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Dr. Andrew Rynne

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What does presence of IgM and IgG antibodies in HSV1 test report indicate?

Answered by
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Dr. Chobufo Ditah

General & Family Physician

Practicing since :2009

Answered : 6186 Questions

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Posted on Sat, 23 Aug 2014 in Infections
Question: hello!

I just wanted to start off saying that I have been worrying my self so much that I have given myself anxiety over this for a year now. So It all started when my ex boyfriend told me he caught something from me last may. He told me he had chylmedia. I had no symptoms of that but I still wanted to go get checked. I came back negative for every std. I didnt stop there. I kept going to the doctor every two weeks for three months to get blood work down etc. They all came back negative. I let it go but wanted to just see one more time. I went in October 10 (Last time i went was august 8 and those results were negative) and my test results came back Positive HSV 1 iGg(positive) IGm Positive. I am STILL freaking out and the doctors i have haven't really been informative. WHen i asked what all this meant was the IGM shows I just acquired it since i have been getting tested left and right. but when i read the internet it says igg is a past exposure and IGm is a recent exposure. So did i not acquire this recently? She said that i am freaking out for no reason since i hadnt had sex or done anything since may and all my results have been negative until then. I get that HSV1 is SO common such as cold sores but im still freaking out. I have never received oral for anyone but i know you can get HSV 1 genitally as well but these results and my history arnt matching up. Am I just freaking out about a cold sore orally? Please help me cause this has literally caused me so much anxietiy for a year now
doctor
Answered by Dr. Chobufo Ditah 2 hours later
Brief Answer:
Means it was recently acquired then...Check now!

Detailed Answer:
Hi and thank you so much for this query.

I am so sorry to hear about these numerous laboratory findings an the disturbing results you have reported about HSV1. Your results showing both the presence of IgM and IgG antibodies suggested a recent infection. This is not a strictly sexually transmitted infection and can be transmitted through multiple means including hand shakes to persons who have a cold sore. 2months was enough time for these antibodies to all develop and be picked up by a subsequent test after your last negative test.

Could these results be faulty as well? Yes. In this case, I will suggest that you go on and get a control. If IgG shows positive, it means you were for real infected and what remains a unknown is how you contracted the infection. If IgG should return negative, then we can question how true the initial test results were.

Have you been having any symptoms? If no, why allow laboratory findings to cause more disease that the possible disease itself? This is being too hard on yourself and making you even sicker than you should be. Being able to accept undesired but painful information in life, digest, work on and walk on rather than letting it hold you back is the right attitude to adopt.

I hope this helps. I wish you well. Thanks for trusting us with your health question this day and feel free to ask for more information and clarifications if need be.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Chobufo Ditah 14 minutes later
Thank you for your response.

Just a few more questions. Do you think I got the hsv 1 between last July and October (3 month ) and not at the beginning of last May since igm was positive? Just trying to rule out scenarios. Cause in explanation you mention the 2 months from the test and I'm a little confused And I haven't had any symptoms, not has my partner who I made get tested in October as well and we are still together and we hasn't mentioned anything.

I had shingles before could this possibly show up and throw the test off?

How common is is to get hsv 1 genitally from having sex?

doctor
Answered by Dr. Chobufo Ditah 36 minutes later
Brief Answer:
See below!

Detailed Answer:
The presence of IgM suggested a recent infection. And because the last known test was in August, the window period could be the possible time during which you got infected.

Shingles could but I wonder why all the other previous tests came back negative. You may still want to control this test just to make sure it wasn't a laboratory error.

The chances of contracting this infection sexually all depends whether your partner has an active sore and you got in contact with it. It would be similar to that of HSV2 as they are all by contacts.

I hope this addresses your questions fully. Feel free to ask for more precision if warranted.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Chobufo Ditah 4 minutes later
Thank you!! One last question.

Do you think it's safe to say possibly that I didnt contract this from my ex boyfriend in May (if he were to have it. He said he got checked and it was chlamedia not herpes) and I contracted it later from drinking after people etc? Cause with all those test, igm and igg were negative until the one in October
doctor
Answered by Dr. Chobufo Ditah 9 minutes later
Brief Answer:
UNlikely to have bene from him!

Detailed Answer:
It is highly unlikely that you contracted this from you ex boy friend way back in May.

Most likely after August or shortly before the last test since regular testing showed no abnormality up to then. Beside, did you ever get these test results controlled?

I hope this helps. I wish you well
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Chobufo Ditah 6 minutes later
Ya your rights they would have at least shown in the results somewhere correct?

And controlled as in?
doctor
Answered by Dr. Chobufo Ditah 32 minutes later
Brief Answer:
see below!

Detailed Answer:
Controlled in this case means getting another set of tests done just to make sure this was not a laboratory error as all other tests were normal leading up to that and with no clear idea as to what the source of contamination is.

I do believe with the intensive checkups, it would have been detected long before then if you had contracted it sometime back in may.


I hope this helps. I wish you well.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Chobufo Ditah 23 minutes later
I didn't get another test done cause the docs said hsv 1 is common in most people and that igm showed it wasn't from last May.

Do you think from my explaining I am std free and that maybe I'm just over reacting?
doctor
Answered by Dr. Chobufo Ditah 25 hours later
Brief Answer:
Yes,, you are STD free!

Detailed Answer:
Hi and thanks for following up.

I am sure you are std free because all the tests found nothing for me to be concerned about. Since then, you have had a single sexual partner and that puts you at low risk for contracting any STD.

Tests are carried out by humans using machines and you know we are not infallible. But, at least correct in most of the cases.

I hope this helps. I wish you well. Feel free to ask as many questions as possible. It's my pleasure responding!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Chobufo Ditah 12 hours later
I am very confused. I just got this messages from my OBGYN and at first when she first told me she said it was a recent exposure but she just sent this:


Our nurse XXXXXXX forwarded your message to me regarding your questions about herpes. No, it means that it is a previous exposure to the virus. There there are two antibodies that can be present when you have an infection. The IgM antibody is the first antibody that shows up when you are having a new infection or if you have an active infection (current outbreak). If you had never been exposed, the IgM antibody stays positive for up to about 4 weeks. The second antibody, known as IgG, shows up later after you have already been exposed to the virus. If IgM is negative and IgG is positive, the infection is considered dormant. If IgM and and IgG are both positive at the time of the bloodwork, it means that you have a current active infection (current outbreak) to and infection that you have already been exposed to. Your blood work shows only previous exposure to type 1 herpes.


What do I make from this:( I am so confused now.
doctor
Answered by Dr. Chobufo Ditah 4 hours later
Brief Answer:
You need not get confused!

Detailed Answer:
IgM refers to recent infection. IgG refers to old infection.

Both can be noticed in a short window period during primary infection and subsequent infections would show IgG only.

Because serial tests never showed any antibodies and later showed IgM, it means it was a recent infection.

I hope this is clear to you at this time.
Thanks
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Chobufo Ditah 5 minutes later
Oh ok. Why do you think she said it's a previous infection? Just curious
doctor
Answered by Dr. Chobufo Ditah 57 minutes later
Brief Answer:
I don't know why!

Detailed Answer:
Hi and thanks for this follow up.

Once you have had herpes, IgG would remain positive for ever. It will not wait on another outbreak to become detectable. This means that if you had been exposed before, the test would have shown IgG from the very first testing. Getting a positive result months after routine testing cannot suggest otherwise!

She has a right to her answer. I do not totally agree with her conclusion but agree with her on most of the content.

I wish you well. Sorry for seeing you caught in the disagreement of physicians.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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