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HSV, IgM I/II Combination question
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The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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HSV, IgM I/II Combination question

Ok I recently went to LabCorp for testing b/c I had some symptoms, which include pressure in the testicles, a sort of bubble feeling in the tip of the penis, and I had a single small bump that resembled a pimple or an ingrown hair but it drew some worries from me. Anyways I got my results back and I'm just a little confused as to what some of this means. Next to the HSV, IgM I/II Combination my result was 0.59. Now it says that Negative is <0.91 which my results fall under but what does a result of 0.59 actually mean?? I was just a little confused bc everything else says either negative or non-reactive. Should I be worried at all?? Should I get another test done?? I've read ppl saying that the IgM isnt accurate and you should get the IgG or something of the sort. I'm just wondering what could be causing my symptoms if everything is negative. Any help would be appreciated. Thank you.
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Dr. Handsfield tried to answer your psot earlier but a software glitch prevented it from being posted.  Here it is.  EWH

I'll try to help. The bottom line is that you may or may not be infected with HSV-1 or HSV-2.  If you are, it probably does not explain your symptoms.

In HSV antibody testing, all IgM results are pretty much useless, as you already seem to know. You might or might not have an infection with HSV-1 or -2; the current result doesn't tell one way or the other.

"I went to LabCorp" suggests you might have decided on your own what tests to request, without professional advice.  If so, it was a mistake.  Only IgG testing is useful; it was a waste of money, time and energy to have an IgM antibody test.  And if that was the only test done, that's a second big mistake.  Only type-specific IgG testing is useful to assess presence or absence of HSV infection.

With respect to your result, the value of 0.59 means is negative, since it is under the cut-off for an abnormal result (0.91 or higher).  Below that level, the numbers are meaningless.  There is no difference between your value of 0.59 and, say, 0.3 or 0.8.

If you tested on your own, without professional care, please seek that professional advice before you proceed further.  If any further HSV testing is done, it must be an IgG test.  But your symptoms don't suggest genital herpes, so I am not convinced herpes testing is warranted at all.  If you were to have a positive IgG test for HSV-2, my conclusion would be that you have asymptomatic HSV-2 plus some other cause of your symptoms.  As to other possible causes of "pressure in the testicles" or a "bubble feeling" (I don't know what that means), no STD likely to be responsible -- and this forum doesn't get into non-STD possibilities.

The bottom line is that you should not cut corners.  See your health care provider for professional assessment, then follow his or her advice about possible causes of your symptoms and the appropriate diagnostic tests.

Best wishes--  HHH, MD
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So is it possible to receive a negative result on the IgM test and a positive on the IgG test?? Well before I got these tests done, I went to a doctor at my university twice. The first time, they had me do a urine sample thinking that my symptoms were related to chlamydia or gonorrhea. I was given treatment for these 2 at the time of my visit before I even received my results. My results for this test, however, came back negative, and the symptoms persisted but seemingly to a lesser degree. So I went back to the same doctor a few days after receiving my results to try and figure things out. He checked everything out and couldn't seem to find anything conclusive but had me do another urine sample for just a simple urine analysis. He said something about checking blood cells but I'm not sure if that's possible through urine...?? Anyway, my test for that came back normal as well, leaving me a lil worried and confused. So I began doing research online to see if I could come up with anything. It seemed to me the closest thing to what I was feeling and observed seemed like syphilis due to the single bump. But I thought it'd be best to test for everything at once. So I came across a site that had me charge a flat fee to be tested at a LabCorp facility for Gonorrhea, Chlamydia, Hepatitis B, Hepatitis C, Syphilis, Genital Herpes and HIV (RPR+HSVIgM+HBsAg; Panel 083824; Chlamydia/GC Amplification; HCV Antibody) I figured this would be the best way for me b/c it didn't require use of insurance (trying to keep this from my parents for now unless something comes up b/c truth is I'm a little embarrassed and I'd rather know what was wrong myself before I had to talk to them about it). However, all the results came back negative, once again, leaving me even more confused!
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Avatar_m_tn
The event that caused all this, btw, occurred around late February or early March. This was my first time too, so as you can imagine I've had a mix of emotions. The reason it took so long for me to seek an opinion on the situation was b/c the symptoms never got too bad as to make me think anything of it. However, the persistence made me worry a little. The weird thing too, is sometimes I feel perfectly normal. Other times I don't. What I meant by the "bubble feeling" is that it feels as if there is a tiny air bubble or something at the very tip of the penis. It's not a constant thing, but it lasts for about 10 seconds and goes away and recurs often. Is there any suggestions you can give me as to keep this as discrete as possible? Should I simply, request an IgG test? Thanks for your help!
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300980_tn?1194933000
The problem witht he IgM test is that it is often all too often.  We asiduously ignore all IgM results and will continue to do so.,  I advise you to do the same.  You have not reason to go for an IgG test.  You do not have herpes, nor do you have evidence of an STD.  EWH

p.s.  There are character limits for the forum.,  You exceed them. If you have foillow-up questions, please be succinct.  EWH
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239123_tn?1267651214
And I will add that your situation is an excellent illustration of the waste of money, time and energy that often accompanies broad STD screening through labs and internet service providers, without input by a knowledgeable provider.  Based on the risk circumstances and nature of your symptoms, you needed few if any of the tests that were done, for which you probably paid $300 or more.

Of course return to your university provider(s), or find a new health professional you trust, if your symptoms persist or you otherwise remain concerned.  But don't make the assumption that just because your genitals are involved, you must have an STD.  You can be sure you do not.

That will have to end this thread.  But look at the bright side:  you don't have hepres or any other STD; and you got 2 expert opinions for the price of one.
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Avatar_m_tn
I greatly appreciate both of you guys help! Sorry about the length of the previous post but I had a lot to say. And yes it may have been a waste of money looking back (only $170 btw), but it helped me feel a lot better about my situation. Although I'm still a little worried, your opinions have made me feel a little better about this. I will make another appointment with someone who will be able to help me just to be completely sure of everything. Once again, I can't explain how grateful I am to you both!
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