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Transmission and treatment of Herpes - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Sexually Transmitted Diseases
Answered by

General & Family Physician
Practicing since : 2004
Answered : 1777 Questions
User :   I recently got tested for hsv 1/2 my results for igG came back positive as well as my igm..... the md said i had it awhile because i had a rate of 4.22....... how is it my igm is positive is this accurate?
Doctor :   Hi
Doctor :   let me read ur query
Doctor :   The IgG antibody indicates that you are immune to HSV
User :   which means i have herpes definetly
Doctor :   the IgM antibody is not specific in case of HSV
User :   correct?
Doctor :   it does crossreact with other herpes family viruses
Doctor :   so measuring it in case of long term infection does not mean anything
Doctor :   presence of IgG antibody indicates that the body is immune to herpes
Doctor :   and it is indicative of a previous infection
Doctor :   if only the IgM was positive it would indicate a recent infection
User :   my bf had an outbreak recently something that seemed to be an outbreak.. which is why i recently got tested the bothof us.... my igg came back positve his neg...... in speaking to the nurse yesterday she explained to my bf that my igm is positive as well... hes some what upset with me thinking that i recently had another sexual partner becaus eof the positve igm
User :   im so scared and so nervous im lost
Doctor :   i understand the situation
Doctor :   herpes serology reports can sometimes be confused
User :   i protect myself i dont have unprotected sex only with my boyfriend weve been together almost two years we live together
Doctor :   since he had only IgM positive , he had a very recent infection as i had explained earlier
Doctor :   since you have IgG positive , it is a very old infection
User :   is it possible for the report to be innaccurate the igm results that is?
Doctor :   the IgM is not a very sensitive test
Doctor :   it can give false positive due to cross reaction with other viruses
User :   okay the way the nurse explained it to him..... she is making it eem as if i recently contracted it but if my igG is positive as you said the infection is old... if weve had unprotected sex wouldnt his igG have come back positve as well?
Doctor :   no
Doctor :   since the IgG antibodies cannot be transfered from u to him
User :   what exactly do you mean by cross reaction
Doctor :   cross reaction means, that other viruses like CMV, EBV etc produce antibodies too
Doctor :   these antibodies are similar to that of HSV
User :   okay
Doctor :   So the tests can have false positive results
Doctor :   for proper evaluation, the IgM tests have to be retested in 6 weeks
User :   so ive had it for awhile now..... the only way for his igm to come back positve is if i had a recent outbreak correct?
Doctor :   if the titres come down, it would be proof that he had actually a recent HSV infection
User :   or it can be a false...
Doctor :   FYI IgM specific Herpes Simplex Virus antibodies occur with primary infections, reach a peak in 6-8 weeks, and
decline rapidly
Doctor :   IF THE titres come down, in the second test, it would mean a true recent infection with HSV
User :   with the nurses explanation correct me if im wrong but..... if your igG is positve youve had it for awhile if your igm iis positve it means youve recently contracted it...
Doctor :   a four-fold rise or fall in titer in acute and convalescent sera is needed to differentiate between a true recent infection and a false positive test
Doctor :   No not at all
Doctor :   IN your case, the IgM Test could be false positive
User :   but what im asking is if weve been having unprotected sex for the past two years why wouldnt he have caught it a long time ago/ why would his igm come back positive as if it were a recent infection?
User :   meaning its possible that he doesnt have it correct?
Doctor :   yes
User :   there is no known cure for this is it?
Doctor :   for proper interpretation, of both of your IgM tests ,u need to repeat it again in 6 weeks
Doctor :   a four-fold rise or fall in titer in acute and convalescent sera will give the proper interpretation
User :   herpes can spread through what? an outbreak?
Doctor :   if there is a fall, then the infection would be a recent one
Doctor :   HSV can be spread through saliva, direct contact, deep kissing, etc
User :   if were only sleeping with each other how can the infection be recent....
