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IGG test equivocal after 6 mos still...why?
Feb '05 had unprotected sex w bf and after 10-14 days I saw 2 painless blisters and went to GP ASAP. Culture was taken and I was given Valtrex (500mg/30 days). Culture result is pos for herpes. Next several weeks have regular leg muscle/lower back discomfort, mysterious pangs/pings and have felt an ulcer 2-3 times at one of the blister sites..thankfully totally painless. I took Valtex for 4-5 mos..although since I had no major symptoms I would stop for 2-3wks at a time.
I decided to get type tested (IGG) in June ..results for Type 1 & 2 both equivocal - asked to return in 4-6 wks. In July, test results equivocal range again. So, I'm told
to come back 8 wks, & see a Infect. Disease specialist. Late Aug, IGG & now IGM done..just told the results today -IGG equivocal again for both 1 & 2(IGM 1.64, which tells me zilch, yes I know).
Is this "normal" to be equivocal after 6 mos? The I/D specialist has no answers...just to come back AGAIN! I just want to know what type I have.. I do have an occasional burning, leg pain, typical of mild herpes symptoms (only when fatigued), so:
1. Why no definitive test results after 6mos?
2. Should I be given another test?
3. When should I go again and safely expect a non- equivocal result?
4. Will I ever develop measurable antibodies?
5. My body is responding to something (IGM results), then why
not to the IGG testing?
Ironically, thru all this I met a great guy who has HSV-2. He does not want to transmit HSV-2 to me, if I only have HSV-1 with it's mild symptoms. I'm still friendly with the x-bf who gave this (at least I think he did..you just don't know with this virus)..he noticed a blister after my presumed initial outbreak..nothing again, therefore he doesn't think he has it and I can't get him to test. What are your thoughts?
I decided to get type tested (IGG) in June ..results for Type 1 & 2 both equivocal - asked to return in 4-6 wks. In July, test results equivocal range again. So, I'm told
to come back 8 wks, & see a Infect. Disease specialist. Late Aug, IGG & now IGM done..just told the results today -IGG equivocal again for both 1 & 2(IGM 1.64, which tells me zilch, yes I know).
Is this "normal" to be equivocal after 6 mos? The I/D specialist has no answers...just to come back AGAIN! I just want to know what type I have.. I do have an occasional burning, leg pain, typical of mild herpes symptoms (only when fatigued), so:
1. Why no definitive test results after 6mos?
2. Should I be given another test?
3. When should I go again and safely expect a non- equivocal result?
4. Will I ever develop measurable antibodies?
5. My body is responding to something (IGM results), then why
not to the IGG testing?
Ironically, thru all this I met a great guy who has HSV-2. He does not want to transmit HSV-2 to me, if I only have HSV-1 with it's mild symptoms. I'm still friendly with the x-bf who gave this (at least I think he did..you just don't know with this virus)..he noticed a blister after my presumed initial outbreak..nothing again, therefore he doesn't think he has it and I can't get him to test. What are your thoughts?
MEDICAL PROFESSIONAL
Thanks for the compliment.
1) My inclination is to have the special testing done now at the UW labs. But it depends largely on how anxious you are and how soon you want to sort this out. You could wait 2-3 month and have another standard HerpeSelect test; but a specimen to UW lab for special testing would sort it out sooner.
2) I don't understand you ID doc's advice--IF you have HSV-2. In that case, you can't catch HSV-2 again, as far as is known, thus no reason to protect yourself when having sex with another HSV-2-positive person. On the other hand, you don't know for sure your genital infection was HSV-2; could have been HSV-1. It probably is a good idea to protect yourself until your blood test results are sorted out once and for all.
Good luck-- HHH, MD
1) My inclination is to have the special testing done now at the UW labs. But it depends largely on how anxious you are and how soon you want to sort this out. You could wait 2-3 month and have another standard HerpeSelect test; but a specimen to UW lab for special testing would sort it out sooner.
2) I don't understand you ID doc's advice--IF you have HSV-2. In that case, you can't catch HSV-2 again, as far as is known, thus no reason to protect yourself when having sex with another HSV-2-positive person. On the other hand, you don't know for sure your genital infection was HSV-2; could have been HSV-1. It probably is a good idea to protect yourself until your blood test results are sorted out once and for all.
Good luck-- HHH, MD
Hello Dr. HHH,
I'm a little bit confused here. In many other threads you have indicated that pain in the legs/buttocks, lower back discomfort/pain, and occasional stinging in different parts of the lower body are NOT symptoms of genital herpes. However, in this thread we have a person who most likely has a confirmed case of genital herpes and has experienced those symptoms. Could you please comment on that? Thank you very much (I value enourmously your expertise in this desease and the service you provide in this Forum).
I'm a little bit confused here. In many other threads you have indicated that pain in the legs/buttocks, lower back discomfort/pain, and occasional stinging in different parts of the lower body are NOT symptoms of genital herpes. However, in this thread we have a person who most likely has a confirmed case of genital herpes and has experienced those symptoms. Could you please comment on that? Thank you very much (I value enourmously your expertise in this desease and the service you provide in this Forum).
First, thank you so much for your reply and knowledge! You're awesome! Two last questions:
1. In your opinion, so if I didn't have the Herpeselect, go that route first, then use the WB as a last resort? I just called Univ of WA, obtained the lab ph#, but not sure if I'm
being excessive or if the HerpeSelect should be able to give me my results (if it wasn't used). I really, really don't want to hear equivocal a 4th time! Obviously the WB will require more work, particularly if I have to provide the shipping.
