[Question #1837] Herpes IgM positive IgG negative 6 weeks

42 months ago
Teri,

I had condom protected vaginal sex with a CSW  almost 7 weeks ago.  I just tested and all STDs were negative except the HSV IgM 1&2 came back positive at 1.20, but the HSV IgG 1&2 came back negative under .90.  My primary care physician said I'm positive for HSV and wrote me a script for Valtrex.  I'm confused as to the results.  I have had some pimples on my pelvic area near the top and one near my thigh.  Some of these came on after I shaved down to skin looking for imperfections.  The spots that I have are all separate pimple looking and when I pop them they release similar to a pimple.  I have had some itching post shaving...I've never had a fever (checked daily) and do not feel ill in the least bit other than being ridden with anxiety...Another possible symptom (maybe) my soles on my feet hurt for a week or so directly after the event and I had muscle pain on one but cheek for that week (kinda weird but worth mentioning).  I also had an itchy back post workouts and hot showers that last for a few hours post hot shower.  I had really not happened before.  This mostly came on after I used the back brush to aggressively clean my back.  What are the odds of having a false positive on the IgM at 6 weeks, should I start the valtrex, what else would you recommend?
  
Am I positive for HsV please help!
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
42 months ago
oh dear, how unfortunate - another person tested by IgM.  This test is terrible - many false positives.  The CDC recommends that it never be used to try to diagnose herpes.  With a negative IgG at 7 weeks out,there is more than a 70% chance that you are going to stay negative on the IgG, which is the correct test to have done. 
If you were my patient, I would recommend that you not take the herpes medication at this point and wait until 12 weeks and repeat only the IgG test.  If you are negative, you should consider, with 95% certainty, that you are not infected with HSV 2.  I'm going to bet money that you are not.

It might be good if you could print out the CDC STD treatment guidelines for your physician that says not to use IgM testing.  This causes such anxiety for people and the worst part is that once a person has a positive IgM test, it is difficult for them to believe that they are uninfected even when an appropriately timed IgG test is done and is negative.  Please don't become one of those people! 

I obviously cannot say for certain at this point that you are not infected but I think the chances are excellent that you are not.

Terri


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42 months ago
Teri,

I'm hopeful from your response but still concerned as both of my IGG tests 1&2 were negative.  I was thinking if I was IgG positive for HSV1 then it would be easier to understand that there would be a cross pick-up and then the positive hsv 2 would likely be negative as a recent infection.  

My apologies but this will ruin my marriage if I'm positive and I'm so overwhelmed with guilt and anxiety.  

Can you please keep my thread open I will pay another fee I just find the conversation helps give hope.

My real question is that I did have some pimples as previously stated at 7 days and they did pop with a pimple filled center.  Are most Herpes marks similar to blisters?.  Additionally, since this IgM test came back positive for both at 6 weeks and negative for IgG if there was a false positive what are the variables driving that.  I have had Chicken Pox and Mono in my past do these affect the IgM?  Another question is the Igm at 1.20 when 1.10 as the marker a variable?  I read that the IgM is more accurate between 10 days and 4 weeks, does that mean the 6 weeks positive is less accurate. I will likely test next week at 8 weeks and then again at 10 weeks if these are negative does the percentage change?  

I've read that anywhere from 70% to 95% will test positive on the IgG by six weeks are those numbers correct?

Please help with clarity!!!!
42 months ago
Sorry I forgot to ask one thing on the previous post; how often is genital herpes transmitted via female to male in protected vaginal sex?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
42 months ago
Yes, about 70% of people who are going to test positive for HSV 2 will do so by 6 weeks from exposure.  You must really disregard the IgM result and all information about the timing of positives, etc because there are so many false positives.  And do NOT retest using the IgM - it will just freak you out for absolutely no good reason.  If you are going to test further, plese use only IgG.   We don't know why there are so many false positives on the IgM test, just that it is a terrible test and should no longer be on the market.  One large national laboratory has completely removed the test from the list of tests clinicians can order, in fact.  I surely do wish Quest and LabCorp would do the same 
Herpes lesions are normally filled with clear fluid not pus as with a pimple.
The female to male transmission rate, having sex about twice a week for year, with condoms (104 intercourses) is about 2%.  So you can see that one protected sexual encounter presents a very low risk to you.
I see from previous posts that you are quite a worrier.  I am going to allow you one further post on this thread but then we must close.  Please pull your thoughts together before you post so you can be certain to include all of your questions, OK?

Terri
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42 months ago
Terri,  

Thank you for your help to this point but I've come to the realization that I have likely contract HSV.   After doing much research and knowing my body I've realized I've had several symptoms.  First things first, the positive IgM which leads me to believe I have contracted one of the HSVs in that the only other logical positive response would be a false positive to chicken pox or epstine bar.  Then looking back to a few days post event I had very sore soles of my feet and unexplained pain on the sides of my butt which gaglian nerve ties into.  Next I had a very bad itching back that I could not explain and lastly sores or pimples on my pelvic area along with some itching.  All of this seems like to much of a coincidence wouldn't you agree?  I'm in fear that my outcome is that I'm positive  and in that thought I need to prepare on how my life will change I.e.  how do I tell my wife, do I leave so she can have a normal life without worry of contacting this virus.  Ive  been reading horror stories on what this virus does to some women and couldn't live with myself if she got it.  Next what advice would you give to best position my future, are there foods that help, vitamins that help, are there specialists I should reach out too?  I know I have not tested positive but I really think it will be the case so please give me a road map to the best path in the future.  I can't believe one drunk night and one mistake changed my perfect life ...3 young boys, a great wife, a great job, in a great house and my view each morning will likely change in the near future!
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
42 months ago
Wow, I feel like you either aren't ready my responses, don't understand them or your anxiety is just so high you cannot absorb what I'm saying to you.  You have taken some very general symptoms and the results of a very poor test to just take off into your lived being ruined.  I hope you will try very hard to settle yourself down, reread everything I've written and wait for the final IgG test at 12 weeks.  Having said all of that, even if your test is negative at 12 weeks, I have a feeling you may not believe it.  Sigh.

This is your final post.  You have posted several times recently to various experts on this forum and new posts will not be accepted. 

Terri
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