Am I Crazy?

[probneurotic]

Hey Doc,

First of all, great job.  Second, here is my problem.

I had protected sexual intercourse with a girl in October 2004.  A few days later she came to me saying I gave her genital herpes based on the clinical diagnosis of a GP (I think just a visual exam).  I had a HerpeSelect, ordered from Healthcheck USA, performed three weeks later with results of:

HSV 1 : 0.10
HSV 2 : 0.14

I repeated the test in December (about 8 weeks later) with these results.

HSV 1 : 0.12
HSV 2 : 0.16

The girl I slept with also had a test from the same place that said she was "negative", but didnt get the exact results.
I have since started to date another girl and am constantly worried I am going to get a phone call asking why I gave her herpes.  Going on October 2005 and it is still always in the back of my mind and causes me a lot of grief.  I dont know whether it is legitimate or whether I need to seek mental help and just let it go.  Is it possible she was misdiagnosed in the first place (folliculits, etc) ?  

Last, I am just a med student but I thought maybe I could clarify some of the gG to IgG question about type specific serology.  "Serology" in itself is a measure of our body's Ab response to antigen.  In this case, the HerpeSelect measures our IgG Ab response to the TYPE SPECIFIC glycoprotein G (gG) on the surface of the HSV viral coat.  These IgG's remain in our body for life.  So... the type specific tests are IgG tests testing for gG... Immunoglobulin G response to glycoprotein G...maybe just adding to the confusion.

Thanks

[H. Hunter Handsfield, M.D.]

Your HSV serology results are negative.  Most people who acquire HSV will develop a positive result within 8 weeks, but sometimes it takes 3 months or even longer.  But the chance you got herpes from any single encounter were very low anyway, so I don't reommend further testing.

I don't see a specific question in your last paragraph.  You have the facts right, and I agree the terminology is confusing:  gG stands for glycoprotein G, a specific antigen on the surface of HSV viral particles; and IgG stands for immunoglobulin G, a class of antibody.  So yes, the HerpeSelect test detects IgG antibody to gG-1 or gG-2, designating HSV-1 and -2, respectively.

Going back to the closing comment in the preceding paragraph ("whether I need tto seek mental help"):  As you go through your medical training, you will learn first hand what I have said many times on this forum, that when a person suspects s/he has an emotional problem or needs mental health expertise, s/he is often (usually?) right.  Obviously I can't make that judgment from this distance--but if in doubt, an initial consultation wouldn't hurt.

Best wishes--  HHH, MD

[probneurotic]

The second paragraph was just addressing some confusion I read in previous threads... sorry about the wordiness.

The help I really need is just to be told to stop worrying about it from a medical professional.  This is the kind of help you all give every day.