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hsv-2 igg test result question
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hsv-2 igg test result question

My situation....I had unprotected sex with a new partner on October 3rd. The next day he told me he had herpes, but hadn't had an outbreak in a long time. At that point I believed what he did, that you could only pass it on during an outbreak. After researching it online, I sadly found out different. I called off the sex until I could get a blood test, since I also found out it was possible to have herpes with no symptoms. Figured I might already have it, then it wouldn't be a big deal that he has it.

Well two weeks later I discovered a mild rash on my lower butt cheeks, just behind the vaginal area. The patches were small and never became open sores....the tiny blisters dried up without bursting, and then the skin shed off a few days later to new pink skin....so I guess it was pretty mild compared to the stories I've read online! I saw the doctor 2 days after I noticed the rash and he visually diagnosed it as herpes. I had to force a blood test since his opinion was "You have it, why waste money on a blood test?" So I called the lab and got the code for the type specific test, which he knew nothing about, but my doctor ended up ordering the non-specific test anyway. The result on that one came back 30.5, which was pointless since I already knew I'd had cold sores in the past. So I went back for another test, type 2 specific igg, on October 27. That was 3 weeks and 3 days after my "encounter" with the known herpes carrier. The result on that test was 1.81.

What I'm trying to figure out is if I just caught this, or if I could have had hsv-2 previously and never had symptoms. Before this partner, I hadn't had sex in nearly a year and a half. If the infection is older than that, wouldn't the number be higher? On the other side, is it possible to have a 1.81 reading just over 3 weeks from infection? I've read that you usually need to wait longer for the antibodies to show up on the test. I'm mainly concerned that I might have had it for years and unknowingly spread it to somebody else. Any help or opinions would be appreciated!

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Avatar_m_tn
It seems unusual, although possible, to have a positive test after 2 weeks.  It's most likely that you've had this for a long time, assuming that the test was accurate.  Any positive result below 3.5 or so is considered a low positive by the experts on this site and they usually would like to see that result confirmed by a western blot test, which would be more conclusive.  Your antibody level wouldn't necessarily be higher if you had it longer.  
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897535_tn?1295210035
It's actually more difficult to transmit herpes than most people think. On average there's a 90-92% chance that you WON'T contract herpes, and that's based on having sex 2x a week annually. The risk of you getting it from a one-time encounter is incredibly small, and unfortunately you don't know that the symptoms you had were in fact herpes (only a swab/culture can tell you that).

Your test was a low positive and done too soon after this encounter. You can wait 3-4 months and re-test, but realize even if positive, if you've never been tested before and it comes back positive, you have no way of knowing how long you've had it. Also, if it comes back with a low positive number again (between 1.1 and 3.5), you'll need to confirm it with a Biokit or Western Blot test.

Your doctor did you no service by visually diagnosing and not doing a swab/culture. A visual diagnosis can be wrong 30% of the time, and must be followed up with proper testing.
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Avatar_f_tn
Thanks for your input CJC and petal. Actually there were 2 encounters, one the day after he told me, because at that point I still believed it was safe. It was later that I started researching online and discovered there was no real safe time. I was definitely stressing over this and I'm sure that could have caused my outbreak 2 weeks later, if it reallly was an old infection. Or if it is a new infection, what I read online sounds like 2 weeks later is typical.

CJC, the test taken at 2 1/2 weeks was the non-specific, and it came back as expected since I already knew I had cold sores in my past. The specific test was almost 3 1/2 weeks after having sex. Don't know if that extra week would make a difference, but wanted to clarify.

I know my doctor did me no service, and his attitude was surprising to me. Having to retest was especially irritating, after I had requested the specific test and even called Labcorp for the test number. I have no insurance and paying for two lab tests, one perfectly worthless, is not really in my budget. Finding a new doctor is on my list of things to do, one who is more educated and understanding about herpes!
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Avatar_m_tn
You're perfectly welcome.  Not that I'm some sort of expert, I've just been researching the same as you, except that I've been doing it for months now.  Grace and others here have been extremely helpful.  

I think that about 50% of people would test positive around 3 1/2 weeks.  I had to wait 12 weeks too, and believe me, it's tough, but totally worth it.  Hang in there!
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Avatar_n_tn
Looking back I am less than satisfied with my health care providers.  5 years ago I asked my ob/gyn how common herpes was.  Told him I dated 2 men that told me they had it and gave me the choice of moving forward in the relationships. (I ran)  Dr said I hope you used a condom.  Told him I didn't have sex with them and he said you could have-- would have been fine with a condom.  Looking back he should have better educated me and suggested I be tested- since so many people don't know they have it.  

Recently after a bad ending to a serious relationship I decided to be tested after learning of his "encounters" with others.  Went to a clinic and said I wanted to be tested for everything.  Lo & behold they didn't test for herpes because it was the wrong day to have the blood sent off.  If I hadn't have pursued it I would have assumed I was tested for everything and clean.  
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897535_tn?1295210035
For those of us here who DO have genital herpes, we try to educate and not instill fear in others (quote "I ran"). Herpes is incredibly manageable in a discordant relationship, and one doesn't need to end it when one person has herpes and the other doesn't.

