Newly diagnosed, very confused. Need answers

Thanks for your response. I just got to know IgM showed hsv 1 as postiive. No, didn't swab lesions. Partner hasn't been tested. Now I'm beginning to think his mouth ulcers may be more than innocent canker sores!

I will be getting the IgG type-specific results soon too.

 

I must add I have never had cold sores, except for what i thought were canker sores inside the mouth maybe 4 times in all AFTER being with my monogamous partner.

I must also add that he isn't into performing oral on me, but since January he has performed oral sex on me and used saliva as a lubricant (which he has done in the past too).

We always thought he had canker sores since he never had any sores outside his mouth, only in the inner lining of the lips, inner cheeks, tongue etc.

I'm planning to get those swabbed next time he or I have what we have been calling mouth ulcers' outbreak

Oral HSV1 (cold sores) usually prefer the lips, lip margins and less commonly the harder regions of the inside mouth. Ulcers on oral soft tissues are typically canker sores, which are unrelated. It is possible to carry HSV1 without ever experiencing symptoms, however, so it could be that. I would literally toss out your IgM results and wait on the IgG. If this is a newly acquired infection, as is often the case with first outbreaks, and it comes back negative, you may need to retest for IgG at 3 months.

I already know IgG IS 4.57, just don't know the type yet, but will do, soon.

Ah yes, I forgot. Issue is whether it's type-specific or combined. You only have one value, so it's either combined or they only bothered to test one type. Not as useful as testing for both types individually.

It's combined, so I called them up and asked them to give me type-specific results.

If my IgG were to show either hsv 1 or 2 positive, what would that mean then?

For starters, HSV1 and HSV2 are similar yet different genital infections, so it's always good to know which type you have. gHSV1 is typically much less infectious and bothersome than gHSV2.

If you score a low positive for HSV2 IgG and a high positive for HSV1 IgG, there's a chance that the HSV2 is a false positive, especially if the test kit is HerpeSelect, as I suspect in your case. That's another good reason to separate the results.

oh wow! thanks for all that info. I will post my IgG rtype-specific result as soon as I get it. So from what I know so far: my combined IgG test is positive, and IgM showed positive for hsv 1, can it be concluded it's a recent infection? How about if IgG shows positive for hsv 1 as well, is there any way we can assume it's a new or dormant infection?

Thanks so much for all your reponses, I'm so very grateful!

IgM testing really isn't advised for herpes. Even the CDC and leading HSV experts don't recommend it, but many doctors and clinics still use it, because normally IgM testing can be used for other conditions. I would thus forget you even had that test done and ignore the results.

As for the combined IgG, I think it's best to wait and see how you test individually before trying to interpret anything. This is why a swab test is always preferable when lesions are present, by the way. Direct test for the virus in the affected location, versus indirect tests for antibodies that only indicate general infection, not location.

From the result I read it looks like hsv1 on your genitals acquired recently.

Let's wait for type specific

You cannot interpret anything reliable from IgM, so you cannot assume that. The IgM test is not recommended for herpes for various reasons, including poor reliability/accuracy and inability to determine recency of infection despite (false) beliefs to the contrary.

Thanks, John! Type specific says IgG also positive for HSV 1

Hi! Type specific says IgG also positive for HSV 1. Now what?

What's the index value? Did they also test for HSV2 IgG to cover all bases, and if so, how did you also score in that test?

unfortunately, no idea. They just told me IgG test shows hsv 1 posutive

I doubt they'll give me any more info esp since they weren't willing to give me type specific, to begin with.

Assuming it's only hsv 1, what can I conclude? remember I've never had a classic cold sore except for what I thought were mouth ulcers after entering into a monogamous relationship for years.

A recent first outbreak would seem to also indicate a recent infection (most occur within a week), *but* the fact your IgG is already positive for HSV1 indicates it is not so very recent (high index value means it's certainly not very recent, but you don't have that info). However, because it is only an antibody test, it does not indicate location of infection. One can conclude it is presumably genital due to your outbreak, but many people carry HSV1 orally without symptoms, so did they also test for HSV2 IgG to rule that out? Pity you cannot request a copy of your results. Should be within your rights.

Hi!

I harangued the lab guys so here are ALL the values finally!

HSV 1 IgG: 4.93

HSV 1 IgM 1.98

HSV2 IgG 0.13

HSV IgM 0.16

I am really looking forward to some opinions now about when do you think and how I contracted it, how come I've never had a cold sore but (probably) a milder version of genital outbreak, is there a possibilty I contracted anything from the men I've been with last year (out of the 3, only ONE perfromed oral sex on me twice, that's it. I did kiss all of them several times).

Long time partner gets 'mouth ulcers' from time to time and I've gotten them after being with him. He did perform oral sex on me briefly couple of times since jan this year, uses saliva as lubricant. 

Does it look like a primary outbreak? could it have stayed dormant?

can i pass it on by a brief kiss on lips to kids etc?

So, according to your IgG results, you did not have HSV2 at the time of testing or around 2-3 months prior. However, you already had HSV1 at least 2-3 months prior, maybe even much longer than that. Your genital outbreak was only visually diagnosed as herpes, but assuming that to be correct, it would seem likely to be HSV1 unless you have a very new HSV2 infection.

Your blood was drawn at the time of your first outbreak, so what's interesting is that you already had HSV1 before, so you either missed your first outbreak or are one of the few to not get a first outbreak until later. You can retest for IgG 3 months after your outbreak to rule out new HSV2 infection.

Not sure if you want your partner to get tested as well, just to see if he even carries HSV1 (although the HerpeSelect test kit can miss some cases). Do not waste time or money on the IgM test. It proves nothing and is prone to false results.

Unfortunately, that's the most that can be interpreted from the results. Hope it's somewhat helpful!

Thanks, Feliz! That IS really helpful. I'm now wondering whether I will get cold sores?

Is it safe to kiss kids etc.? share cutlery etc. with them?

How likely do you think it is that the mouth sores are actually herpes INSIDE the mouth?

If a genital outbreak due to HSV 1 is mild as they claim to be, then it IS actually possible that I might've missed it previously if it were a milder outbreak. I do remember tearing down there but putting it down to sex. It would clear up on it's own. This time it was definitely more noticeble and sores were present at the sides of the vaginal opening too, probably unlike before.

I will definitely test for IgG 3 months later too.

Just one ques: even though you've told me a few times that IgM is useless, but since I did do it around the time of my outbreak, then if it were a new hsv2 infection, the test would've picked that up?

If you already had HSV1 orally from before, you should in *theory* be immune from getting it elsewhere (unless you acquired both at the same time). There is thus a chance that you only have it genitally, and even if you do have it orally as well, if you've never had cold sores, it's less likely to be as infectious. So I wouldn't worry too much about the oral aspect, unless you get cold sores.

Cold sores are usually external or less commonly on hard internal surfaces (gums, near palette). If the sores you and your partner get are on soft internal structures (inner lip, tongue, far palette), that would seem to indicate canker sores, which are unrelated.

One might think that the IgM test should still show up something if the virus is present, but I have read so many expert views discrediting the IgM test for herpes and its results, I wouldn't put any money on that.

Thanks a ton, Feliz!! Appreciate all your patient reading and replies!