that given the exposure time, the IgG test would have at least been in the equivocal zone at this point.

[Fleetwood20]

Less than 0.5% of the population, maybe somewhat less, has an oral HSV2 infection. It sheds an average estimated 3-5 days a year and for some people it may not at all. On most of these days there will not be sufficient virus to result in transmission.

Hence this is next to zero chance. The only practical transmission opportunity was for HSV1 and as you have that, the odds of a genital infection are also next to zero.

Only you've had a positive IgM would you even need to think about a further test. Only get IgG at 16 weeks and negative is conclusive for HSV2 at that point.

[bubsterino]

I probably had a FEW cold sores when I was in my teens.  That was confirmed positive many years ago in a test, but I don't believe I was ever tested for HSV 2 at that time.  

Thank you again for clarifying the lab numbers - I have been concerned about this because of worrying about giving something to my partner, and I was not satisfied with the answers I got regarding the test from the clinic so I went to another doctor a few days ago to have another test administered.  Awaiting those results now, but understand there's a window still of uncertainty...

I think the encounter I'm concerned about prior to my relationship involved unprotected oral (receiving) from a woman of unknown status...I realize there's not great data out there on this stuff, but what are the chances from a one time encounter of contracting HSV 2 from that?

[Fleetwood20]

One thing we didn't cover was the HSV1 result. This is most likely indicative of an oral infection from your youth, have you ever had oral cold sores in your life?

Many labs to report the actual value, nothing strange about a 0.12 reading it is a very clear negative. Other labs report <0.91 as I suspect there are too many questions about 0.6 and 0.8 results etc. that are still negative but people get nervous about why they aren't really low like your reading.

You produce antibodies from the time of infection not from the time of first outbreak if that does not accompany infection. So no, dormancy is a term used for the clinical outbreak but does not apply to antibody manufacture. I would suggest that if for some reason, most unlikely, that you were infected with would be well inside the last 90 days.

[bubsterino]

Thank you both for the replies.  The results clearly state 24.50 for type 1, and .12 for type 2...

Does it strike you as odd that they typically don't report below .9 and they gave me a result of .12 given what Life360 mentioned about reporting levels?

The relationship is recent so there is a potential for someone else inside of the 16 week window.  Is it all possible that I've had this for years and it's just starting to show since I've never been tested for it until recently with the prior test being many many years ago?  

Thanks so much for the replies.

[Fleetwood20]

The high reading for HSV1 is of no particular meaning, apart from a healthy strong level of antibody detection by this blood test. A lot of people will test at level. Some labs cut of the readings at a level, say 5.

Type specific tests for IgM are highly inaccurate and frequently through up false positives. Once you have one type of HSV then type specific IgM testing becomes quite invalidated, the body will not produce IgM antibodies with any reliability associated with an infection or not.

I believe it is still the case that the FDA has not approved any type specific IgM testing.

The IgG is a clear negative and rules out infection conclusively except theoretically for up to the past 12 weeks. If you've had just the one regular partner who is negative, then you will be negative no question.

Regardless of an IgM result for you, another partner in the 12 to 16 week window before the test is theoretically a source as much as it would be for anyone.

I suspect this isn't an issue for you and you would hence be a clear negative to the present day.

[Life360_Dave]

Hi, most labs simple report all results as 5 or above as greater than 5.. However i think the values you posted are not correct as you say your hsv2 is .12. Value numbers stop at .9 not .12