Herpes Test came back Positive

[ralph01]

About 6 weeks ago , I received a handjob at a massage parlor in Malaysia. I inspected the massuers hands and did not see any lesions or visible marks.

I have been anxious and inspite of the potential low risk exposure, I had an STD screen done last week (Fri). I got a positive for Herpes as follows :

IGM : Positive for Recent Exposure
IGG Type1 : Negative
IGG Type 2: Positive (1.16)

The handjob that I received has been my ONLY exposure outside of my regular relationship (my partner is also  been monogamous throughout).

How do I interpret this ? I do not have any symptoms - never had any in the past as well. I have been taking some oral medication (Grifulvin) for some skin irritation and rash for the last week.

Are these results conclusive ? What should be my next step ?

Regards,

-R

[ralph01]

My medical practioner was surprised at the result. At 1.16, given my past history (single partner) he suggested  that this was tripped by some other protien and not hsv-2.

But to put my mind at ease he did a Western blot test. Would that be conclusive ?

In your opinion is this the right course of action ?

-R

[H. Hunter Handsfield, M.D.]

The explanations for false positive results are unknown.

[ralph01]

Thanks for the clarification

One final question - if, hopefully, this is a false positive - what factors can lead to this ?

Thanks

-R

[H. Hunter Handsfield, M.D.]

I guess I don't understand what wasn't clear.  But yes, I am saying the IgM result is invalid.  You should ignore it entirely.  It is meaningless.  For more information, use the search link and enter "herpes diagnosis" or "IgM".  You'll find lots of discussions about it.

Make sure the IgG test was one of the type specific ones.  If it was, just repeat the same test as before, except tell your doc to not request the IgM test.  You can do it any time now, since the hand job is not a possible source of infection.  But if you don't believe me and insist on believing that could be the source, do it 12 weeks after the event.

[ralph01]

Thanks for your response.

Based on your comment above - are you saying that the IgM results are invalid. Can you pls clarify how I should interpret these ?

You also recommend that I get re-tested. How long after potential exposure should I get re-tested.

What specific testing should I seek to confirm these results ?

Thanks
-R

[H. Hunter Handsfield, M.D.]

If the blood test was a truly type-specific test (e.g., HerpeSelect, Captia, or Kalon brands), then you probably have HSV-2.  (Some other HSV blood tests claim to be type-specific but are not; that is, they do not accurately distinguish antibody to HSV-1 versus HSV-2.)    All IgM results are non-type specific, and the IgM result is meaningless.  Despite claims by the manufacturer and some laboratories, a positive IgM result is not evidence of recent exposure.  

However, your HSV-2 result is very weak. It is technically positive, but it's a good bet the result is false.  It is conceivable that you are early in the course of your infection, and a later test will show a more strongly positive outcome.  So repeat testing would be a good idea.

If the positive result is confirmed, you can be sure you didn't catch it during the hand job you describe.  Many people have positive results despite no known exposure.  If either you or your wife ever had other sex partners before you became a couple, then that is the source of the HSV-2.  But as I said, it's a good bet you aren't infected at all.

Griseofulvin does not alter HSV blood test results.

Finally, your story is a good lesson why you should not have been tested at all.  If you had asked me before the test was done, I would have advised you not to do it.  Why?  Because after such an exposure, the chance of a false positive result was higher than the risk you acquired HSV from that kind of exposure.  That appears to be what happened, and all you're getting out of testing is worry, frustration, and additional expense to work it out.  Other forum users at low risk for STD, please take note!

Best wishes--  HHH, MD