Positive IGM HSV2 result with low/negative IgG of .07

[Gerry360]

I am at high risk as I am active sexually, male/female sex. I had an encounter on July 13th no reaction whatsoever. I was fine for weeks. I had a second protected encounter on Aug 16th.the condom came off as she got off me but we put another one on and continued. On August 19th I had a regular check up where my doctor tested for all STD's including type specific IGM and IGG tests for HSV1 & 2 but I already knew I have had HSV1.My ex partner had HSV1 since college and we were together for 20 years. (I am 43.) I had a cold sore 3 years ago and never had another although when stressed, my lip will bother me but goes away with a cream my doctor gives me once a year. A small tube lasts all year so I don't need it often. I had a 3rd encounter August 25th , this time unprotected with a girl I have been dating for 3 months. It was the first time we had unprotected sex, this also included an accidental insertion into her anus. It was quick but my penis was completely inserted before noticing. Anyway back to my issue. The next day after this last encounter, on August 26th, my doctor called me in for the results. He advised me that I was positive for HSV2! I was shocked. He said we needed to retest as the IGG specific HSV2 test was very low at .07 but the IGM only said positive no number. Although there is something on the test that says IGM Titter is 1:40. I don't know what that means.I spoke to both women I had unprotected sex with and both swear they have been tested for all STD's and nothing. the first encounter only said she did a full panel in June and was negative but she couldn't for certain tell me she tested for HSV2. She is getting tested on Tuesday this coming week. My doctor will not retest until the 19th. Another issue that has popped up is I am having a bought of urethritis but this was a worry of mine from the anal sex.  I have had UTI's before and no doctor could tell me what it was. I ran every STD and nothing would come up. Finally my doctor prescribed a 2 week course of Zpack and it did the job. I say this because it is very similar to that. I have no lesions and never have. I also use a fungal crème as I tend to get yeat on my penis every once in a while and the cream does the trick, It's Ketoconozole. It is actually helping my urethritis now but not completely. As you imagine, I worry this is a mild outbreak due to me already having HSV1 and those antibodies are helping??? My question is, knowing all of this, what do my test results mean. I think I know the answer is retest but wanted a professional opinion. thanks!

[Donnymax]

Hi, did you ever get 100% relief after finishing your z pak? I saw that you mentioned you started to feel symptoms 2 days after ending treatment. How long did it take for you to feel complete relief?

[feelingundone]

I am bet the kitchen sink your negative.

[Gerry360]

Hello Again, I had already been scheduled with my doctor to retest on September 9th, 8 weeks after exposure. Here are the results for the IGG negative .10. The IGM still came back positive. Not sure why he requested it since I told him I knew these were suceptable to false positives. He also ordered a HSV2 & 1 DNA PCR. These results were odd as they both came back negative which doesn't make sense since I know I have HSV 1. I feel better as I haven't had any signs of a break out outside of the urethritis and back and leg pain but I am worried my IGG came back a little higher at .10. The last test 14 days prior was .07. Does this mean anything? Thanks for the follow up!

[feelingundone]

Your urine test doesn't mean much as far as hsv is concerned. It would be rare that hsv would cause urethritis without other obvious symptoms like lesions. Either way the odds are statistically that is 85% likely to be a false positive with that low a number. My opinion is you don't have genital hsv

[Gerry360]

I appreciate that. I understand there is still a chance but will update you on the results as I know you track these well. If I am positive, my hope is I will be lucky enough to only get mild outbreaks because I already have HSV1 antibodies.

[feelingundone]

In the absence of lesions this would be extremely rare.

[Gerry360]

Thanks again. Sorry, would the urethritis be rare or not finding bacteria in my urine. I imagine if this were a mild outbreak it would show something in my urine?

[feelingundone]

I guess it did go through. Go figure. Lol

[feelingundone]

I wrote out a lengthy response that didn't go through. Here's the cliff note version. No Dr should EVER give an igm test for hsv to an adult. They are very unreliable and wrought with false positives. They also don't differentiate between hsv1 and hsv2. No expert recommends the igm. Even the CDC is against them. Disregard the igm results and retest with an igg only test 12 weeks from the first exposure you describe above.

[Gerry360]

Thanks for your response. Could a mild outbreak cause the urithritis but not show up in a dip stick urine test. I went to an urgent care center last night where They performed the dip test to check for bacteria and found be none. He said my urine was clean but I think I may have an infection from the anal sex. I have no sores or lesions though.

[feelingundone]

Hsv igm tests should NEVER be given to an adult. They are completely unreliable and wrought with false positives. No std or herpes expert recommends the igm. Even the CDC is against igm testing for the above reasons. I get at least two people just like you every week on this forum. Scared ******** because Dr's are not up to speed and just order every test on the menu. Flat truth of the matter is to completely disregard the igm results. Retest 12 weeks from original encounter with igg only. Here is another fact. Igm doesn't differentiate between hsv1 or hsv2.