Condoms only give some protection; herpes in fact can still be transmitted with condom use.

As well, a person is not always positive for herpes because their partner cheated. I know my situation wasn't that way, and many can be in loving relationships, neither knowing their herpes status and yet one has it unknowingly and transmits it.

Clean means you've showered and smell purty. I shower daily, wash my hands frequently and use a nice soap. I have genital herpes and guess what -  I'm also clean!
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Avatar_f_tn
I noticed that Grace is the resident expert with special training. I hope that I will be "graced" by her prescence on my question!
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Avatar_f_tn
So did you go back for the herpes test, and what was your result?
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101028_tn?1348750963
not much I can add. About 1/2 of folks do test + for herpes within 2-3 weeks of being infected. At this point best you can do is wait another 2-3 months and repeat your type specific herpes igg blood test. should you get a recurrence of symptoms prior to that, be seen within 48 hours of their appearance for a lesion culture and typing.

the risk of contracting hsv2 from 2 encounters is very low but not impossible. since you've never been tested before, no easy way to find out if this is a newly acquired infection for you if you do test + for hsv2 with your repeat testing. You can ask your provider to look into herpes avidity testing through the U of washington if you want to pay out of pocket for it. It can tell if a herpes infection was acquired within the last 4 months or not. Honestly though it's probably not worth paying for it - what's important is knowing if you have hsv2 for sure or not, not if it's new or not.

grace
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Avatar_f_tn
This information is confusing. If it's such a low risk to catch genital herpes from 1 or 2 encounters, why are there so many people who claim to have caught it from one night stands? At least that's what I'm gathering from alot of the posts I've seen online, that people have it just because they "messed up" once. Similar to the way you can get pregnant from only having sex once. Once is all it takes if the moment is right (or wrong).

I guess there is no real answer to my question....whether my 1.8 is low enough to assume this is a new infection. Sure I could have had it for a long time and never had symptoms. Just interesting that I broke out with this rash 2 weeks after my new partner told me he has herpes. I still wish I knew for sure, just for my own peace of mind. I certainly hope I haven't had it for years and passed it on to someone else!
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101028_tn?1348750963
Studies have shown that about 1/2 of all folks who assume that they have a newly acquired genital herpes infection, actually are just having their first obvious recurrence of a previous infection. Many folks are not getting the proper testing to even say that they caught it from a one night stand - that's just their assumption because the symptoms turn up after one. You can get it from one night stands, that's how I got it actually, but most folks aren't getting that way, they only think they are.  

follow up on your testing so you can see if indeed this is a true positive or not. At this point waiting 3 months from the encounter is the next step to repeat your testing. if it's still a low positive then then getting a herpes WB is recommended. You also can just wait 4 months post encounter and get the WB then to avoid potentially having to pay for additional testing anyways. The WB is most accurate 4 months post encounter .
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Avatar_f_tn
I've been looking at online test ordering, since it's so expensive to go through my doctor. I found one site that offers type 2 specific for $40 (justgettested.com). Do you have any experience with online ordering and with this site in particular? And as far as the WB goes, how does a person go about getting that test ordered? My doctor really seemed clueless, so it would probably blow his mind if I asked for a western blot, LOL.

Also in reference to an earlier response, somebody mentioned that your rating doesn't get higher the longer you've had the infection. But most everything else I've read indicates that it does. I mean that it will be low in the beginning like mine may be, and once your body has time to build up the antibodies fully, the rating will be higher....like in the 4 to 5 range. What's your opinion on that?

Thanks to you and everyone else so far in answering my questions. Sorry I haven't been real quick to respond but I'm in the middle of alot of house renovations, so the herpes has sorta been at the back of my mind lately. Guess I've already accepted it for what it is, and haven't let it totally rule my life. Good for me!
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101028_tn?1348750963
if your provider uses quest labs they can order up the herpes WB for you. It's test #34534.

it appears that justgettested is only offering a herpes igm if you only order the 1 test so don't bother with it if that is the case.  the herpes igm test isn't worthwhile.

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Avatar_n_tn
I did go back and have the hsv test.  hsv2 was 2.75.  I am considering the western blot test.  My last exposure was in June-- the ending of a 1 year relationship that I found out was only exclusive on my end.  
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Avatar_f_tn
Just wanted to check in and am adding to the original post so you can read back if you want to. After all this time I finally ran across a cheap IGG Type 1 and 2 (Herpeselect to be specific). It's a place called Any Lab Test Now and they have franchises all over the US. The cost was only $49....$39 after the $10 coupon I found on the website. So that's the good news for anyone interested. Check anylabtestnow.com for locations in your area. FYI they do use Quest labs for the testing, got my results in less than 2 days.

