[Question #6017] Herpes symptoms, negative tests

17 months ago
I am a 33 year old female. I experienced what I became to believe  was a herpes outbreak in the beginning of June, June 6th to be exact. It started with burning and itching  in my genital area,  and pressure during urination. I took antibiotics for what in the very beginning I thought was a UTI, and then developed symptoms of a yeast infection. I noticed that I had 2 linear cuts right in the entrance to my vagina. I no longer have itching, but I do get swelling and pain and tingling in my vaginal opening and in my perineal area. I was tested for HSV 1 and 2 antibodies on August 28th. My IgG was .24, my IgM was .31. The linear lesions are persistent- they have never healed or scabbed. They were also swabbed and sent for DNA testing, which was also negative. My last possible exposure would have been March 18. Is more testing warranted? 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
17 months ago
I don't feel that more testing is warranted, no.  When you say your IgG was 0.24, was that HSV 1 or HSV 2?  The IgM should never have been done and should be ignored.  The lesions don't sound herpetic to me, at all.

Terri
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17 months ago
It appears to be a combined antibody test. With the results reading: Specimen tested negative for Herpes Simplex virus type 1 and/or Type 2 antibodies. No additional testing needed. 
The lab test was 
HSV 1/2 IgG/IgM w/ Reflex IgG type Specific

Herpes 1 and 2 IgG AB 0.24

Herpes 1 and 2 IgM AB 0.31
17 months ago
I appreciate your response, and wanted to ask an additional question. Does IgG antibody production begin after exposure or after infection? I’ve read many conflicting things. For example, my last possible exposure was 6 months ago, but I didn’t develop symptoms until 3 months ago. So do antibodies begin forming with exposure or infection? Thank you! 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
17 months ago
Well, in most cases, exposure and infection happen at the same time.  Although you can certainly be exposed and not become infected.  In your case, the timing of antibody development is at the last possible exposure, not when symptoms develop.  I think what you mean in your question is do antibodies develop at exposure or symptoms (not infection) and the answer is at exposure (given your choices)

Terri
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17 months ago
Yes. That is exactly what I meant. Thank you for being able to decipher! It’s so hard to get answers, because some doctors just don’t know. I was trying to develop a timeline. But if you are saying that antibody production begins at exposure and not at the start of symptoms, I feel much more confident in the blood work at 6 months after exposure. Thank you again for all of your help. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
17 months ago
You are most welcome.

Terri
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