Second opinion of sorts / IgG results

[cj_nc]

Good morning/evening.

I'm looking for some clarification as I don't feel that I'm getting the best knowledgeable opinion from my primary doctor. But first let me give you a little bit of the story before results. FYI, I have being getting cold sores on my lips since I was 16 for as long as I can remember. I'm now 32.

I was told about 3 weeks ago that I was HSV-2 positive. I was in shock so I didn't ask any questions that day. I basically just took the news and the prescription that was given and left. I've felt psychologically out of it ever since as I don't take any meds regularly. My blood work was taken March 2nd and I got the results on March 12. The reason I went to get tested is because I felt burning when I urinate every once and awhile. No visible classic Herpes symptoms.  I had sex about a week before that with current girlfriend. The burning has come and gone a few times over the past year as far as I can remember. Last year around June 2009 this girl I just started seeing (current girlfriend) said she had Chlamydia so I went to my doctor to get a full run of STD tests. My doctor did not even test for Chlamydia he just gave me some Antibiotics which I completed, however the girl that I was seeing had sex again before we should have as we didn't wait 7 days and did not go back for follow-ups. More on this later.....

So over the past few weeks I've researching and reading up on the the virus, testing, etc and I don't understand why I didn't test postive for HSV-1 in the past. I know I had STD tests in 2008 and 2009 and again this year but have never understood why the HSV-1 has never shown up. I get a couple a cold sores a year, nothing recently.

So today I went and got a copy of my results and I'm confused. I hope you guys can shed some light. I also don't understand why the doctor had 2 sets of blood tests for  Chlamydia tests when he could have just gave me a urine test. Here are the results as they appear on paper from Spectrum Laboratory.

2009
Herpes I and II, IgM,              Reflex
HSV I/II Combined Ab, IgM          Not Detected
Reference range:                   Not Detected
HSV I/II Ab Titer, Igm             Report Not Indicated

March 2nd 2010
Herpes I and II, IgG with Reflex            Out of range
Herpes 1 and II, IgG                        28.2     H
HSV 2 Glycoprotein G Ab                     0.25

The test HSV 2 Glycoprotein G Ab, IgG has been reflexed as a confirmation of the positive result obtained for Herpes I and II, IgG

Chlamydia pneumoniae IgG              1:64    H


So basically what I'm asking is did I get a type specific test or not. Could this be a combo IgG test that is detecting my HSV-1 that I've assumed I've had? Also is there a chance I still could have Chlamydia? I went for a urine test at another clinic today as my family practice didn't give me a warm and fuzzy the day I got my results. The doctor even brought in another younger PA to help translate results.....

Any advice will be greatly appreciated.

CJ

[gracefromHHP]

In theory, the igm would only be present for a few weeks after being newly infected. A oral herpes infection for many years should never show up on the igm test ( in theory , reality is it sometimes does which is why we never recommend igm testing due to the high false positive issues ).

#4 - already explained this when I discussed your combined results.

grace

[cj_nc]

Grace thanks for the response.

I find it absolutely astonishing that a health care provider could give me this news without being 100% certain. While I don't think I'm in the clear yet as I girlfriend of eight months has yet to be tested this entire experience has been humbling to me on so many levels. I don't think I'll ever be the same again, and thats not necessary a bad thing. I was living a Russian roulette type of life before my current girlfriend....

I also got my Chlamydia results (from different doctor) and bills for my HSV testing back on the same day Saturday. Could you clarify a couple of assumptions for me Grace?

1) The urine came back negative so this doctor told me. So I will look for other reasons why I experience this burning every once and awhile assuming I don't have HSV-2.

2) Is it safe to assume that the reason my HSV-1 never has shown up in the past is because my doctor has always ordered the IgM tests which becasue I've been infected for so long, my IgM levels come and goes???

3) My doctor also told me I probably had a recent infection when he originally told me my HSV results. Am I correct to assume this cannot be done with just IgG testing? From the results I gave you yesterday how could he or his assistant come to this conclusion?

4) What does this statement mean on my original results from above? " The test HSV 2 Glycoprotein G Ab, IgG has been reflexed as a confirmation of the positive result obtained for Herpes I and II, IgG"? This was on the same page as the combined 28.2 number, btw

Its almost like the doctor didn't even read the 3rd page of my results. My lab work was 3 pages. Page 1 had all the info I listed in my original post. (minus the 0.25  HSV-2 figure) Page 2 was all Chlamydia info and page 3 had this line:

HSV 2 Glycoprotein G Ab                     0.25



Thank you for you time Grace

[gracefromHHP]

2009 you had igm testing done which was a waste of time and money

this march, you had a combined hsv test done which came back positive. this test was totally inappropriate to order on you since you already know you have hsv1 orally so of course it will come back +.  Your provider erred in ordering the combined test probably due to under education about herpes blood testing :(

Because your combined hsv test was +, the lab did a hsv2 igg . some labs operate this way under the age old assumption that most adults do have hsv1 so why test for it and just check to see if they have hsv2. this is a very flawed assumption but some labs still test that way ( it's the default herpes testing for labcorp unfortunately ).  your hsv2 igg was negative.

so bottom line is - you don't have hsv2.  your current partner should get tested to see what her hsv1 and hsv2 status is since you went through testing.  that way you'll know that  you don't have to worry about herpes in this relationship.

following up with urine testing for chlamydia was the best idea too.

grace