[Question #10304] Herpes Simplex Virus (HSV) Antibody Type 1/2, IgM
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24 months ago
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My 17 year old son had a sexual encounter back in March 2023 that worried him, so, a few weeks later (April 2023), he took a 10-panel test and everything came back clean. However, he was warned about potential false negatives. Unfortunately, he started having symptoms in late June 2023 and was diagnosed with chlamydia after another panel of tests (Herpes was not tested). His pediatrician put him on doxy and he took it for a week. His symptoms didn’t improve, so it was increased to 21 days. He’s had burning off and on for the past two months, so I took him to a urologist last week to discuss the burning sensations and he took another panel of tests. This time, herpes was tested. Everything came back negative, except for HSV Antibody Type 1/2 IgM. It came back equivocal at 1.06. All his IgG tests were negative/nonreactive. His urologist told him he has herpes! He is slowly feeling better from the burning pains (doctor put him on meds for those), but he is devastated. As his mother, I don’t know what to do. It’s been at least 12 weeks since his last sexual encounter. Please help.
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Terri Warren, RN, Nurse Practitioner
24 months ago
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OMG, this is so messed up. I'm so glad you found us! The HSV IgM test should NEVER be done. Big labs like the Mayo Clinic discontinued this years ago and so should LabCorp and Quest - they said they would be so far have not. The reason the Mayo Clinic discontinued using it is due to the VERY high rate of false positives. If his IgG is negative, that is what he should trust and SHAME on the MD who did the IgM to start with, much less telling a 17-year-old that he has herpes. I am literally shocked to hear about this experience. It is so out of the range of what is normal practice in herpes testing in 2023.
If his burning continues, he might want to get tested for mycoplasma genitalium if that was not done. But the doxy should have taken care of the CT.
I'm so sorry that your dear son has had to go through this due to a clinician who did not understand appropriate herpes antibody testing. The CDC says to no longer ever do even the IgG test for HSV due to high rates of false positives unless someone has symptoms consistent with herpes.
Terri Warren
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24 months ago
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Thank you, Terri! I am so glad I found you. He is about to start school again and this has really caused him to have anxiety and withdraw socially.
When we questioned the doctor about the equivocal IgM finding of 1.06 and the test stated, “retest in 2-4 weeks’” he said , “oh no, he has it, but he should be able to manage…” No medication suggested. Nothing . Honestly, he couldn’t explain and I couldn’t believe what I was hearing because he wasn’t explaining what we were reading from the tests results. Therefore, I started searching for answers and found this site.
I will look into the having him tested for the condition you suggested. He has been on Uribel for 6 days (one day left) and Meloxicam (on day 6 of 30) now for the burning pain.
I want to assume the IgG is enough, but i have an additional question. Do you think he should have any additional panels done? He’s had 3 panels over the last 6 months and they have done a number on his mental health.
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Terri Warren, RN, Nurse Practitioner
24 months ago
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I don't feel that additional testing is necessary, no.
I think it would be useful for you to share the CDC recommendations about herpes testing with this urologist. You can find this by searching CDC STD treatment guidelines, and search the herpes section. This physician made a huge error that had a very negative impact on your child. I am biting my tongue about how upset I am about this or I would say a lot more.
The medications that he's taking now appear to be for urethral discomfort and inflammation. They are not antibiotics, just so you know what they are for.
You're a very good mom for searching this out; he's a fortunate teenager.
Terri