Now to the rest of the story. I wanted to get retested since my original reading of 1.81 could have been a false positive, from what I've read online, and especially considering I already knew I had cold sores as a kid. Well unfortunately the verdict stands. My latest test shows Type 1 at 4.95 and Type 2 at 3.68, so it looks like it's for real. My original exposure to the person who told me they had herpes was just over 10 months ago.

With this info, isn't it pretty safe to assume that my first low result was because it was a new infection, tested 3 1/2 weeks after exposure and with an active outbreak? I know it's pointless to go on about it, but I would feel better if I knew I hadn't been running around spreading herpes for years, and that I did actually catch it from this one person 10 months ago.
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Avatar_n_tn
I guess everyone around here will tell you that it is very hard to pinpoint precisely when one was infected. We usually count on symptoms (initial infections usually consist of multiple sores, not a single lesion, and usually occur on both sides of the body, while recurrences usually are limited to one side of the body) and also on seroconversion - testing negative and then testing positive a few weeks later.
In your case, you had a positive test 3 weeks after exposure, which does not rule out a recent infection - as Grace said above, many people show positive within 3-4 weeks. Then you got a higher titer 10 mos. later, which doesn't mean much in terms of infection timeline (titers float a low) but it confirms that you indeed have HSV2.
You didn't say much about your symptoms during that first outbreak. Do you remember if you had multiple sores, bilateral? Flu symptoms, swollen groin pain? Also, your symptoms were most probably mild because you already had HSV1.

Did you experience recurrences after the initial episode? Are you taking anti virals daily?

Last, but not least - if you are worried about having transmitted it without knowing it, relax, really. You can't kick yourself for not being better educated about herpes. In fact, the medical community is not providing the right info, so it's really hard for the average joe to actually care about getting tested for herpes and knowing everything about it. So don`t feel bad about it, really. What matters is that you're seeking info now and doing the right thing.
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Avatar_n_tn
Just to add: it's not that all initial infections will have multiple sores/bilateral. But having such features helps to distinguish initial obs from recurrences.
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101028_tn?1348750963
Unfortunately your hsv2 igg is still a low positive so that means you'll need to get a WB to confirm your status after all :(

have you had any further symptoms since the initial ones back in november?  

grace
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Avatar_f_tn
My first outbreak was on both sides, a little larger area on one side than the other, lower butt cheeks right behind the genital area. It was a pretty mild rash from what I've compared online, tiny blisters without alot of fluid inside. There was a patch on each butt cheek, right opposite each other. The largest patch was on the left and was maybe a little bigger than a silver dollar. Within 2 days by the time I got to the dr. he said it already appeared to be going away. The skin did peel off but in a thin layer over the entire area, like a sunburn, and never had any open or weeping sores/blisters. I can't remember exactly how long that took, but I think the skin peeled maybe a week later. The rash was itchy and I was kind of sore in the surrounding area, but was never extremely painful sitting or anything like that. I don't remember having any flu symptoms, but I was drinking too much due to stressing out over it, so I did feel run down overall...

The dr. did give me acyclovir which I took as prescribed until all signs were gone. There was one time a couple months later that I thought it was coming back just on one side, so I started acyclovir again and it was gone within a day or two. That could have been razor burn, who knows if it was a real outbreak, as I was being extra paranoid and noticing every little thing. I don't take the acyclovir daily and I haven't had any other outbreaks since. I'm afraid of doing daily with acyclovir because I read it can cause hair loss, and my hair is fine and thin enough as it is.

I do take Lysine 1500mg daily, along with zinc and some other choice vitamins. I was taking 1000mg Lysine before this happened, so maybe that also kept the initial outbreak under control. (Not sure if I mentioned this already, but I had read that Lysine helps control "embarrassing" skin conditions, and I thought they were talking about acne. So that's why I was taking it, only to find out they were probably talking about herpes all along, LOL)

Thanks for replying!
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Avatar_f_tn
See my reply above for more info. Is 3.68 really considered low? I thought the cutoff was at 3 or 3.5? And are you the one who told me the WB can be ordered through Quest?
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Avatar_f_tn
Oops, just read back through the posts and found the Quest test number. I thought you could only order the WB directly from Washington University? I'll have to call Any Lab Test Now and give them that test number. If it's alot less than the $400 I see people mentioning online, I would consider it. Otherwise I'll just assume my test results are correct and live my life accordingly!
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101028_tn?1348750963
It's under $200 for the herpes Wb to be done.

Not sure if any lab test will be able to order you a herpes WB or not.
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Avatar_m_tn
I believe the result could be low due to the fact that you tested a little too early...if the active IgM antibodies were still producing the numbers could elevate anytime within the 12 week period. If it were an infection from a situation earlier in life the antibodies could possibly be low...but in the event that you just had a recent outbreak, those antibodies should be more active and should have been elevated a little higher. When doing an igg test it is best to wait between 6-12 weeks for testing, especially if you are concerned with what the titers mean...
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