POSITIVE IGM AND NEGATIVE IGG

[Marcus1911]

Hello, I am a 35 yr old male that had non penetrating contact with a women clitoris for about 1 minute. This encounter happen on the 16th of December 09. Essential my tip of my penis rub her clitoris.  I used a condom during sexual intercourse. The next day I experience a tingling sensation on my the tip of my penis. It has continued off and on for about 10 days. I have no visible blister or bumps, no fever, no flu symptoms, or any of the other symptoms typical for herpes. Just the tingling sensation at the tip of my penis. With this concern, I ordered the a comprehensive herpes test from an online labatory. I received my results yesterday and they were a follows.  

IGM Positive 1.42
IGG Negative

Could any help me decipher this? Do I have herpes? I spoke to the girl with whom I had the sexual encounter and she stated that she did not have any STDs. She also stated that its been a while since she has been test. Will I have to wait until March to confirm if I have herpes? What are the statistics for IGG conversion at the 2 month mark?

[H. Hunter Handsfield, M.D.]

The large majority of people with new HSV-2 infections have positive results by 7 weeks.  Therefore, it is unlikely any future testing will be positive. I recommend a single final test, perhaps at 16 weeks. It will be negative; you don't have it.

Let's end this thread, unless a future test is positive for HSV-2 -- which is very unlikely to happen.  I hope the stress is now over.  It should be.

[Marcus1911]

Good Afternoon Dr. HHH,
     I just wanted to give you a quick update on my status. I just received a 7.5 week negative IGG test from Planned Parenthood. What is the likelihood that this result will turn positive at the 12-week mark (10 March)?  In addition, should I proceed with the 16-week test if I have a negative result in March? As of to date, I have no visible signs of a herpes infection (i.e. blisters, rashes, or fever).  Just a little irritation on the tip of my penis, which seems to be diminishing overtime.  This entire ordeal has been very stressful.  I truly value your opinion. Thanks for your time and support.b    

[H. Hunter Handsfield, M.D.]

Interesting question, but no answers are available.  I am unaware of any research into whether HSV-2 influences the interpretation of HSV-1 test result.  In my experience, this has never come up, either on the forum or among my clinic patients.  I simply cannot say whether your strongly positive HSV-2 result increases the chance your weakly positive HSV-1 result might be false.  Sorry.

If you need more information than this, you'll have to start a new thread about it.  But it probably isn't worth the posting fee; the reply would not be materially different.

[ineedsomehelp344]

I have read many threads and some of your research on HPV. I have one question that I can not find the answer to. I have seen where you have documented where a HSV1 infection can affect an HSV low poisitve test result but can it work the other way where some one may be greater than 5 for HSV-2 herepeselect test and also have a low HSV 1 result like a 1.4. Could this be a false positive because of the HSV 2? Very interested and curious.

[H. Hunter Handsfield, M.D.]

Your partner definitely has both HSV-1 and 2.  But your result was negative.  Therefore, it is highly unlikely you caught your partner's infection with either virus.  Among heterosexual monogamous couples in which one person has HSV-2 and the other does not, and who have unprotected vaginal sex an average of 2-3 times per week (60-70 times per year), the infection is transmitted in only 1 in 20 couples every year.  That comes to about 1 chance for every 1,000 sexual exposures.  Since there was no penetration, your risk is lower than that.

Most people with new HSV infections have positive blood tests within 4 weeks, so your negative result is reassuirng.  However, you might consider one final test yourself about 3 months after the sexual contact you had with her a month ago.  Almost certainly it will be negative.  In the meantime, mellow out.  This situation is not worth anywhere near the amount of stress and anxiety you are having over it.

[Marcus1911]

Okay here is the update. I got my results back and they were negative. My partner’s tests were positive for both 1 IGG 5.0 and 2 IGG 5.0. I am freaking out. I used condoms throughout, except for a brief 1-minute direct contact of the tip of my penis with her clitoris. There was no penetration. We briefly kissed twice and minor contact with her clitoris. We did not have oral sex.  My partner did not have any visible sores. I was almost sure that I did not have herpes but now I am a nervous wreck. My last negative test was at the 4-week point. I do not have any visible sores, no fever, my tingling has gone away, little aches and pains in my leg but I am optimistically treating that a nervous induced pain. At this point, I am asymptomatic if I have the virus. I spoke to the Planned Parenthood doctor and she told me to come back 8 week after the initial exposure. If that test is negative then in you are in the clear. 8 weeks for me is on 13 February.  About 4 days after our discussion, I got nervous and went to a walk in clinic on 10 January. I got a complete STD. All were test negative.

My questions are what are the odds that I contracted HSV 1&2?

What are seroconverion rate using the Herpeselect at 4 & 8 weeks?

I am so nervous; I could have caught HSV without actually having unprotected penetrating intercourse. What are your thoughts and what is my next step?

[H. Hunter Handsfield, M.D.]

In the absense of a likely source of infection (the contact you describe was extremely safe, with little or no risk of HSV or any other STD), and without symptoms to suggest herpes (and truly, your symptoms don't suggest it), you can definitely rely on the current test at Planned Parenthood.  If that's negative, please accept it.

Feel free to return with a final comment to report that test result.  You can expect a negative result.

[Marcus1911]

I would like to give you a small update. Today my partner and I went to planned parenthood and tested for HIV and HSV. The HIV test was negative for the both of us. We wont recieve the HSV test until next week. I am soooooo nervous and I pray that both of our test are negative. I have so much anxiety surrounding my positive IGM result. I know you have stated in the past that the IGM test is virtually useless in diagnosing Herpes but a positive finding is still a hard pill to swallow when the results are for you.  Question, if we are both lucky enough to receive negative IGG is it your expert opinion that I need no further testing or should I still wait until the traditional 3 month window period?

[H. Hunter Handsfield, M.D.]

Welcome to the STD forum.

The HSV IgM blood test is highly unreliable.  Almost certainly it is a false positive result.  Further, your symptom don't really suggest herpes, which does not cause "tingling" in the absence of overt blisters, sores, etc.

Here are two threads that go into detail about the HSV IgM tests.  You can find many others; I just tried entering the term "HSV-2 IgM" into this forum's search window and it came up with 389 different threads.

http://www.medhelp.org/posts/show/541451

http://www.medhelp.org/posts/show/1072887

My bet is the tingling is no more than genitally focused anxiety related to the sexual exposure.  But if you need further proof you didn't catch HSV, talk to your partner about being tested.  Or you can have a repeat test (IgG only!) ~3-4 months after the event.  But truly I don't think it's necessary.  You can go forward with confidence you don't have it.

Happy new year--  HHH, MD