[Question #10852] HSV1 Igg fluctuate
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19 months ago
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Hi,
I had a herpes 1 & 2 IGG test few years back around 2020,
Herpes 1 IGG was around 1.1+
Herpes 2 IGG was 0.1
Due to several low risk encounter (oral & protected sexual intercourse), I had another herpes 1 & 2 IGG test on April 2023
The test came back negative for both
Herpes 1 IGG 0.7
Herpes 2 IGG 0.1
I had a herpes 1 & 2 IGG test few years back around 2020,
Herpes 1 IGG was around 1.1+
Herpes 2 IGG was 0.1
Due to several low risk encounter (oral & protected sexual intercourse), I had another herpes 1 & 2 IGG test on April 2023
The test came back negative for both
Herpes 1 IGG 0.7
Herpes 2 IGG 0.1
And again the only exposure i had was an single oral sex on June 2023, and I had another test on 11 Jan 2024,
Herpes 1 IGG 1.1
Herpes 2 IGG 0.1
I couldn't recall whether i have cold sore or not in the past, but for genital herpes outbreak i did not notice any as well.
My question is :
1. Should i do a confirmatory test? Or should i just assume that i am not infected as both positive test false right at the cut off line and it has went from positive to negative and positive and since i have read through a few resource from internet stating that new genital hsv1 infection almost always cause primary outbreak (which i assume is hard to miss)
2. Is it possible to get a western blot at Malaysia?
3. Is outbreak hard to notice or it would be very obvious?
Looking forward to your reply.
Herpes 1 IGG 1.1
Herpes 2 IGG 0.1
I couldn't recall whether i have cold sore or not in the past, but for genital herpes outbreak i did not notice any as well.
My question is :
1. Should i do a confirmatory test? Or should i just assume that i am not infected as both positive test false right at the cut off line and it has went from positive to negative and positive and since i have read through a few resource from internet stating that new genital hsv1 infection almost always cause primary outbreak (which i assume is hard to miss)
2. Is it possible to get a western blot at Malaysia?
3. Is outbreak hard to notice or it would be very obvious?
Looking forward to your reply.
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Terri Warren, RN, Nurse Practitioner
19 months ago
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If you want to know if you really have HSV 1, you could get a confirmatory test, the western blot from the University of Washington would be far the best. The IgG test for HSV 1 misses 30% of infections compared to the western blot so it is not reliable with these kinds of scores. The problem is, living in Malaysia, it would be challenging to obtain and expensive, but I've worked with patients as far away as China to get this. The other thing is if you were positive and haven't identified a cold sore history and the HSV 1 is positive, you can't know where the infection is, either oral or genital.
Terri
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19 months ago
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Hi Dr Terri, am so glad to see your reply.
Since that is the case, is it okay to say that the best course of action for my situation right now would be just put this ordeal behind (since even a confirmatory test proving a positive would not change much), and just look out for any future outbreaks(oral/genital)), and if there is then i would just refrain from sexual activity during outbreak.
Is it safe to say that i am in favorable position since genital HSV1 is very rarely transmitted through intercourse without outbreaks? (saw one of the answer by Dr Terri as well).
Last but not least, I have read that outbreaks sometimes could be so mild that it would go unnoticeable, is there any symptoms that i need to cautious of that signals an outbreak or the outbreak would be quite obvious that it would be unmissable.
Thank you again Dr Terri for your reply and your effort.
Since that is the case, is it okay to say that the best course of action for my situation right now would be just put this ordeal behind (since even a confirmatory test proving a positive would not change much), and just look out for any future outbreaks(oral/genital)), and if there is then i would just refrain from sexual activity during outbreak.
Is it safe to say that i am in favorable position since genital HSV1 is very rarely transmitted through intercourse without outbreaks? (saw one of the answer by Dr Terri as well).
Last but not least, I have read that outbreaks sometimes could be so mild that it would go unnoticeable, is there any symptoms that i need to cautious of that signals an outbreak or the outbreak would be quite obvious that it would be unmissable.
Thank you again Dr Terri for your reply and your effort.
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Terri Warren, RN, Nurse Practitioner
19 months ago
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Yes, I agree with your proposed strategy. it is correct that genital HSV 1 is rarely transmitted through intercourse correct. Most people who acquire genital HSV 1 get it from receiving oral sex from someone who has oral HSV 1, with or without symptoms.. It is correct that many episodes of HSV can be with very mild symptoms or none at all.
Terri
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