Need an explation of HSV 1 and 2 positive result values

[bollywood]

I am currently living in Central America and just this week got back a blood test for HSV that came back negative for IgM, but positive for IgG for both HSV1 and HSV2. This was of course very distressing as, for 10 yrs now of annual STD testing, I have never had anything show up (and yes, HSV testing was performed although I'm not sure if it was type-specific). I have always done my best to practice safer sex with condoms; however, it appears that unprotected oral sex was most likely, finally, my downfall. Also, given that I have never had any symptoms all whatsoever (no lesions, no fever, no pain, nothing), I feel I cannot take the risk of engaging in sexual relations again because, without any symptoms of any kind, I can never be sure when I might potentially be shedding, therefore presenting a risk to an uninfected partern. In any case, I have three questions:

1. If IgM was positive but IgG was negative last October, and my last known contact with an HSV infected person (he was on daily Valtrex) was in February of last year, does that then mean that the contact that is now showing up as a positive IgG (likely meaning that the IgM result of October was not a false positive as my doctor and I thought) was likely not from him but actually from a different partner sometime in the May to July timeframe (i.e. 3 to 5 months before the positive IgM result in Oct)?
2. Is it likely that someone could have a positive IgG result within less than 3 months of contact with the virus? My concern is for my current boyfriend who also tested positive (with negative IgM) but very high levels of IgG. We were first intimate in late February and I'm concerned that I could possibly have unknowingly infected him and it's showing up just 2.5 months later in positive IgG results? Or is it just as likely that he also already had it before we became intimate (he had never been tested before).
3. My results here in Central America are given as 1:160 (HSV1) and 1:80 (HSV2), with a reference value of >1:40. How do these results compare to >1 reference that I have seen used on this and other sites related to HSV results?  Also, my bf's results are 1:1610 (HSV1) and 1:640 (HSV) - is there any significance to the relatively higher results of his numbers as compared to mine?

I know this was a long post. I appreciate any responses you can provide to my questions. Thanks much!!

[gracefromHHP]

some tests do only report back with a + or a - .  It depends on the test. There are many out there - some much better than others.

grace

[estrellab]

I don't know, mine was just pos on the herpes select there were no numbers that I know of. At least I wasen't told that, just that it was positive for hsv 2. Worst news of my life, but then again, if I have known that something was not right and thinking it was for many yrs, why be surprised now, eh? Get a better test maybe? Good luck.

[bollywood]

Thanks Grace.  Appreciate your perspective.  If we assume that the reference should be 1.1 for the HSV tests, then it should maybe be 1.0 for the Chlamydia test as well, which could mean that I'm positive.  I realize you're an HSV expert so I'll post my Chlamydia question on that forum.  I feel so much more informed on the HSV subject now and thank my blessings that I may have just narrowly escaped a major bullet.  I would be wise not to engage in unprotected oral henceforth.  Thanks again!!

[gracefromHHP]

HSV 1 IgG - 3.7 (>11 reference)

HSV 2 IgG - 0.5 (>11 reference)


Ok I am going to assume then that it's really >1.1 is positive because that is the normal scale of most type specific tests, not 11 since you got these results over the phone.  

Your hsv1 is + which isn't too surprising since most folks do test + for hsv1. Statistically your infection is oral.  Your hsv2 is negative.

completely disregard your igm results - they aren't accurate and should've never been drawn on you in the first place ( a zillion posts on this already ifyou want to search for them or go to herpesdiagnosis.com under the testing section ) .  

As for repeating the test - I wouldn't bother.  I already told you and so did this doctor you saw this time that the other test wasn't accurate and wasn't the best choice ( not that you had anything to do with that ). Even if this test you had done wasn't a herpes select it's still more accurate and I know I'd feel comfortable with the results of it if I was in your shoes.  If you know you won't rest until you've repeated the test - wait 1 month and then repeat it again but there's really not good reason to do so.  

grace

[bollywood]

My doctor read the results to me over the phone to me late Friday night so I don't have the report in my hands.  One would think that he wouldn't have misread the results and that he should know what the reference limit is, but you never know.  I am picking up the report on Monday so I'll be able to tell for myself if it's 11 or 1.1.  Of course, I'm hoping, hoping, hoping, it's 11 as he said.  Then again, it sounds like you aren't aware of a test that would have a reference of 11, so perhaps I should be worried that these test results are also suspect.  Oh dear, I guess I probably have to just wait until I'm back in the US to run that final test...

Well, let's just assume that these test results represent a valid test with a reference of 11, then I have a quesion.  Is there as large a problem with false negatives with HSV tests as there is with false positives? Being fairly neurotic about these things, I'll probably do the third confirmatory test anyway, but I was just curious if, generally speaking, a negative test comes with a higher confidence than a positive one.

Thanks!  I'll no longer be posting on WebMD, I'm going to limit my questions to this MedHelp site.

[gracefromHHP]

can you look at again at your newest results - is it >11 or greater than 1.1?

grace

[bollywood]

Well, I was so devasted but also confused by those initial results that I wanted a retest as soon as possible.  So this past Tuesday, I had blood drawn again for the HSV tests and Chlamydia, this time at a different lab that I hoped might have more up to date testz or testing methodologies.  Late today, my doctor finally called me with the results (I haven't actually physically seen the paperwork myself yet).  He information he provided was as follows:

HSV 1 IgM - 5.2 (>11 reference)
HSV 1 IgG - 3.7 (>11 reference)

HSV 2 IgM - 8.3 (>11 reference)
HSV 2 IgG - 0.5 (>11 reference)

Chlamydia IgM - 8.6 (>10 reference)
Chlamydia IgG - 2.6 (>10 reference)

Do these results make anymore sense to you?  I asked my doctor about why the prior results would have been positive and these are indicating that I'm negative.  He said that given the manner of reporting (i.e. 1:80 for HSV 2 IgG) that these were "dilution tests" and that they have a much higher rate of false positives, and that would be the reason for the earlier positive tests.  He did also say that I might want to do a specific "ELISA" test which would be most accurate.

So now I'm unsure what to do.  I feel like I should do that third test to "break the tie"; but then again, why didn't they just run the ELISA in the first place.  This kind of testing is extremely expensive here in Costa Rica, and I'm looking at shelling out major bucks for the third time in just over a week.  But then, that may just be the only way for me to obtain ultimate peace of mind on this HSV topic one way or another.

Any thoughts?

[gracefromHHP]

my response to this is the same I gave you over on webmd.  You did not have accurate enough testing done to have your final answer yet.

grace