Misdiagnosis? Confusing HSV 1 & 2 Test Results and a Misinformed Doctor

Hi,

My ex-boyfriend had herpes so I got into the habit of getting regularly tested (I always tested negative and never had symptoms), both during and since that relationship, which ended over a year ago. In February, I tested negative (HerpeSelect) for both HSV1 and 2 (HSV1 IGG: 0.8, HSV2 IGG: 0.54), as I always had.  

This past summer I dated someone with HSV1, who took Valtrex for frequent cold sores. He never had a cold sore in the time that we dated, and to this day, I've never had a cold sore. But when that relationship ended in August, I decided to get tested for everything again, on August 18. My results: IGM: 1.29, HSV 2 IGG: 0.2. I understand that IGM is not type-specific, is unreliable, and that there's a school of thought that anything under 3.5 should be considered negative (all of which I had to educate my doctor about, as he had diagnosed me, based on these August IGM results, as "positive for types 1 AND 2" and then put me on Valtrex for 2 weeks - this was before I did my own research and educated myself about IGM/IGG etc...so for a month I was devastated, thinking I had a type 2 diagnosis).

I got re-tested on 9/21/10 (HerpeSelect). My results: IGM: 2.09, HSV1 IGG: 0.2, HSV2 IGG: <0.2. My question is, if my IGM is a true positive, shouldn't my IGG numbers have started to elevate by now? And why over time would my IGM number be increasing while my IGG is apparently decreasing? My last possible exposure (the guy I broke up with in August claims to only have HSV1 and not HSV2) was August 11, 2010. I realize it's only been 7 weeks and I should get tested again at my 3 month mark, but I've been pretty freaked out about the possibility of having contracted type 2, should my ex not know he has type 2 (he's supposedly never had a type-specific test and his doctor won't give him one because he says they're unreliable). I have no symptoms and have never had any lesions/ulcers that I'm aware of. In the past I've had some infrequent yeast infection-type itching...but I've always tested negative for HSV1 and 2, and never had a positive IGM result until now. (I guess it's possible I never had an IGM test in the past, I'm not sure.)

I'm just hoping that the IGM is a false positive, or that at worst, my ex gave me type 1 - and ONLY type 1. How likely   is it, given the info above, that the IGM could be a false positive? It's just hard to be in doubt and have to sit and wait until 3 months...especially after my doctor's office so nonchalantly handed out a type 2 diagnosis without even knowing if that was the case...Once "type 2" is planted in your head, it's tough to stop thinking about it.

Sorry this is so long! Thanks for any insight you can provide!

Worrier1099

[Still_Worried_]

As you already know, IgM is worthless, period.  Completely disregard them.  They are typically not indicative of a true infection, regardless of their level or fluctuation.

As for your IgG, you are completely negative.  There will be fluctuations in these tests, which is completely normal.  Anything below <.90 is negative, no matter if it's <.2 or <.70, for example.

No reason to think your ex (who had HSV I) also had HSV II.   I don't see any reason for further testing but if you won't be able to move on without it, then that's fine.

[gracefromHHP]

your provider needs to stop ordering and treating based on +igm results on their patients. it's poor medicine in general, worries patients needlessly as well as wastes their money several times over.  

up to you if you want to do additional testing or not.  best thing would be if your ex partner from august would get hsv2 testing and share his results with you.  

http://www.ashastdwebstore.org/herpes-testing-toolkit.html  for under $3 you can buy this , highlight the igm info in it and give it to your provider for them to learn more about herpes testing and how to best serve their patients.  At this point with the igm tests for herpes we have, treating based on a +igm is poor medicine and leaves them vulnerable for legal action.

grace

[Worrier1099]

Grace,

Thank you so much for your response. I wish my ex-partner from August would get tested, but ever since his doctor refused, he hasn't been responsive to my request and I can't force him. Which is why I wanted to try to reassure myself a bit during my waiting period until the 3-month mark by finding out the likelihood of getting two false positive IGM results in a row, given my situation. If my IGM result were actually a true positive, wouldn't my IGG #'s have started to elevate even a little bit by now (7 weeks since last possible exposure)? Instead, over the past 7 weeks, my IGM has increased and my IGG has actually decreased - could that indicate a likely false positive IGM result to you?

I will definitely pass along the toolkit to my doctor...makes me feel not very confident about our medical care when the patient knows more about accurately diagnosing a condition than the medical professional!

Thanks again so much for your replies, much appreciated!

[Worrier1099]

Thanks Still_Worried_ for your response as well. I'm hoping you're right - I would just like some certainty but 2 (hopefully false) positive results are not putting my mind at ease...but knowing that the IGM test is so unreliable does help. Hypochondriac that I am, I'm going to get tested again at the 3-month mark and will report back then.

Thanks again for your response!

[gracefromHHP]

we used to have a post going here for folks to report their follow up on + igm results. No idea where it's gotten to at this point.   Not many folks who have a + igm  and no symptoms come back with + igg results later on.  

At this point nothing to do but wait and repeat your igg later on for peace of mind since it looks like you need that.

grace

[maybelle81]

update?