[Question #8818] HSV 1 and 2 test results
39 months ago
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Trying to interpret these results. IgM for HSV1 is 1:80. IgM for HSV2 is 1:20. IgG for HSV 1 is 1.69 and IgG for HSV2 is negative. I understand that it seems there was an old exposure to HSV1 and not to HSV2. Also that there was recent exposures to HSV1 and 2. Is the IgM of HSV2 considered a low positive? Should I be retested? I have heard that a IgM for HSV1 can also cause a positive for HSV2. What type of re-test would you suggest? There are no symptoms or outbreaks and exposure was about a month ago.
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Terri Warren, RN, Nurse Practitioner
39 months ago
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The IgM should never be used to diagnose herpes. The CDC recommends against ever using it, Mayo Clinic discontinued its use in 2019 and both LabCorp and Quest will discontinue in 2022 due to high false positive rates and cross reactivity with other viruses.
Your HSV 1 IgG is a low positive and may be a false positive and your HSV 2 is negative. Both were done too early after possible infection to be accurate. I would recommend that you retest at 6-8 weeks out, and if either value is below 3.0, get the best test, a herpes western blot. If you have ever in your life had a cold sore on your lip or in you nose, your HSV 1 is accuate.
Terri
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39 months ago
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Thank you for your prompt reply. Your information is extremely helpful. It's terrible that this specific IgM test is still being used. It has been extremely scary since receiving the results.
Do you want the retest for IgG to be 6 to 8 weeks out from TODAY or from possible exposure? Is the 3.0 value the threshold for IgG ? Above 3.0 would be considered positive I assume. I will definitely retest and if below 3.0, get the western blot. There have never been any sores or outbreaks on lips, nose or genitals. My local MD did say that if there was any outbreak, they would culture the sores to see if it was HSV1 or 2. You also mentioned "other viruses" that can cause a false positive. Is it worth having those IgG levels check or not really? Thank you so much. You have given me some needed peace of mind. I know it is not 100% until we retest, but this certainly helps.
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Terri Warren, RN, Nurse Practitioner
39 months ago
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The timing should be from the exposure.
I've had false positives at 17 from the IgG so while the CDC says the threshold is 3.0, I have most definitely and often seen false positive values above 3.0. It is definitely NOT worth being checked for other viruses. Most adults will have had most of the other herpes viruses at some point in their lifetimes. If you continue to be concerned about HSV 2, it would be OK to check those values again down the road a way. You should print out the CDC guidelines (particularly about the IgM test) and give it to your provider. They clearly don't know better.
Terri
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39 months ago
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Thank you. I really appreciate your help. I will print out the CDC guidelines and give it to the OB/GYN. I will retest 6 to 8 weeks from exposure. I am currently searching for where I can get an HSV Western Blot. Should I just skip the followup IgG and go straight for the Western Blot?
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Terri Warren, RN, Nurse Practitioner
39 months ago
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oh, I can help you with that at westoverheights.com OR you can work with the University of Washington and your own provider to get the test done. Your provider seems to be a bit behind the times in terms of understand HSV testing so they may not be familiar with this test - either way you can get the blot is fine.
Terri
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