2. Regarding the guy I met w/ HSV2..he's had it 10 yrs & is asymptomatic. My I/D spec. recommended condom usage ALWAYS (even if I'm HSV2 too)is that really necessary? I think it's overdoing it if we're both HSV2...Her concern is spreading the virus to other areas..how likely is that? Am I being too casual about this?
1. In your opinion, so if I didn't have the Herpeselect, go that route first, then use the WB as a last resort? I just called Univ of WA, obtained the lab ph#, but not sure if I'm
being excessive or if the HerpeSelect should be able to give me my results (if it wasn't used). I really, really don't want to hear equivocal a 4th time! Obviously the WB will require more work, particularly if I have to provide the shipping.
2. Regarding the guy I met w/ HSV2..he's had it 10 yrs & is asymptomatic. My I/D spec. recommended condom usage ALWAYS (even if I'm HSV2 too)is that really necessary? I think it's overdoing it if we're both HSV2...Her concern is spreading the virus to other areas..how likely is that? Am I being too casual about this?
Yes, I also read the other threads about not being symptoms of herpes...but I definitely had them and did not have them before Feb. It only occurred in the first 3 mos, but was almost continual jolts, pings, spasms, zaps (that's best how I can describe it) below the waistline..more of an annoyance. I just got used to it..then one day I realized I wasn't getting them anymore. I will get an occasional leg pain, under the skin burn -rarely in the genital area and no outbreaks have ever followed. What was worse than these jolts was a crawling feeling (paresthesias?) that I developed in my arms and legs around mos 4, wasn't sure if it was the Valtrex or the virus, one of the reasons for stopping the Valtrex. I've had it reoccur maybe one night since..??
In June, when I went for my 1st IGG test I also was tested for a list of other stds (peace of mind) all negative and I'm in great health, so I definitely believe all this was fr the HSV.
In June, when I went for my 1st IGG test I also was tested for a list of other stds (peace of mind) all negative and I'm in great health, so I definitely believe all this was fr the HSV.
MEDICAL PROFESSIONAL
Since you had a postive culture for herpes, the only reason for the antibody test is to know whether your infection was due to HSV-1 or -2; but that could have been learned by testing the virus itself, which should have been done. (But if they already discarded your specimen and the virus isolate, it's too late.)
Since an IgM test was done, it is possible the IgG result also is unreliable. Make sure the IgG test was a HerpeSelect test. If it was, the next step is to ask your ID doc to send another blood specimen to a reference lab for an HSV Western blot test. That still is the gold standard. The best lab for that purpose is the University of Washington in Seattle, where the main research on HSV antibody testing was done. A few people with real HSV infection have results like yours but the WB almost certainly will sort it out once and for all.
1) There is no firm answer as to why; see above.
2,3) See above re Western blot for HSV antibody.
4) Hard to say. Probably you eventually will have a definitely positive standard antibody test.
5) IgM is inherently unreliable. For a comprehensive discussion of HSV IgM test results, see a comment I made in a recent thread, just a few days ago, posted by username Paperdahl. The IgM test should never have been done; just as in your case, that test has no clinical value and only increases confusion.
In the large majority of people with genital herpes, the disease is an inconvenience, not a serious health threat--and eventually not much of an inconvenience. In my opinion, nobody should forego a promising relationship solely because one partner has herpes. If you have HSV-2, you won't catch it from him again; if you have HSV-1, then if you get HSV-2 it probably will be mild or asymptomatic, thus no big deal; if the two of you avoid sex when he has symptoms, your risk will be low anyway; he also can use condoms to further lower the risk; and/or he could take valacyclovir to reduce transmission risk. So there are lots of ways to have a sexually satisfying, mutually rewarding relationship despite genital herpes. There are several options.
Good luck-- HHH, MD
Since an IgM test was done, it is possible the IgG result also is unreliable. Make sure the IgG test was a HerpeSelect test. If it was, the next step is to ask your ID doc to send another blood specimen to a reference lab for an HSV Western blot test. That still is the gold standard. The best lab for that purpose is the University of Washington in Seattle, where the main research on HSV antibody testing was done. A few people with real HSV infection have results like yours but the WB almost certainly will sort it out once and for all.
1) There is no firm answer as to why; see above.
2,3) See above re Western blot for HSV antibody.
4) Hard to say. Probably you eventually will have a definitely positive standard antibody test.
5) IgM is inherently unreliable. For a comprehensive discussion of HSV IgM test results, see a comment I made in a recent thread, just a few days ago, posted by username Paperdahl. The IgM test should never have been done; just as in your case, that test has no clinical value and only increases confusion.
In the large majority of people with genital herpes, the disease is an inconvenience, not a serious health threat--and eventually not much of an inconvenience. In my opinion, nobody should forego a promising relationship solely because one partner has herpes. If you have HSV-2, you won't catch it from him again; if you have HSV-1, then if you get HSV-2 it probably will be mild or asymptomatic, thus no big deal; if the two of you avoid sex when he has symptoms, your risk will be low anyway; he also can use condoms to further lower the risk; and/or he could take valacyclovir to reduce transmission risk. So there are lots of ways to have a sexually satisfying, mutually rewarding relationship despite genital herpes. There are several options.
Good luck-- HHH, MD
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
