Should I do an IgM test?

[luke84]

Hi Terry, as per my previous thread, I tested 0.2 and 0.08 for hsv 1 and 2 roughly more than 2 months post exposure. My only Symptoms are a month long lightheadedness and headaches. I am being treated primary for anxiety now.

But I am still stressing regarding my status. What is the good news in my current results? I spoke to a doctor that does std testing and he told me to do a igm to put me at ease. Given the fact that I have no history and a negative igg, the igM can be purely interpreted as a marker of a new infection. Do you agree with me doing this?


Also, I had a huge fear about hsv2 meningitis. Can I know more about this? How long does the igg take to go positive post primary infection meningitis? And were the episodes long lasting or self limited?

[Terri Warren, RN, Adult Nurse Practitioner]

The IgM is useless and has many false positives.  I would strongly suggest that you don't do it.  Period!  
Your results at a little more than 2 months after possible infection is very good news.  There is probably a 75% chance that your results will stay that way.  

Aseptic meningitis is not uncommon with first infection, but the headaches and light sensitivity usually go away in 2-3 weeks, if they occur at all.

Terri

[Terri Warren, RN, Adult Nurse Practitioner]

If you are most concerned about knowing if you have HSV 1, you should know that the ELISA misses 1 out of 10 HSV 1 infections.  I cannot decide for you if you should do a western blot or not.  I don't have an opinion on this.

Terri

[luke84]

I would like your opinion if whether I should go through the trouble of setting up the overseas WB with the above titres if I want maximum conclusiveness. Whether taken now or at 6 months.

Thank you!

[Terri Warren, RN, Adult Nurse Practitioner]

The western blot is more sensitive for HSV 1 than the standard screening test, yes.

Terri

[luke84]

Dear Terri,

I got my negative 18.5 weeks IGG results today. 0.15 and 0.08 respectively.

May I ask if titres like this ever turn out differently on a WB? Particularly for HSV-1, given it is more sensitive. If no, I will stop testing.

[Terri Warren, RN, Adult Nurse Practitioner]

OK

[luke84]

Hey Terri, about that spinal tap, not my idea. The ID Specialist I am seeing wants to do it. I am having headaches, chills and visual issues lasting till now. No other cause found so far. At the moment chronic meningitis or even mollarets is his main worry, and HSV is a possibility according to him given my exposure.

I would have ran with the 12 weeks test if I wasn't sick and also having this nagging possibility hanging in front of me. So my best bet was to listen to your expert opinion regarding seroconversion timing and to use the WB. I hope you understand. Sticky situation.

I'll do the 18 week IGG today and will keep you posted.

Luke.

[Terri Warren, RN, Adult Nurse Practitioner]

I think taking an ELISA at 16 weeks would be just fine.  If it continues to be negative and you can let this go, then YES, do it!  I'm just not sure you can really let it go, is the problem.  

A spinal tap???? For what??

Terri

[Bigtimeworried55]

If I may add my 0.02. I'm taking my 16 week test Monday and have had the same titer's as you more or less. As Terri mentioned in my post, I highly doubt your positive and your blood regardless of the type of test will continue to show negative. I would bet many dollars on it.

Me? Unless Terri specifies otherwise, I'm taking my 16 week IGG Monday, getting that result, posting it here, and moving on with my life. Your antibody levels are very low and I think it's anxiety at this point with you. I've been there...my 0.02 cents...take the IGG, get the negative, and move on. Choice is yours.

[luke84]

Terri, yes I called. Roger wasn't in so I will try again. But anyway I am having trouble finding a provider for the draw. Turned down by everywhere so far. Still trying.

Should I do another ELISA (18 weeks) while trying to sort that WB out? Can I take it as conclusive if its negative again? I know you said to skip it, but the last 3 weeks have been quite punishing stress wise.

To recap:
Lingering on and off dull headache and neck pain, chills and light sensitivity till now. Had a bout of itchy dry scrotum and irritated follicles in the pubic area a week back(examined).

8 weeks: 0.20 / 0.08
12 weeks: 0.17 / 0.10

Going in for a spinal tap soon, so a conclusive-ish result would help with a diagnosis.

[Terri Warren, RN, Adult Nurse Practitioner]

Did you call the office and they said they weren't sure?  Ask to speak with Roger.  We can include a lab draw requisition, yes.

Terri

[luke84]

Hi Terri, I can try my luck with private home nursing providers. But I require the clinic/laboratory form, will that be provided with the kit? Also, not sure why your front desk still isn't sure about shipping the kits yet. I will call to check again next week.

[Sakura_Pumpkin]

hello,

Because of your experience with herpes, i would like to ask a question.

thanks.

[Terri Warren, RN, Adult Nurse Practitioner]

Yes, that's what we thought at the office.

I'm honestly not sure how they work the draw out.  

Terri

[luke84]

Shipping will be to Singapore. That's great, will be in touch with your office then. Trying to sort out the drawing at my end. Do your international patients typically work with local labs? Because I phoned a few GPs and they said they wouldn't do the draw just like that because it wasn't something they ordered.

[Terri Warren, RN, Adult Nurse Practitioner]

We had a meeting about this yesterday and we are now ready for international shipments.

Where do you live?

Terri

[luke84]

Apologies, Terri. No, that was not what I meant. I was just upset that there were still issues processing it because I thought everything was in the clear. That was just disrespectful on my part, I did not consider yours and the clinic's situation. Sorry.

[Terri Warren, RN, Adult Nurse Practitioner]

Oh, and one more thing.  I have spent HOURS on the phone trying to get this cleared up so I can arrange testing for you and others who are overseas.  

Terri

[Terri Warren, RN, Adult Nurse Practitioner]

The kits are brand new to the office as of my post to you on the 26th.  I will help them with it this week.  Yes, we can ship you the kit.  I would skip the ELISA and do the western blot.

You are bummed about being charged for a consultation?  Did you misunderstand that we are a free clinic?  So sorry if you got that impression.  It is not the case.

Terri

[luke84]

Hey, Terri. Made a consult and spoke to Lisa earlier on, but had issues with the front desk setting up the WB for shipping. Is the green light still on for shipping the kits overseas? Kinda bummed about it (and also being charged for the consult as well haha).

16 weeks is coming up soon. Should I do another ELISA or just skip it wait for the WB?

[Terri Warren, RN, Adult Nurse Practitioner]

We actually are now able, as of yesterday, to send you a kit to have your blood drawn and return to us and we will send to the University of Washington for the western blot.  If you are interested in this, you can contact my office and set up a consultation to arrange this.  

Terri

[luke84]

Terri, I am approaching the 16 weeks mark. Will update you, hopefully this thread is still functional. Can I ask why my titres are not much lower, especially the HSV-1? Or is it still considered low enough?

About the WB, I did not enquire with UW yet, but I am not in Europe. My location is Malaysia. Sounds like I am out of luck?

[Terri Warren, RN, Adult Nurse Practitioner]

It was done privately, yes, though I'm thinking you could likely work it out through UW labs, but I am not certain.  I'm not sure how this was done from the Europe standpoint, but we did receive a blood sample from Vienna without any problem.

Terri

[luke84]

Was this done privately? E.g shipping me the kit for me to draw blood? Sounds sketchy. Is there no import restrictions of blood samples into the US without a lab to lab proxy? I guess this is something I need to discuss with your office yes?