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STDs (Expert Forum)
HSV Test IgM and IgG
Answered by
University of Washington
Seattle - WA
Welcome to the STD Forum, which 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.
HSV Test IgM and IgG
by ReneeHodge, Oct 23, 2009 08:08AM
I am a 28 year old woman. I have always received yearly physicals/gynecological exams, always testing negative for STD’s. After having unprotected sex with a new partner (09/29/09) I developed a urinary track infection. On 10/01/09 I was treated with antibiotics (Ciprofloxacn 500mg) & given diflucan to treat any potential yeast infections caused by the antibiotic. Four days later I still did not feel better, so my family physician prescribed me (SMZ/TMP DS 800-160) for the still current UTI. I had pressure while urinating and felt like I had an extreme yeast infection, but no discharge. My vagina was inflamed & seemed swollen to the point where I had to ice myself.
I had a birth control check appt with my gynecologist on 10/12/09 & told her of my recent situation. She decided to do a full vaginal exam and blood work. Everything came back fine but I tested positive for HSV 2. I have never had a lesion/sore in my life. I've been researching this & found that this certain blood test is not reliable. I have also received a second opinion from my family doctor and a third opinion from Planned Parenthood both saying that this particular test is inconclusive.
I cannot comprehend how one doctor can diagnose me with HSV 2 because of a blood test and two other medical professionals say that since 1) I have never experienced lesions/sores 2)the IgM test is inaccurate I do not have it. How can doctors not be up to date on these tests?
Here is what my lab results say:
HSV 1 and 2 IgM Antibodies, Indirect
HSV 1 Igm Antibodies <1:10 Titer <1.10
HSV 2 Igm Antibodies 1:100.H Titer <1:10 (What does this H mean & is that a high score?)
HSV Type-Specific Immunoblot Negative
HSV-1 IgG Antibody Negative
HSV-2 IgG Antibody Negative
Please help clarify this for me. I am devastated. If this test is inaccurate why are doctors administering it? Also, this partner was tested this week and is negative for everything.
I had a birth control check appt with my gynecologist on 10/12/09 & told her of my recent situation. She decided to do a full vaginal exam and blood work. Everything came back fine but I tested positive for HSV 2. I have never had a lesion/sore in my life. I've been researching this & found that this certain blood test is not reliable. I have also received a second opinion from my family doctor and a third opinion from Planned Parenthood both saying that this particular test is inconclusive.
I cannot comprehend how one doctor can diagnose me with HSV 2 because of a blood test and two other medical professionals say that since 1) I have never experienced lesions/sores 2)the IgM test is inaccurate I do not have it. How can doctors not be up to date on these tests?
Here is what my lab results say:
HSV 1 and 2 IgM Antibodies, Indirect
HSV 1 Igm Antibodies <1:10 Titer <1.10
HSV 2 Igm Antibodies 1:100.H Titer <1:10 (What does this H mean & is that a high score?)
HSV Type-Specific Immunoblot Negative
HSV-1 IgG Antibody Negative
HSV-2 IgG Antibody Negative
Please help clarify this for me. I am devastated. If this test is inaccurate why are doctors administering it? Also, this partner was tested this week and is negative for everything.
Doctor's Answer
by H. Hunter Handsfield, M.D., Oct 23, 2009 09:48AM
, Oct 23, 2009 09:48AM
Welome to the STD forum. The bottom line is good news: Almost certainly you do not have HSV-2.
The HSV-2 IgM test is very unreliable. We never do it in my STD clinic, and real STD specialists never order it -- it's simply a useless test. For lots of discussions about this, use the forum search link and enter HSV IgM; you'll find loads of information. In any case, your result is barely elevated (yes, H means high) -- but at 1.100 it is exactly at the borderline -- and even if the score were, say, 2.0 or higher it wouldn't mean a thing. In other words, the doctor who says the IgM is inaccurate is correct and the other one is wrong.
The important thing is that your IgG test is negative, which proves you have never been infected with HSV-2. Actually, it takes a few weeks for that test to become positive, so there is a technical possibility you were infected recently. But your symptoms really don't suggest herpes. You need to continue to work with your doctor to figure out the true cause -- and conceivably s/he will recommend yet another IgG test in a few weeks. But I don't expect that to be positive either. Something other than herpes is responsible here.
I hope this helps. Best wishes-- HHH, MD
The HSV-2 IgM test is very unreliable. We never do it in my STD clinic, and real STD specialists never order it -- it's simply a useless test. For lots of discussions about this, use the forum search link and enter HSV IgM; you'll find loads of information. In any case, your result is barely elevated (yes, H means high) -- but at 1.100 it is exactly at the borderline -- and even if the score were, say, 2.0 or higher it wouldn't mean a thing. In other words, the doctor who says the IgM is inaccurate is correct and the other one is wrong.
The important thing is that your IgG test is negative, which proves you have never been infected with HSV-2. Actually, it takes a few weeks for that test to become positive, so there is a technical possibility you were infected recently. But your symptoms really don't suggest herpes. You need to continue to work with your doctor to figure out the true cause -- and conceivably s/he will recommend yet another IgG test in a few weeks. But I don't expect that to be positive either. Something other than herpes is responsible here.
I hope this helps. Best wishes-- HHH, MD
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