What do these IGM and IGG Test Results Indicate?

[smz]

Dear Doctor,

I recently had a full spectrum STD blood test done.  My Herpes results came back positive.  I do not know what test was used, but here are the results:

IgG Type Test:
HSV-1: 0.06
HSV-2: 0.01

IgM General Test: 1.21

The Nurse Practitioner who called me with the results said that I should be tested again in 3 months because the IgG test is inconclusive; because it has levels for both HSV-1 and HSV-2 it can't distinguish which type.  But in looking through the forums, it seems like all these numbers are very low.  She said that it looks like I've never had a previous infection because the IgG levels are both below 0.9.  She said that generally for IgM, however, they look for a number below 0.91.  I know that you've mentioned on this forum that IgM tends not to be useful, however.  What are the actual chances that I have herpes?

My boyfriend has also since gotten a herpes test; next week we'll get results.  I've had unprotected sex before with partners whose STD status was unknown (I'm female), and my mother has oral herpes.  His mother also has oral herpes.  He has never had another sexual or romantic partner other than me.

I have had no signs of an external or internal vulvar/vaginal outbreak, and I've never had a cold sore, though I do currently have a small pimple-like spot near where my upper lip meets the skin beneath my nose.

I have also been having recurring yeast infections lately.  At least 6 this year, with most of them occurring in the last 6 months.  I was on Monistat treatments which did not seem to work; I went on Diflucan, which ended up needing a supplementary cream to help clear up the infection.  Then I had bacterial vaginosis for the second time this year.  

All of these yeast infections/complications led me to get the test, but I was HIV-negative; though I am overweight, I am not diabetic.  I think (and hope) the yeast infection symptoms are attributable to diet (eating a lot of sugar around the Thanksgiving holiday) and supplements (I went off of my oral acidophilus/bifidus pill.)

I have done a good deal of research on HIV, yeast infections, and herpes recently, but I do not know what these results mean.  What are the chances that I actually do have herpes?  And would there be any other reason for all of these repeated yeast infections?

Thank you for your time,

[H. Hunter Handsfield, M.D.]

Your results are entirely negative; you are not infected with either HSV-1 or HSV-2.  The IgG results are reliable, but your NP is wrong in the interpretation.  Negative, negative, negative.

But IgM testing is not reliable.  (In 30+ years, we have never once requested an IgM HSV test in my STD clinic and aren't about to start!)  Search this forum for "herpes diagnosis" and "IgM" for a large number of discussions on this topic.

As to what what is causing your symptoms, I cannot say.  But it isn't herpes.

I hope this helps. Best wishes--  HHH, MD

[love770]

A related discussion, not clear was started.

[abcba]

Can having hepatitis vaccine shot few days prior to herpes testing show increase in iGm level?

[smz]

This is smz's boyfriend.  I wanted to thank you for your advice and analysis.  I also wanted to add that these blemishes did not itch or hurt in any way, except when I experimentally popped one.  There was a clear, maybe whitish fluid, similar to the contents of very shallow pimples.  It healed within 2-3 days--no redness or anything left after that time.  I know that herpes lesions can take several weeks to fully heal, and these did not strike me as anything other than a couple of acne blemishes on the shaft and head of the penis.  Like she said, I first experienced this along with a bit of a red rash after we used a spermicidal gel without a condom.  I highly suspect that this was due to a chemical burn from extended

We normally have unprotected sex since Kim is on the pill and we have no other sexual partners.

Again, I'd like to reiterate that I have had no sexual or romantic partners other than smz.  When I heard that she/we might have herpes, it was a shock to me given the all-clear she had gotten on several previous STD tests.  I was very upset.  Your words have given us great relief.  As a student at the University of Washington, I know what great minds operate the institution, and I have great respect for your expertise and commitment to your field.

Thank you once again,

smz

[H. Hunter Handsfield, M.D.]

I can't say what is causing your boyfriend's symptoms, but it doesn't sound like herpes; and as I said you don't have it.  Maybe sebaceous cysts?  Or other normal anatomic variants?  He should see a health care provider, ideally a dermatologist.  Also, the providers at Hall Health (for others, that's the UW student health center) are very knowledgeable about STD and therefore about genital dermatology, indeed some of the providers there used to work at the STD clinic.  (For example he could ask for a nurse practitioner whose initials are P. McE.)

HHH, MD

[smz]

I just wanted to add that my boyfriend also experienced some red, pimple-like spots on the head of his penis after we had used lubricated condoms.  Once occurred after the condoms had spermicide, so before the results of this test we speculated that it was a reaction to that.  Once occurred after using a non-spermicide condom.  Both were polyurethane, as I'm allergic to latex, so then we speculated that it might be an allergy to that.  But now given my test results we obviously are both wondering if there's a possibility that this might be genital herpes.

Thanks once again.