[Question #11463] HSV-Type II Antibody IgM says Positive @ 33 days

14 months ago

Please look at my history. Both Dr. Hook and Dr. HH had confirmed that mine was virtually a no-risk exposure (only exposure was unprotected fellatio twice and protected vaginal intercourse all the time). But one of my recent STI Panel said that I am HSV II positive which I am not able to comprehend at all. Here is my test history:

Complete STI Panel @ 10 days - Negative for all

HIV 1&2 (P24 Ag & Ab) @ 10 days - Negative

HIV 1&2 (RNA PCR) @ 10 days - Negative

HIV 1&2 (P24 Ag & Ab) @ 17 days - Negative

HIV 1 (RNA PCR) @ 17 days - Negative

HIV 1&2 (P24 Ag & Ab) @ 33 days - Negative

Complete STI Panel @ 33 days - Negative for everything (HBsAg, HCV, Chlamydia Trachomatis, TPHA, SYPHILIS, Rapid Plasma Reagin, Neisseria Gonorrhoeae) but HSV-Type II antibody IgM came back positive with a value of 15.33

The doc said not to worry about it and prescribed a 7 days course of T.VIROVIR (FAMCICLOVIR 250 mg) and I should be fine and you wouldn't have to worry about it.

I haven't had any symptoms at all - no bumps or blisters, no trouble urinating, no swelling in groin, neck or under arms, no fever or muscle aches, not tired. I had even gone to a Urologist who had initially done a Blood Panel test @ 1/2 days (all negative) post exposure because I had a burning penis tip/scrotum pain which is not there anymore.

I am completely bewildered and I am not even sure if this is even a true positive. Please help.

Terri Warren, RN, Nurse Practitioner

14 months ago

What is the index value associated with HSV 2 positive result? Was it only the IgM or also an IgG?

Terri

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14 months ago

The values are:

HSV-Type II Antibody IgG - 3.72 (NTU) [Negative: < 9; Equivocal: 9 - 11; Positive: > 11]
HSV-Type II Antibody IgM - 15.33 (NTU) [Negative: < 9; Equivocal: 9 - 11; Positive: > 11]

14 months ago

I also read this from Dr. HH on one thread where he said:

.....The HSV IgM antibody test is highly unreliable, frequently giving false positive results, undoubtedly explaining the positive HSV2 IgM test. Only the IgG antibody test is diagnostically useful -- something understood by all truly experienced STD and herpes experts, but not by many other clinicians.

My IgG is negative and so that makes me believe this is possible a false positive.

Thanks Terri for the help. Also if possible, looking to hear your thoughts too Dr. HH.

Terri Warren, RN, Nurse Practitioner

14 months ago

Dr. Handsfield doesn't answer these herpes questIons, sorry.

You must not be in the US with index values like this, but your value is currently in the equivocal range, per what you've posted, not negative. If you've recently had a sexual encounter that could result in herpes, then you should repeat the test when about 12 weeks have passed since this encounter. As I read this, only 33 days had gone by since your last testing was done. Also I would advise not taking any further antiviral medication as this can interfere with antibody development and cause a false negative.

While condoms are very useful, they reduce the risk of acquiring HSV 2 by 65%, not 100%, so I would encourage you to do the follow up testing.

Terri

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14 months ago

Yes, I am not in the US.

I don't think we have Western Blot tests here.

Would you recommend I take a IgG or both IgG/IgM after 12 weeks ?

14 months ago

At this point in time, I am telling myself that I am HSV-2 positive. I made a grave mistake. I failed to understand that condoms can only protect from HIV but things like HSV. I cannot forgive myself for what I did. I do not know how to process this and I am completely devastated, sad, angry, depressed and I hate myself for what I did. I am single and I was never married but I don't think I will ever be able to find a partner anymore (its very difficult here in India and in an arranged marriage context). If it were not for my family, I would really really considered ending it all. I am sad thinking that I will never be able to find a partner but I am more sad thinking that I won't be able to tell this to my parents. The stigma associated with this is a lot here. They are too sensitive to handle this. I am happy to live the remaining of my lives taking care of my parents but I am sure they would find it hard to see me single throughout. I just wish I would somehow cope through this.

Terri Warren, RN, Nurse Practitioner

14 months ago

I think you have jumped to a conclusion here that is not necessary. I am, in no way, saying that you have HSV 2! Please reconsider this situation and your reaction to it.

All I suggested was that you repeat the antibody test when the appropriate a amount of time has gone by for testing. I see this in the US often - people testing too soon for a completely accurate result and I recommend that they follow up at the right time.

The likelihood that you would become infected through intercourse with a condom is unlikely, but what you said was "protected vaginal intercourse all the time". I don't know if that means lots of intercourse or once or twice? Let me know.

Terri

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14 months ago

Thanks Terri. Sorry for jumping into a conclusion. I just couldn't handle the emotions.

To clarify on that:

Unprotected Fellatio with CSW - Thrice
Protected Vaginal Intercourse with CSW - Twice (for a very short time; probably less than a minute)

This is all I have had ever.

14 months ago

I also have access to DNA PCR Test for HSV 1 and HSV 2. Do you think I should take that ?

Terri Warren, RN, Nurse Practitioner

14 months ago

absolutely not. HSV is not in your blood, if you are thinking of the blood test. The DNA PCR from skin is not useful unless you have a lesions of some kind So your sexual history is very limited, and that also greatly reduces your risk of acquiring herpes, for sure! It was hard to tell from your post how many times you had had protected intercourse, but honestly, your risk is really low. I think the thing really throwing you off here is the damn IgM test! It is so poor and I so wish it had not been done for you but that is water under the bridge now, right? When you repeat the test at the appropriate time, please - do not allow anyone to order the IgM test again for you. We've gone over the usual amount of questions, but I wanted to be sure that we've covered the areas that we need to cover. If you want to post a follow up question with your appropriately timed results, please do. I'll be thinking about you and feel very optimistic about your results. Best, Terri ---