Test Results

[greg19]

To Dr. HHH,

I had received oral sex with no vaginal sex 6 weeks ago.  There was skin to skin contact with our genital regions so I decided to have a herpes test.  My doc had the hepres select igg and an igm test performed done by Quest.  My results were as follows:
HSV 1  IgM - 1.2
HSV 2  Igm - 1.4

HSV 1  IgG - .17
HSV 2  IgG - .35

I have read many posts on Igm results and the fact that they are not reliable.  My question is with my hsv1 igg result being negative, can I assume that my igm positive results are from this recent exposure.  Also, is it simply possible for my results to be a false positive?  I have never had any symptoms suggesting herpes.  What is your clinical opinion on this situation, shoud I have even been tested?

[Edward W Hook, MD]

Dr. Handsfield and I share the site and I got your post.  Hopefully you will be comforted by the fact that while we tend to have different verbal styles, we uniformly agree on our advice and management recommendations.

You are correct about the IgM test, it really doesn't help much.  The HerpeSelect test on the other hand, while not perfect is a very good test when used in context.  You are also correct that the test results that you have are absolutely negative. Let's now add some interpretation.

You exposure was relatively low risk.  Unless your partner had lesions, the chances that you got herpes are very low.  Why?  Because you do not know whether she had herpes or not and if she did, most exposures do not lead to transmission.  Add to that that you now have a negative HerpesSelect assay at about six weeks post exposure and it becomes almost certain that you did not get herpes from the exposure you describe. Certainly there are a small number of persons who do not develop antibodies within this time frame but they are few and far between and in your situation are not a concern.  

In summary then, Did you ever need testing because of this exposure- no, not from a medical perspective.  Is it a good thing to know - probably.  Do you need further testing- emphatically -NO.

Hope this helps.  EWH

[greg19]

Thank you for you response,

I was looking for why my igm results are positive even when both hsv 1 & 2 IGG results were negative.  Knowing that Igg remains in the body for life and igm comes and goes, I took these results as telling me I have never had HSV 1, but due to this recent exposure, i am in the window period of developing hsv 2 based on the igm results. Can I assume that the pos+  igm numbers are leading toward that diagnosis?    

Thank you.