Test results show negative IgM and 0.97 for IgG

I am very confused. I just received test results back for Herpes.

I was told by a testing center interpreting results from Quest Diagnostics that I was negative for IgM antibodies (used to test recent exposure to Herpes virus I and II) but that I had a .97 level "equivacle" (.90 and below is negative?) for IgG antibodies, which was explained as any longer-term (more than 3 months) exposure to Herpes II.

The testing center said that I could "rule out" any recent exposure (less than three months) to herpes, but that I may carry the antibodies for Herpes, which would mean that I was exposed to Herpes sometime in my life. I've never had any herpes symptoms in my history.

I'd like to know what is a truly negative reading for IgG. I have seen tables that say that 110 or above is positive and 90 or below is negative.  I had a sinus infection at the time of the test and was being treated with Augmenten. Not sure if that matters. I will test again in three weeks. Very scared and confused.

[H. Hunter Handsfield, M.D.]

Almost certainly you have neither HSV-1 nor HSV-2.  The 0.97 result is probably negative, but you are right that it's in a borderline range.  You could re-test in another 3-4 weeks to be certain.  The testing center is wrong to say you carry antibodies (your test result shows that you do not); and if you did, it would mean you were infected.  The manufacturer recently modified the technology so there will be fewer results in the equivocal range; in the future, your problem won't happen to so many people.

Bottom line:  Almost certainly no HSV-2 infection, but to be absolutely sure, get retested in a month or so.

Best wishes--  HHH, MD

[JDoveH]

I failed to say why I went for STD testing. I had sex (some vaginal penetration and oral sex) with a stranger (female) two weeks ago but I wore a condom the entire time. I am was relieved to know that I was IgM negative for Herpes I and II. I was also negative for Chlamydia and Gonhorrea.

[JDoveH]

Dr. HHH,
After reading several postings, I realize what an incredible educational service you are providing. I should have read throughout the entire Herpes thread first, now I realize I left out information that may be helpful for you.

I used a private testing center and explained to them that I had had protected sex with a sex worker 8 days prior to testing. I wore a condom the entire time, penetrated for a brief period and then continued with oral sex. They said I needed to wait 7 days before I tested for any STDs. They said they used HerpesSelect tests. I had been on amoxicillen (not augmenten) for less than 24 hours when I went for testing. The private testing center said it would not effect the results. Would you agree?

As I said in the first posting, they told me yesterday that I was negative for HSV Type I and II Herpes using the HerpeSelect IgM antibody test(which I now know through your postings that the results are worthless, although you said that a negative result may be less so).

Today I was told that I was negative for Chlamydia and Gonhorrea but "equivacle" for HSV II Herpes IgG antibodies at a .97 level.
They told me tat I was IgM negative for Type I and II.

Are the HSV I and II IgM results even valid?

Do you consider the HSV Type II antibody IgG results at .97 to be negative? (you have posted that 1.10 or lower are negative but other posts have used 1.0 as the cutoff). You have stated that in order to get 100% accuracy, the IgG tests need to be at least 12 weeks at least after contact. The testing center I used said I only had to wait 7 days for all the current testing but 30 days for HIV and Syphilis.

The testing center claimed that the IgG antibody for HSV II is an indication that I had been exposed well before my encounter. How far back could I have been exposed- the last unprotected sex I had was prior to marriage 13 years ago.

Is it possible to have antibodies for HSV II for almost 15 years with no symptoms? If so, should I ever expect to develop symptoms if I have been symptom-free for this long?  

Anyway, thank you, in advance for your help. I really appreciate it.

[xtra]

IgM testing is not recommended for Herpes testing because it cannot differentiate between hsv1, hsv2, cross reacts with other viruses, and it's unreliability for determining if the infection is new or preexisting. The IgM antibody is not specific to herpes. It's a general purpose antibody which will show up for ChickenPox, Shingles, Mono, and other viruses including herpes.  The IgM antibody will show up for new herpes infections and about 1/3 of recurrent herpes outbreaks.  While a negative IgM test is good, it's not definitive.  

The IgG antibodies are specific to HSV.  The recommendation for the HerpeSelect, WesternBlot and the Rapid BioKit-hsv2 blood test is waiting at least 12-16 weeks post possible exposure.  While it's possible to seroconvert (turn positive) in as little as 3 weeks, half will by week 6 and most people will seroconvert by week 12, in rare cases, six months may be necessary.

No test is 100% accurate at 16 weeks or 6 months, it's the nature of the beast.  Most testing accuracy is at about 97-99%.

Because IgG antibodies can show up in 3 weeks, and IgM antibodies come and go like farts at chili cookout, it would be hard to pin point how long someone's been infected.

Yes it is possible to have hsv antibodies for 15 years and not know it.  90% of the people who have herpes, don't know it cause the symptoms are so mild they go unnoticed or misdiagnosed.

[JDoveH]

Thanks Xtra, but my question related to the level that I was tested at for IgG. IgM negative is a good indicator potentially according to Dr. H, but IgM positive has a strong probability of being a false positive. One can't assume that a false positive trumps a negative result- either you are infected or not. More than likely, a negative means no recent infection, right? Dr. H confirmed it.

What's your overall read on the .97 IgG reading, given the circumstances?

[lad82bg]

I had been with this guy for 6 years and we split.  A couple of months later I met someone else and slept with him without using protection.  About a month later an ulcer appeared around the opening of my vagina.  I went to the emergency room as soon as it came up.  They did test on me.  The HSV IGM antibodies came back as detected but the herpes culture,rapid came back as none detected.  I went to my gyn the other day and she has me freaked out that I may have genital herpes.  She said she was going to do a HSV IGG test I and II.  I haven't received the results and I am worrying about it it's about to make me sick.  I might find out the results in 2-4 days.  Is there any advice that can help to ease my mind.

[lad82bg]

I had been with this guy for 6 years and then we split.  I met someone else about 1 1/2 months later and we slept together without using protection.  About a month later I had an ulcer come up around the opening of my vagina.  I immediately went to the emergency room and the test for HSV IGM antibodies came back as detected.  The herpes culture,rapid came back as none detected.  I went to my gyn the other day and she has me freaked out that I may have genital herpes.  She wanted me to wait until the end of February when I have my annual exam to have the herpes test done but insisted on having it.  She did a test for HSV IGG for I and II but I won't know the results for another 2-4 days.  I am worried sick about this.  Do you have any advice to ease my mind.  I would not be able to stand it if I really have herpes.  I am currently in a monogamous relationship and love him very much and knows about this.  What can I do?

[T321]

A related discussion, Herpes testing was started.

[kimmie146]

A related discussion, igg negative test results was started.