[Question #7448] Western Blot Test

2 months ago
Test A: Few weeks after sexual activity with former partner. Negative for Type 1 and 2 iGG. Test B: A year and a half later, iGM positive at a 1.59 and iGG was still negative for both types, (under .90). Test C: Re-tested after four months. My iGM was a 1.3 and iGG was positive at 1.2. Current Partner is negative for both antibodies. No symptoms for either of us. Should I consider the Western Blot test? I’ve accepted the diagnosis, but a small part of me is still hoping that it’s wrong as this is still extremely difficult to digest. I’m confused on how I got this since the iGM picks up “recent” exposure. Not even sure of the time frame of “recent” between initial exposure and the test. If I got it from my former partner, I would assume 
since iGG tests pick up past infections and antibodies can take up to six months to appear, MY iGG on Test B would have picked it up since it’s been a year and a half vs it taking almost two years to come up on Test C. I haven’t engaged in any sexual contact or kissed anyone else besides my current partner who is negative. My only contact was when I ate after someone a few months before Test B.  Not sure if he has it. I saw some articles that mentioned it can be passed through saliva. Can someone provide some clarity? I’m just trying to make sense of it.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
2 months ago
So you don't mention with test C whether your 1.2 was HSV 1 or HSV 2. 
You should NOT even consider accepting this diagnosis. 
The IgM test is terrible - the CDC says never to use it.  It has a tone of false positives.  Forget it's ability to determine new infection.
I would bet a whole lot of money that you are actually negative, at least an 85% chance, if not 90%.
Yes, a western blot would provide huge clarity in your situation but I would bet a whole lot of money that this is a false positive.

Terri
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2 months ago
Thank you Terri! The iGG on Test C was positive for Type 1. I will get the Western Blot test and just hope for the best. For future reference, can oral HSV be passed without skin to skin contact,  (i.e. sharing utensils with someone, sharing cigarettes, or drinking/eating after someone who is positive,  etc)? If it does come back positive by any chance, I would just want to try to understand how I got it since I haven’t been with anyone other than my partner for two years now as I mentioned, unless it’s normal for iGG antibodies to take that long to appear on a test.  I also read that it’s usually better 
to get a culture swab vs. the antibody test, so I see why the CDC doesn’t recommend routine testing without symptoms. That “incurable” word definitely causes a high level of anxiety and stigma. I haven’t shared ANYTHING with my partner because I’m so afraid of passing it. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
2 months ago
We don't really believe that sharing inanimate objects is a risk for transmission.  is it possible?  theoretically it is, yes but really unlikely. 
I don't think it would take that long to make antibody, no, from your regular partner
The culture or other swab test should be done when visible symptoms are present.  Swab testing is not indicated for people who are asymptomatic.  The CDC also says that HSV antibody testing should be considered for those seeking an STD screen.
Get the blot and get clear about your results.  It is also possible that a previous test missed an old HSV 1 infection - compared to the western blot, the HSV 1 IgG misses 30% of HSV 1 infections.

Terri
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2 months ago
Got it.  Thank you so much!! You’ve been so much more help than my primary care doctor to be honest. Thanks again! 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
2 months ago
You are most welcome.

Terri
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