Doctor :   direct contact means contact with open sores on the mouth
User :   if someone has an open sore on there mouth and i drink from the same cup i can get it?
Doctor :   in your case, u r not infective
Doctor :   just coz, ur IgG is positve it does not meen u can infect any one
User :   which means it cannot spread by me?
Doctor :   yes
Doctor :   unless u have had sores and lesions anywhere u cannot pass it on to others
Doctor :   hi
User :   right....
Doctor :   are u there ?
Doctor :   ok
User :   yes had to repay sorry
Doctor :   ok , that is fine
Doctor :   as i said, u cannot infect anyone just coz, u have had IgG positive
Doctor :   if u are IgG positive, it means u have IMMUNITY TO HSV and u cannot infect anyone
User :   okay so if in two years ive had herpes and ive never had an outbreak until now for some odd reason.... its possible that this is the reason my boyfriends igm came back positve as a recent infection
Doctor :   does he have any symptoms as of now ?
User :   not meaning i went outside and had sex with someone else contracted it again and passed it on to my boyfriend or vice versa
User :   he had wart looking things........ '
Doctor :   it does not mean that way at all
User :   the doctor called it a bacteria infection or hsv
Doctor :   u need to understand that u are not INFECTIVE to him at this moment
Doctor :   warts can occur due to viruses like EBV
Doctor :   HSV causes sores and multiple blisters and ulcers
User :   she said if it cleared up fast with taking meds it was definetly hsv if it didnt it was an infection
Doctor :   warts are not usually due to HSV
User :   the were like bumps with an eye im calling them warts
Doctor :   So both of u need not worry about it at all
Doctor :   it may be due to molluscum contagiosum as well
User :   thanks for answering so many questions..... sorry if it seems like im being repititve... im just trying to understand
Doctor :   the IgM in your bf could be false positive
Doctor :   i understand
Doctor :   and you are welcome for clarification
User :   if im correct please tell me
Doctor :   ok
User :   i am not infective..... unless i have an outbreak that is the only way my boyfriend can retract herpes
Doctor :   yes that is right
User :   its possible for me to have invisible outbreaks
User :   ?
Doctor :   no
Doctor :   not at all
User :   like noit seen to the eye like inside of me?
Doctor :   if an outbreak occurs, u will have symptoms like pain , multiple ulcers , blisters etc
Doctor :   they will present in the mouth or near the genetalia
User :   ok
Doctor :   please understand HSV blood tests are confusing to patients and to clinicians as well.
Doctor :   proper knowledge and experience is needed to interprete them
Doctor :   unless u guys have symptoms of herpes as i have explained, u need not worry
User :   okay i will keep tghat in miind both him an d i are going to the doctors office on monday.... i wanted another opinion
Doctor :   sure
Doctor :   that will help to clear ur doubts too
User :   correct
User :   what makes you say that i am not infective is it because my number is so high...........
User :   ?
Doctor :   the presence of IgG in you is a proof
Doctor :   that u r not infective
User :   so if igg is positve that means you are non infective/
Doctor :   yes
User :   so does that mean in terms of children i cant pass it along? or can i?
Doctor :   you can pass on the antibodies to them and those will protect them
User :   if ive been checked for ALL STDS Ghon.chlymidia the whole nine why would my igm come back positive?
User :   i wouldnt be able to bhave any cross reactions so thats weird
Doctor :   but sincce u dont have active lesions, any where u will not pass the infection to them
Doctor :   cross reaction are common in acute infections due to IGm
User :   ok
User :   what does that last comment mean in depth
Doctor :   ur IgG antibodies will be there for life
User :   antibodies do what protect you in a sense
Doctor :   yes they protect
Doctor :   the last comment - meant that IgM TESTS are not type specific
Doctor :   and can cause confusions
Doctor :   i hope u have understood my advice
User :   yes thanks
Doctor :   you are welcome
User :   whats the best meds for this
User :   last /
Doctor :   acyclovir
Doctor :   are antivirals that can help to cure the infection
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