IgM "indeterminate" and 2 IgG negatives- Am I ok?

[Haraald]

I've read that you say IgM tests are meaningless, but that you've also said they do indicate, if positive, that in 2/3 of cases one definitely DOES have either HSV 1 or 2, it's just not sure which one.... is this true?

I ask because I got results of an "indeterminate" IgM- I was .96 in the  .91 - 1.09 'indeterminate' span, (above 1.09 being "positive").   My doc basically told me I had herpes, he just wasn't sure which one yet (!).  I'm shocked. I have no symptoms.  I did however have a cold sore about 3 weeks prior to this test, and had cold sores in my past... which makes me wonder though why my IgG HSV-1 came back negative, really negative (I was .06 with .90+ being positive).

My girlfriend and I are freaking out, and we're thinking of going to the UW Viral Clinic you mentioned for further input (we're in Seattle).  Should I be worried at all, stop having unprotected sex with her, or get tested again?  I realize you say the IgM is useless, but surely it would indicate SOMETHING right??  -thanks so much!!

[Edward W Hook, MD]

Just read your supefluous follow-up post.  Based on the tests that count, the IgG tests, the results for both you and your GF provide no reason for repeat testing.  I wonder if what you are calling a cold sore actually is.  EWH

[Edward W Hook, MD]

There was no need to re-post.  We answer questions as time permits.  Be patient.  `

Your GF is over reacting.  You still have not indicated why you think you may have HSV other than your possible cold sores.   My guess is that I would not have recommended testing to start with and now that you have, your results do not suggest HSV.  Unless there is some reason for testing (still waiting for your answer to this), I probably would not re-test.  EWH

[Haraald]

I'm not sure if follow-up questions are answered, so I will re-post my above follow-up as a new question.

[Haraald]

Thank you so much for the reply.  Is it advisable then that I get re-tested, and if so, when?  Or is the 'indeterminate' result I got so amorphous that my partner should not even be concerned?  My girlfriend is thinking about breaking up with me over this, and I'm not sure if it's proper for me to tell her she shouldn't worry about it at all, which your reply seems to indicate.

I gave the 2/3 figure because it was stated that 1/3 of positive IgM results were erronenous, so I assumed 2/3 were correct... but now I see that is incorrect.  Regardless, I'm 'indeterminate', not positive, so the figure is probably even better for me.

[Edward W Hook, MD]

You have misinterpreted something you hear or read an I have no idea where the 2/3 figure you cite comes from.  Positve IgM tests are of virtually no use because the IgM test has many cross reactions which lead to either falsely postive or indeterminate results.  These false positve results do not occur becuase of any single sort of problematic antibody but lots of antibodies.  Antibodies to the chicken pox virus, antibodies to HSV-1 for that HSV-2 test, antibodies to other viruses an even other unrelated antibodies which you just happen to have.  For this reason we do not recommend use of these tests.  Your doctor is incorrrect.

If  you have gotten cold sores for years, the HSV-1 tests do occasionally miss a small proportion of infections  or alternatively, what you call your cold sore may not be a HSV-1 related cold sore.

You say nothing about why you got the antibody test.  The sorts of problems you cite are precisely the reason we do not recommend testing unless there is a reason for suspicion about HSV.  EWH