[Question #4741] IGG Testing

28 months ago

Hello, Teri I have read your posts and I appreciate the time you have put in to learning this subject matter, so thank you. I am a 35 year old male who has been dating since 18. I’ve had partners I’ve had sex with, with or without protection depending on the situation. I have had no reason to think that any of them have had something to transmit to me, although some were one night stands 10-15 years ago. 1.5 years ago I had a woman put the very tip of her tongue on my scrotum and base of my penis for 5-30 seconds, nothing more. 4 months later it started burning when I would urinate. UTI was negative but did have elevated WBC in urine.Took antibiotics for it and started drinking more water, went away on its own 3-4 weeks later. At this same time I started taking SSRI's for ADHD. I’ve noticed differences in urinating more frequently, not as long 15-20 seconds, and less semen during orgasms. I read these are side affects of SSRI's for men. At (17 weeks) after the above encounter I was IGM and IGG HSV tested plus tested for all other STD's through Quest

IGM Type 1 Negative

IGM Type 2 Positive 1.20 (I have had the Chicken Pox)

IGG Type Specific AB Type 1 Negative

IGG Type Specific AB Type 2 Negative

I waited an additional 10 weeks now 27 weeks total and IGG tested again.

IGG Type Specific AB Type 1 Negative

IGG Type Specific AB Type 2 Negative 

I read the IGM should never be ordered. In my life I have been tested 7-10 times full panel blood and urine always IGG only for HSV and it has always been Negative

Present time the burning came back a year after the first time but much more intense and painful almost sharp and taring feeling and the exact night I increased my medications. Its lasted 20 days so far but pain is 95% better with more water intake.

Is 2 IGG tests enough at 17 and 27 weeks to rule out HSV or should I get a WB? I’ve read your IGG 1-2 30% and 8% rates. Are these percentages the same regardless of multiple tests and incubation periods? 


Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
28 months ago
So it has been my personal experience that once a test misses an infection in an individual it can miss it multiple times.  The data on which I base this was collected both at my clinic when it was open and western blots done as part of a study since then.  For all patients, we recommeded that they wait 12 weeks after any concerning encounter before doing the blot.  I can't promise that they did that but it was explained to them that any other duration of waiting would be a waste of money. 
I would certainly ignore the IgM completely.
Statistically, it is unlikely that you are infected but this test is truly not perfect.
If you want to know your true HSV status, the western blot is what you want. 
The symptoms that you have had are interesting and confusing but they do not sound herpetic to me.

Terri
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28 months ago
Thank you Teri for your response.
So the 70% & 92% HSV 1&2 accuracy for the Quest IGG Type Specific Test is compared to the WB. However, how is it compared to nothing? I am curios for my own general understanding. 

Meaning is the sensitivity rate 70% and 92% overall ? Because that seems incredibly inaccurate. Everyone should get the WB than if 30 out of 100 people get the wrong result for example. I realize nothing is 100% and we all live in probability, but 30% inaccurate. 
If overall compared to nothing those percentages are much higher for overall accuracy than I would just leave it be and go a different route.  

Two weeks ago I had a physical inspection from a urologists and was told everything looked normal but he ordered an IGM and IGG HSV test and said that the IGM and IGG compliment each other and that the IGM is also Type Specific and that it doesn't pick up Chicken Pox. Most doctors just don't understand much about these tests. 

If I choose to,  how can I order the WB? Can I order it through you? What is the fastest way to get this done? 
Thank you. 



Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
28 months ago
How would I know if you compare it to nothing?  I don't get your question.  Sensitivity is always achieved by comparing two things.  In this case, we looked at people who done both the IgG and western blot as part of screening for herpes and looked at how much infection the IgG missed in comparison to the gold standard western blot.  And I do agree that the lack of sensitivity by the IgG test is stunningly poor
The physician who ordered the IgM is unaware of it's limitations.  It is not type specific and picks up who knows what.  I agree that most clinicians do not understand herpes well.
I can work with you to get the blot - you would arrange a video conference with me at westoverheights.com.

Terri
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28 months ago
Yes my question is not to clear, there is just not enough space to ask it correctly.  However, thank you for your responses. I scheduled a video appointment with you to order the test. 
Basically I found some research that showed the sensitivity of the WB and the Quest ELISA Test. ( They were both somewhere around 97-99% sensitivity, I cant remember now) I am guessing that must have been compared to the IGG.
I only found this info because doctors keep ordering IGM tests.
In your expert opinion you find the WB better than the ELISA?  The WB is a little bit more of work to get it ordered and received than the ELISA, only reason I am asking. You know all about this better than anyone so I trust your advice. Thank you for all your help, I greatly appreciate it. 
28 months ago
I am reading different articles that site your research so the WB is clearly the most definitive test. How long does this test take?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
28 months ago
The western blot is far better than the IgG test when we look at populations who are being screened - this is different than the literature the test makes quote which is sensitivity for those you already test positive from a swab test.  Do you see the difference?  Compared to the western blot, the IgG misses 30% of HSV 1 and 8% of HSV 2. 
The IgM is useless.
From the time you order the kit from the UW to be sent to you until you get results is anywhere from 2-4 weeks.
If you want me to be the ordering provider, you will need to have a video conference with me which you can schedule at www.westoverheights.com

Terri
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