IgM and IgG test results questionable negative

[JArnt]

I am in a committed relationship which began in march. After discussing our STD testing past and the addition of birth control we have had unprotected sex and have continued to do so with him. I have never seen any signs or symptoms of herpes, which I understand is common but wanted to make sure again that I was clean so I got tested.

I had a blood test that included an IgM and IgG test. The IgM came back positive and the IgG came back negative. It had been over four months after the initial intercourse at this time. I have had Chicken Pox and Mono so that could be what it is picking up?

What do these test results mean? Do I have herpes? Is this infection from this relationship that started in March? Or a previous relationship?

[H. Hunter Handsfield, M.D.]

When IgM testing works as it is supposed to - i.e., early antibody that goes away - that change occurs in a few weeks. If the problem a year earlier were due to HSV, the IgM test would be negative and IgG definitely positive.  You can be sure that event wasn't herpes.  Same for infection 4 months ago.

I repeat my judgment above, you don't have HSV (of whatever type is reflected by the IgM result).  I'm sure the details of the test are in fact available if you or your former provider wants to dig for it.  Even if that's not practical, you can be very certain you do not have genital herpes.  But for even further assurance, talk to your (new) provider and get retested.  Tell him/her to specifically tell the lab to not due an IgM test, only IgG with a type specific test, such as HerpeSelect.

But trust me on this:  You don't have it.

[H. Hunter Handsfield, M.D.]

You don't have herpes.  If you wlll use the search link to find threads with the words "herpes diagnosis" and/or "IgM", you will find many (maybe 100 or more) discussions that point out that IgM testing is highly unreliable; it very commonly gives falsely positive results.  The IgG result is the only one that matters; it shows you aren't infected and you can ignore the IgM result.  (Theoretically, you might be early in a new infection, and later testing would be positive by IgG.  But it really doesn't work that way with HSV, even though that is the theoretical reason for using IgM testing.)

You don't say anything about virus type.  The comments above refer to HSV-2, i.e. the usual cause of genital herpes.

So probably you don't have HSV-2, assuming that is the virus type you refer to in the test results.  If in doubt, you can post the detailed test results (i.e., the numerical values of your IgG test results for both HSV-1 and -2) and we probably sort it out with even more certainty.

Best wishes--  HHH, MD

[skbala]

A related discussion, IGG & IGM Test Results was started.

[JArnt]

Thank you. I cannot tell you how much you have helped. Of course I was praying for this result but even if it had turned out the other way just knowing and being informed is the most important part.

Thank you again for your professionalism and expert opinion.

[JArnt]

Thank you for your response.

I am sorry, I do not have information regarding the numbers of the IgG results. They were not given to me, nor are they available. The test was performed at a clinic that had it sent out to a university to be tested. I quite frankly do not feel this clinic is up on their HIPPA guidelines and other patient rights/confidentiality policies and will not return there for further testing due to that fact.

Could a 'new' infection be considered over a year ago? Since IgM cannot accurately determine the length of infection or even if it is a recent infection, could IgM still be in my system from an infection a year old? I have read that there could be symptoms of a meningitis infection during the first outbreak of herpes. Is this true? I had a low fever and a petikia rash on my legs last year shortly after ending my relationship with a man of high risk behaviors. Which doctors could never figure out. I had a pelvic exam and pap swab, and what I thought was a full std panel. I have recently found out that it doesn't include a herpes test. I am so upset. Do those symptoms sound like initial outbreak of herpes? My doctor did not find any bumps or lesions at that time.

Also, you said there is a possibility that I might be early in the infection. Is this possible even a year after the rash and a good solid 4 months after contact with my current boyfriend AND the test results?

Thank you again for your response, it helps a lot! I just need to put my mind at ease for it would be absolutely devastating if I were to pass something along to my boyfriend that I could have prevented and could have notified him of the risk.