IgM and IgG confusion

[etc24]

Hello Dr.

I just got diagnosed with Herpes, although I have my doubts.  I have had no sexual contact within the past 5-6 weeks (possibly more than that, i cannot quite remember) and the results concluded that I only have IgM antibody present in my blood.  This is what my results look like:

HSV 1/2 IGG, Herpeselect Type Specific AB
Herpes Simples Type 1- 0.93
Herpes simplex Type 2- 0.09

HSV IGM Antiobody W.Refl titer
HSV IGM Antibodies were detected/ Ref. range was not detected
HSV IGM Titer was 1:20

What does this mean?

In addition to that, is there any way to tell wether I have type 1 or type 2?

Should I get tested again soon?  The Doctor put me on Valtrex and told me to do a follow-up in two months (I think that is only for my liver/kidney analysis).  I have been reading alot about the virus and the presense of IGM without IgG...could this elude to another infection.  Do I really have genital herpes?  What do you suggest?  How long does it take for IgG to become detectable?  How long does IgM remain detectable?  

Please help.  I appreciate your time.

[gracefromHHP]

sounds more like you had canker sores - not cold sores.  Canker sores are more typically inside the mouth area. They are not contagious.

irritation is common. I know it's hard to believe but really sometimes it really is just irritation and not something like herpes.  Have they tested you for yeast and bacterial vaginitis at all since the first u/a when you thought you might have a uti going on?

grace

[jambalaya]

hi grace

Since you seem do have a good understanding of this matter I was wondering if you could help me clearify my problem.
I aquired genital HSV-1 3 weeks ago (found out through culture test)
And I know that once you have the antibodies you are almost immune or at least very resitant of spreading the virus to other parts of you body or aquiring a new HSV-1 infection from someone else.
My question to you is how much of a risk could I be in of aquiring HSV-1 orally or a new genital infection if I have intercourse or oral sex with another genital HSV-1+ lady that just aquired HSV-1 too?

As I read it too, If you recenty got exposed to the virus you build LgM antibodies until you build LgG antibodies.
But will the LgM ones protect me now untill I build LgGs?

[etc24]

I think the last cold sore I had was on the inside of my mouth...i cannot even recall one on the outside since i was a child/highschool.  

Yes, I had irritation (just on one side of my vulva)...and it was right after a sexual act and right before my period.

I exercise alot and a little over a month ago I had a urine analysis and it came back positive for protein in my urine...I got retested at the same time I got the STD test (5/5/08) and the UA came back negative at that time but IgM detected.  Could this be indicative of anything/do they correlate?  

I thought I may have had a UTI infection or something at the time/just prior of the first UA and PAP (march 20th) (mainly because my "symptoms"/ sexual act were right before that)...and then decided I would get STD tested at the second UA date (5/5), for a peace of mind (never had before)...so much for a peace of mind!!  You are definately helping though, and I really appreciate your insite...it will be tough waiting two months for another exam.  Should my partner get tested?  

and you are right...the more I think about it...the more I think there is an irritation/tingling...ugh...am I making this up now??

[gracefromHHP]

Even your hsv1 is negative though that's not unusual even if you do have a history of cold sores.  Even the best tests we have still miss 1 out of every 10 hsv1 infections.  When you last had a cold sore - was it on the outside of your lips or in the inside of your mouth?

You only had irritation - it might not even be herpes.  Not sure why your doctor is insistant that you have herpes.

grace

[etc24]

Thank you grace,  easier said than done.  I am in a situation that makes this complicated and I really appreciate your input.  It is funny, I have called my doctor a few times and the more I question her the more I doubt her.  For example...she didn't even request a re-test on my HSV status...just on my liver/kidney counts...I had to request that I get retested in July.  Is this odd?  And I asked that if she knew what type I was...she said since you already have a sign of HSV-1 and this is a 'new' infection...we assume it is HSV-2.  Assumption??

I really want to believe you 100% and I pray to god that you are right...but when a Doctor says that you have something...we are conditioned to believe it.  Although i am doubting it more and more...I am still going to find it difficult not to think every single thing "down" there or anywhere is an outbreak!  

Why don't doctors educate themselves on these issues.  

What other viruses would cause an acute raise in IgM count?  It looks like I could have HSV-1, but I haven't had a cold sore in years.  

Thanks again for all your help, my mind is starting to "ease" a bit.  Trust me, i was in a full fledge panic!

[gracefromHHP]

Who can you believe? Well me of course! No honestly I take great pains to be as up to date as possible on herpes and I'm not making any of this up.  etc if you take absolutely nothing else away from this board - remember that the igm herpes test is not accurate and should never be drawn on you ever, ever, EVER again. Got it?  If you feel the need for more reading - search for igm herpes testing posts by HHH - he's covered this so much he won't even type as much as I do on it at this point.  


How long is it before IgG is present in the blood?  I read that it is 4-6 weeks before you see IgG...is this correct?  Would taking ValTrex change my results or the onset of IgG?  

- in about 1/2 of folks it's present by 2-3 weeks after infection.  Some folks take up to 6 months but the vast majority of folks are testing accurately by 3-4 months post infection.  taking a round of valtrex won't affect your results - there is no reason for you to be on daily suppressive therapy since at this point all signs point to you not having herpes.  

You say disregard the IgM test?  Why?  Doesn't it indicate acute infection?  Why do they use it?
- it's not accurately type specific even when it claims to be; it can be falsely + due to other viruses and due to other herpes virus infections; it also frequently reactivates during recurrences of hsv so you can't rely on it to be an accurate indicator of a newly acquired infection either.  Why do they use it? Because most providers are not up to date on herpes blood testing and don't even know that it's not like other igm blood tests are for other infections.  

Of course I am paranoid now and everything I see or feel is an "outbreak" to me.
- put down your johnson dahlin, walk away from the computer for the next 6 weeks and go about your day as usual.  The more you worry and obsess - the more you'll "feel" down yonder.

What do my results above indicate?  
- as I've already said - your test results are negative.

grace