Understanding IgG/IgM results - I'm panicked

Hi Dr. Warren

You seem to be so helpful to so many on this forum and I was hoping you might be able to shed some light on my recent test results.  I had unprotected oral sex and intercourse on 02/01/13. I got a full STD test done on 02/04/13. I just got the following results back:

HerpeSelect 1 ELISA IgG: 42.00 positive
HerpeSelect 2 ELISA IgG: 2.50 positive
HSV 1 IgM Titer: 1.40 positive
HSV 2 IgM Titer: 1.20 positive

Also, I have not had any sores or outbreaks in the almost two weeks since possible infection. Can you help me understand whether I definitely have Herpes? Whether this might be a false positive or low positive? Could the high IgG 1 reading affect the HSV 2 reading? Should I follow-up with additional testing? I am panicking about this and could use your help. Thank you so much for your time.

Thank you,
Very Scared

[Terri Warren, RN, Adult Nurse Practitioner]

I'm a little confused by your results.  I've never seen a 42.0 result on HSV 1 or 2 - there must be a typo in there somewhere.  The highest I have ever seen is 16.  Have you ever in your life had a cold sore on your lip?  Have you ever had any genital lesions?  Your HSV 2 is a low positive result.  This means that the result may or may not indicate that you have HSV 2 infection.  The fact that you have had a recent sexual encounter that was unprotected complicates the situation.  You will need to wait a few months for a truly accurate test result.  This might be helped by you asking your recent partner to be tested for herpes.  If that person is negative, it could shorten your wait, depending upon when your last encounter was previous to that.  

Another alternative is to get a western blot antibody test now.  If it is positive, then you need go no further in terms of waiting.  If it is negative, you would still need to retest when the waiting period is over unless you redid the herpeselect and it was much higher.  

I deal with testing all the time, so this is pretty clear to me, but sometimes, I shorten things inadvertently, making it not understandable by others.  Please let me know if I can clarify.

Terri

[Veryscared23]

Hi Grace, any thoughts here? Thanks very much

[Veryscared23]

Hi Terri,

Thanks for responding to my post.

I have never had a cold sore or genital lesion in my life. In all of the research I've done, the HSV1 result seems so strange to me as we'll. could my results be flawed? The lab was not Quest or Lab Corp - could that matter?

My previous encounter was on 01/01/13 and I was tested on 01/21/13 following that and all STDs came back negative including herpes. Could a test only two days after the 02/01/13 encounter be accurate?

I would like to get the Western Blot test given the low positive. Can I get that now and then again in two months or so?

Thank you for your time.

[Terri Warren, RN, Adult Nurse Practitioner]

Perhaps the test was not one of the usual tests that are used.  

You can get the western blot but it is kind of a waste of money right now because you can't know if it is accurate or not.  

You can get the test in two ways - you can call my office and become a phone patient of ours and we will order the test for you or you can send to the University of Washington and have them send you a test kit and have your provider draw your blood, spin it down and send it back.

Terri