[Question #3103] Testing/Symptom Qs

41 months ago
Hello, 

I have been positive for HSV-1 since childhood. 

I had a full STD panel done in September and was negative for the HSV-1/2 IgM.  I was tested again after having two unprotected encounters with someone who is HSV-2+( he had no outbreaks/symptoms at the time).  Eight weeks post encounter I was positive for the HSV-1/2 IgM,  but was negative for HSV-2 IgG. I have prominent nerve pain in legs and some vaginal symptoms—mild itching, slight burning, internal pain (feels like my left ovary), one sharp pain while taking out a tampon—but no lesions in or out the two times I was examined while having symptoms. My questions are: 

I know the IgM is flawed, but should I be more concerned about my recent positive result since my IgM in Sept. was negative? 

Should I wait longer than 12 weeks to get retested for the IgG since I have type one already? 

What vaginal spotting like for women with herpes? I've had minor brown spotting close to period. Something I've never had before. 


Thank you! 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
41 months ago
I don't think you should be more concerned given the positive IgM.  it is such a terrible test with so many false positives,  I would suggest ignoring it. 
You could wait a week or two longer but even the University of Washington that does the herpes western blot, the gold standard antibody test, has changed their recommendation from waiting 16 weeks to test to 12 weeks to test so I doubt it makes much of a difference, honestly, but maybe a couple of weeks longer would be oK.
Herpes is not associated with spotting.

Terri
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41 months ago
Thanks for your insight and expertise.  Since I have a follow-up...

Have you had patients who are HSV-2+ but never have lesions yet have nerve-related or other symptoms? It's difficult to research this. 

What about patients who have symptoms on and off without lesions for months but then eventually get an outbreak?  Does this happen? 



Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
41 months ago
I have had some patients who are HSV 2 positive and don't have lesions, yes, many and a few have nerve related issues but I have far more people who are worried that they have herpes, have nerve issues and end up not having HSV 2 - lots and lots of those. 
And yes, some people are positive for years and don't have an outbreak and then do, yup

Terri
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41 months ago
Herpes is maddening and fascinating.  Even the testing is complex! 

If anything, it's a lesson in humility and creates compassion for others who are positive. Here's hopin' to a negative result. 

Thanks again. 

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
41 months ago
You are most welcome - and you're right about herpes, it is complex for sure - in so many ways.
I too will hope for a negative result

Terri
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41 months ago
I went ahead and got tested at 12 weeks and my IgG is still negative. 

My doc suggested being tested again at 6 months, but I'm feeling major relief.  Thank you for all your expertise. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
41 months ago
Good news!  I'm happy for your news.

Terri
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