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STDs (Expert Forum)
Herpes Test Results Clarification
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.
Herpes Test Results Clarification
by anne1211, Apr 20, 2009 01:28PM
Hello,
I was recently tested for Herpes 1 and 2 during a routine Gyno exam. I did not have any symptoms or reason for concern but it was done at my Dr.'s recommendation along with all other STD's.
When the test results were received back I was told I was positive for both Type 1 and Type 2 Herpes based on the following numbers:
Type 1, herpeselect test Igg = 3.15
Type 2, herpeselect test Igg = .05
Type 1, IgM = .78
Type 2, Igm = 1.19
(no brand was given on the lab form for who makes this IgM test)
I requested a re-test as I did not trust the findings. She was basing the positive result solely on the IgM results and telling me that it was a recent infection, 3-6 months. I have had the same partner for 2 years and he has never shown symptoms either and we have both been faithful (as much as this can never be certain, I am certain).
Second test results:
Type 1, Herpeselect test Igg = 1.57
Type 2, Herpeselect test Igg = .01
Type 1, Igm = .85
Type 2, IgM = 1.12
Again, she said I was positive based on the IgM and wanted to put me on Valtrex - which I declined. My partner went and got tested and he is negative for both Type 1 and Type 2. (results were = .3 on both Types for Igg). His doctor said we were both fine but I am still concerned since my IgM came back positive for Type 2.
Please let me know your opinion on the matter.
Thank you.
Anne
I was recently tested for Herpes 1 and 2 during a routine Gyno exam. I did not have any symptoms or reason for concern but it was done at my Dr.'s recommendation along with all other STD's.
When the test results were received back I was told I was positive for both Type 1 and Type 2 Herpes based on the following numbers:
Type 1, herpeselect test Igg = 3.15
Type 2, herpeselect test Igg = .05
Type 1, IgM = .78
Type 2, Igm = 1.19
(no brand was given on the lab form for who makes this IgM test)
I requested a re-test as I did not trust the findings. She was basing the positive result solely on the IgM results and telling me that it was a recent infection, 3-6 months. I have had the same partner for 2 years and he has never shown symptoms either and we have both been faithful (as much as this can never be certain, I am certain).
Second test results:
Type 1, Herpeselect test Igg = 1.57
Type 2, Herpeselect test Igg = .01
Type 1, Igm = .85
Type 2, IgM = 1.12
Again, she said I was positive based on the IgM and wanted to put me on Valtrex - which I declined. My partner went and got tested and he is negative for both Type 1 and Type 2. (results were = .3 on both Types for Igg). His doctor said we were both fine but I am still concerned since my IgM came back positive for Type 2.
Please let me know your opinion on the matter.
Thank you.
Anne
Doctor's Answer
by H. Hunter Handsfield, M.D., Apr 20, 2009 02:26PM
, Apr 20, 2009 02:26PM
Welcome to the STD forum.
You had an accurate response from gracefromHPP on the herpes community forum 3 weeks ago.
Your gynecologist is mistaken in her interpretation of your tests (or you misunderstood her -- but that doesn't sound likely). The IgM HSV tests are useless. All health professionals are taught that for most infections (not just HSV) IgM antibody appears first, followed by IgG, and that IgM antibody then goes away. Therefore, positive IgM indicates a recent infection. It's a nice theory, but there are lots of exceptions -- and for HSV, the exceptions are extremely common. Some people with new infections don't develop IgM antibody, and often IgM persists or reappears in people with chronic HSV-2 infections. More important (and the issue in your case), false positive results are very common.
For these reasons, herpes experts and STD clinics, i.e. professionals who really understand herpes, never order IgM tests and always ignore the results when they are done. That is what you and your doctor need to do. Only the IgG HSV tests are useful. (There are a bunch of not-very-good reasons that labs still do such tests -- I won't go into them here, however.)
And your HSV IgG results are clearly negative. Many results that technically are positive (over 1.1) but under 3.5 are false -- so your initial result was suspect of being false positive. The clearly negative repeat test confirms that interpretation. If you had a new HSV-2 infection, the second test would have had a bigger number than the first.
The problems with HSV IgM testing and interpretation of the IgG results have been discussed in great detail and many times. Use this forum's search link; you can find literally hundreds of threads. You may want to discuss this with your gynecologist; you could print out this discussion for her. In case she wants an entree into the medical literature about it, she can look for author name Rhoda Morrow, PhD for lots of sophisticated information.
Bottom line: Neither you nor your partner has HSV-2. Congratulations!
Best wishes-- HHH, MD
You had an accurate response from gracefromHPP on the herpes community forum 3 weeks ago.
Your gynecologist is mistaken in her interpretation of your tests (or you misunderstood her -- but that doesn't sound likely). The IgM HSV tests are useless. All health professionals are taught that for most infections (not just HSV) IgM antibody appears first, followed by IgG, and that IgM antibody then goes away. Therefore, positive IgM indicates a recent infection. It's a nice theory, but there are lots of exceptions -- and for HSV, the exceptions are extremely common. Some people with new infections don't develop IgM antibody, and often IgM persists or reappears in people with chronic HSV-2 infections. More important (and the issue in your case), false positive results are very common.
For these reasons, herpes experts and STD clinics, i.e. professionals who really understand herpes, never order IgM tests and always ignore the results when they are done. That is what you and your doctor need to do. Only the IgG HSV tests are useful. (There are a bunch of not-very-good reasons that labs still do such tests -- I won't go into them here, however.)
And your HSV IgG results are clearly negative. Many results that technically are positive (over 1.1) but under 3.5 are false -- so your initial result was suspect of being false positive. The clearly negative repeat test confirms that interpretation. If you had a new HSV-2 infection, the second test would have had a bigger number than the first.
The problems with HSV IgM testing and interpretation of the IgG results have been discussed in great detail and many times. Use this forum's search link; you can find literally hundreds of threads. You may want to discuss this with your gynecologist; you could print out this discussion for her. In case she wants an entree into the medical literature about it, she can look for author name Rhoda Morrow, PhD for lots of sophisticated information.
Bottom line: Neither you nor your partner has HSV-2. Congratulations!
Best wishes-- HHH, MD
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I just wanted to let you know that I had spoken with my Dr. in regards to what Gracefromhpp said a few weeks ago. The Dr. was adamant that she was correct in her diagnosis. That is why I returned here for answers again.
Thanks again for the information. It was very clear and direct and made complete sense. Should I ever have one of these tests again I will stick with Igg only.
I hope this post helps others in the future also who are unsure of their results and seeking answers.