HSV IgM tested on tongue came negative. Need a second opinion. Is there any Suggestions?

Question

Hello doctor,

My brother had one blood test with herpes simplex IgM diagnosed to be negative, but herpes type 1 was diagnosed to be positive with an index more than 8. Before that he did a test on his tongue and it was negative for herpes. Are these results final? Or is there a chance that he is not infected with herpes? He had so many medications and antibiotics at the time of testing. The problem is his tongue and mouth was affected by burning due to hot beverage and it got infected. The reason for the test was that his mouth was almost bleeding. Doctors saw his tongue and told him it cannot be herpes and as I mentioned a test on his mouth showed negative results. Do you recommend him to take the test again?

Answer 1

Hello,

Welcome to icliniq.com. Herpes simplex virus (HSV) type1 is a very common infection in our population and it usually causes oral lesions known as herpes labialis. At times, the patient is not even aware of the exposure. It can spread through direct contact with the open sores of HSV type 1 in the mouth; it is very rarely spread due to a sexual transmission through genital lesions. Immunoglobulin M (IgM) testing on the lesions means that your brother do not have an active infection, but he can transmit it to his partner if he has active lesions. There may be a minimal amount of asymptomatic shedding of the virus. HSV IgM positive in the blood may mean active or remote infection. If you check immunoglobulin G (IgG) antibody for HSV1 and is positive then it is most likely an old infection or an acute infection in remission to become chronic. I would suggest getting IgG for HSV type 1 and get treatment only when active lesions are present or if recurrent lesions happen after three to four years.