Torch Test

[JainM]

My First baby was missed out due to no growth. After that our Dr advised for Torch test and Results were CMV and Herpes Igg Positive and Rest all (Rubela and Toxoplasma) Negative (Igg and Igm). She had a R - Vaccine afte that.

After 7 Months my wife is again pregnant and Dr advised for Torch Test. This time the results are as follows:

Toxo Plasma Igg and Igm (Non Reactive)
Rubelaa Igg is Reactive while Igm 0.873 (Ratio) indeterminate
CMV Igg is Reactive while Igm is 0.294 (Non Reactive)
Herpes (Type 1 and 2) is Igg Non reactive while Igm is 0.87 (Gray Zone)

Please suggest as Our Dr has kept us in confusion state.

[JainM]

Thanks a lot for reply I will surely get a double check with Dr.

but that was a bit relief for me..

Thanks again

[mkh9]

So if she doesn't have any cold sores or genital herpes blisters then it is probably just cross reacting antibodies. It shouldn't cause a problem with the fetus. I would double check your results of course with the doctor. But that is what I believe.

kind regards,
mkh9

[JainM]

Hello Mam,

No nighter she has genital herpes nor blisters in genital area.
Right now or past few years she never had a oral cold sore.
Chicken pox and flu are common and I think almost every body has this in childhood.

I hope this will not have any negative impact on the fetus..?

[mkh9]

Hi, so this is my take on what you asked:

Firstly, yes IgG doesn't matter it is past infection? Does she have genital herpes now? According to the Mayo clinic:

The Igm HSV test:

In pregnant women, this test should not be used as the sole criterion for the diagnosis of current herpes simplex infection. The presence of herpes simplex virus (HSV) should be demonstrated by molecular methods, which detect viral DNA (ie, LHSV / Herpes Simplex Virus [HSV], Molecular Detection, PCR), or by isolation of live virus (ie, viral culture).

Here is a link:

http://www.mayomedicallaboratories.com/test-catalog/Clinical+and+Interpretive/87998


"Due to commonly shared antigens, infections with one type of HSV, in the presence of antibody to the other type, may produce an amnestic response with the level of the pre-existing antibody becoming higher than the antibody titer of the current infection. Definitive diagnosis of HSV type should be made by PCR." Heterotypic IgM antibody responses may occur in patients infected with Epstein-Barr virus and give false-positive results in HSV1 and 2 IgM enzyme immunoassay tests. A heterotypic rise in anti-HSV antibody level may also be observed in a primary or reactivated varicella-zoster virus infection."

So if there are blisters in the genital area she should get PCR done not serology. If She never had blisters in the genital area it may only be cold sores. Does she have a oral cold sore?

If there haven't been any blisters it might be that she has cross reacting antibodies to a past infection of Epstein Barr virus (EBV) which most of us also have or Varicella zoster (Chicken pox) which almost all have had too. Has she had that as a child as well?

So, I think you need to talk to your doctor about this. But my opinion is it is due to past infections and the antibody is possibly cross reacting. I would ask the doctor whether any treatment is necessary. Show him the article (link) print it out and give it to the doctor if they don't know about the cross reacting antibodies. If they do then you won't have to but I would bring a copy with you to talk about it with them.

hopefully my explanation of what the Mayo Clinic said is clear. let me know if you have any questions.

mkh9

[JainM]

Yes it was a blood test only....

But as I understood with discussion in either case if Igg is reactive or Non Reactive it should not harm much....right?

But for HSV(I and II) Igm 0.87 Gray zone should be taken seriously if yes..what complications it can create and up to what extent as it is on the lower border limit? Is there is any kind of medication for this?

[JainM]

Sorry missed the reference range
its same for Herpes (i and II) igg and Igm

less than 0.8 OD ratio - Non reactive
In between 0.8 to 0.99 OD ratio- Gray Zone
Greater than 1.00 OD Ration- Reactive

[JainM]

Hello Mam,

Once again many thanks for your reply.

For Herpes Type 1 and 2 the laboratery has given combined results
and the combined HSV(TYPE1 & TYPE2) result is :

Igm 0.87 (Gray Zone)
Ref Range:
1.0 OD ratio- Reactive

While

Igg 12.06 (Non Reactive)
Ref Range:
1.0 OD ratio -  Reactive

My doubt is if the result is 12.06 then how can it be non reactive. As per the referance range given in the report it should be Reactive. Is this correct or something is wrong u feel?

[mkh9]

Well, the Rubella should be okay if she had the vaccine. So the IgM wouldn't really matter. That is my opinion.

The Herpes test I don't think the Herpes will matter either if the IgG is already positive. It depends.
So which one was gray zone. It has to match up.
Herpes type 1 was positive IgG, but IgM gray zone?
Herpes type 2 was negative IgG and Negative IgM?
So what exactly were each result for type 1 and type 2?
mkh9

[JainM]

Hello Mam,

Thanks for your reply.

I understand the point raised by you for Rubella. We will surely go for a re-test after couple of weeks. I hope the re-test for Rubella Igm comes negative this time. But just in case if this test was correct, for my anxiety what is the range of Rubella Igm to be negative.    

Regarding Herpes (I and II) Igg value for current test is 12.06 and Igm is 0.87 (Gray Zone) as per the Reports.
Is this Gray Zone  for Herpes should be matter of worry ?

[mkh9]

Hi, we are not doctors on these sites but I am a microbiologist and understand your results.

So, first let me ask you again so you said your wife was first negative for Rubella and then got a vaccine? If that is the case then:

Now: the Toxoplasma is negative,
Rubella now shows immunity due to the vaccine. But you would have to retest the IgM  since it came up indeterminate. It may have been that there was some problem with the instrument. It doesn't mean it was positive. It may be the vaccine interferred with the results too. So, retest now and see if the results are still indeterminate or not or you can wait two weeks.

CMV is negative and Herpes is negative.

most people are positive for Herpes IgG (past infection for type 1) so that is very unusual.  It is Okay but just that most people by the time they are an adult have been exposed to the virus. You might want to recheck that too.

mkh9