Avatar universal

Positive HSV1 Culture, Negative HSV1 IGG, 2.39 HSV2 IGG

(Late 20's male, uncircumcised, negative for both HSV1/2 3/2012).
My girlfriend (until earlier today) and I enjoyed a very active sex life, vaginally and orally. About two months ago she complained of some burning and itching in her vagina. She went to the gyro and all parties thought it was just a yeast infection, no testing. Shortly thereafter I developed some itching and small red spots, thought it was just a yeast infection and from what I read it sounded like it would just go away. Last week I developed some pain during ejaculation which morphed into pain during urination. I went to urgent care and the doctor said it presented like herpes and took a swab, blood and urine to run tests. Last Friday the swab came back positive for HSV1 and the IgM came back negative for both HSV1/2. After doing some research I called back and asked them about the IgG results and they told me that the lab had not resulted the IgG for some reason. I asked them why they didn't and they had no explanation. I asked them to have the lab develop them and I received the results today and it was IgG negative for HSV1 and 2.39 for HSV2.. I have never had any symptoms prior to last week. These results have me rather distressed and I am curious what the various scenarios that could come of these results?

Do I have HSV1 & HSV2 Genital herpes?
How likely is it that I only have HSV1?
How likely is it that I only have HSV2?
Is there anyway I can determine exactly what I am infected with?
19 Responses
Avatar universal
Check out western heights clinic Terri warren is a nurse she knows a lot. They are going going to tell you that you need to confirm it with a wb. Insurance does not cover it you have to pay out of pocket. When my igg for hsv2 was 2.9 Terri told me I had a 40% chance of being negative. My igg went up however so now my chances are lower I'm at 3.2 so I'm at 20%. Terri charges 20$ and you can ask 3 question you pay $20 and then it will allow you to post your first question.
3149845 tn?1506627771
Hi, swabs that come back positive would be conclusive. What area was the swab taken from? Also your test for hsv2 falls into the false positive range and would need another test to confirm.
Avatar universal
Thanks for the response! The swab was taken from the head of my penis. The doctor that took the swab told me that it was more likely that there was a problem with the test from the swab than it was likely that the blood test was incorrect. Based on my research it seems that this would be the other way around. That the cross-reactivity of HSV1/2 would be more likely to cause a false positive in the IgG than it would in the culture swab. Thoughts? At this point I am hopeful for HSV1 rather than HSV2. Also how likely is it that this is a recent infection, within the last 6 months?
3149845 tn?1506627771
Having a positive swab and a negative igg would infer a recent infection. False positives with a swab would be more of a lab mix up. At this point have her tested esp for hsv1. As a rule of thumb a blood test 8 weeks post exposure would be a good indicator. So the best course of action if for you to have another blood test at the 3 month mark and her to have a blood test now.
Also a side note that having a herpes outbreak on the penis head is not common at all.
Avatar universal
So how likely is it that the positive test for HSV1 from the swab was actually a positive for HSV2? Or that the 2.39 HSV2 test was actually 2.39 HSV1?
3149845 tn?1506627771
If they typed the swab for hsv1 then it would not be hsv2 as they are different. The only way a blood mix for 1 and 2 would take place is if they did a combination test.
Avatar universal
Okay well that makes me feel better about the swab test. LabCorp is the lab that processed my samples. Would a recent infection with HSV1 possibly cause a false positive for HSV2 blood test while still showing a negative for HSV1 on the IgG? Thanks for your help. This is the first I have talked with anyone other then my ex-S/O about my status. It is really good to talk about it and get more information. The doctor made it sound definitive that I have HSV2 and most likely also HSV1 genially.That is the worst case scenario. I am hopeful that is not the case. Thanks again for your response.
3149845 tn?1506627771
The hsv2 is very most likely a false positive as any numbers below 3.5 would need retesting. Most labs stop at 5 but can go to 20 and over for long term folks. If you have the money then have another blood test now and if its negative it would infer a recent infection but at 8 weeks post exposure the number should be at least a 1.5 or even a 2 for new infections. But this is only theory.
Avatar universal
Thats why this is so confusing to me. Because I have the positive swab for HSV1 but a negative IgG for HSV1 and a "Positive" (2.39) IgG for HSV2.  My initial symptoms (itching urethrae and spots) was like two months ago. Given the timing I feel like I should have had some HSV1 IgG results. I am going to pic up a physical copy of the lab results this afternoon. Because I can't remember if there was any reactivity with HSV1 IgG.
3149845 tn?1506627771
And let us know the results
Avatar universal
Okay so I got my results back just now.

The culture cam back positive for HSV1. Typing was confirmed by monoclonal antibody microscopic immunofluorescence.

The test ordered for the IgG was HSV 1 and 2- Specific Ab, IgG.
Under the HSV1 portion the result says <.91
Under the HSV2 portion the result  says 2.23 High (I was wrong about 2.39)

What am I looking at here in regards to the possibility of having only HSV1 genital herpes? Or having both and the HSV1 being a recent infection? Or having only HSV2 and the culture test being wrong?
Avatar universal
Grace, I have read through many of these threads and you seem very knowledgable. I appreciate the help from Life360 very much but I was wondering if you would please give me your opinion on my situation. Thanks!
3149845 tn?1506627771
At this point all you can do is have your girl tested now and you have another blood test at the 3 months mark. We can assume a lab  mix up but also assuming is not going to confirm anything. The only way to negate the swab is a blood test at the correct window.

3149845 tn?1506627771
I would also like to add that at best, blood test can miss 10% of infections so if we consider a la mix up vrus a missed blood test, the blood test would be the weak link.
Avatar universal
I plan on getting tested again in a few months, I am guessing around mid-June. Is what you are saying that it is more likely that there is a problem with the blood test (i.e. false positive on the HSV2 IgG due to cross-reactivity with HSV1) than it is likely that they typed the culture incorrectly HSV1?
Avatar universal
Also does it matter that they waited almost a week to run my IgG test?
3149845 tn?1506627771
yes cross reactivity can show elevated  levels but showing a negative hsv1 would compromize this idea theory. So if you were positive for hsv1 your hsv2 could have elevated levels thats why any test under 3.5 needs to be reconfirmed.

No to your second question.
Avatar universal
Just wanted to update you. I got another test done last week after I noticed another spot form on my penis head. I wen to the urologist and had a swab taken and blood work down. It appears the lab lost my swab so I am waiting to find out how that happened and whether they are able to recover it. The results I got are as follows:

Herpes Simples Type 1&2, Herpes Titter:
HSV- 1 IgG - Negative
HSV- 2 IgG - Negative

Herpes Simplex Type 1&2 IgM, Herpes IgM:
Herpes Type 1&2- Positive 1.47
"The following results were obtained with the Diamedix
immunosimplicity Is-HSV1 and 2 IgM EIA Test System.
The magnitude of the measured result, above the cut-off,
is not indicative of the total amount of antibody present.
The magnitude of the reported IgM level cannot be correlated
to an end-point titer."

HSV-1 IgM Antibodies IFA

HSV-2 IgM Antibodies IFA
Weakly Detected

What are your thoughts on my latest results? Pretty unlikely that I have HSV-2?
3149845 tn?1506627771
Just stick with Howard in your other post. Having 2 posts going is difficult to go back and forth reading replies.
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