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Q. My herpes IgM and IgG are 3. 5 and 4 respectively. Why?

Answered by
Dr. Sadaf Mustafa
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Dec 17, 2016 and last reviewed on: Oct 09, 2018

Hi doctor,

I am 34 year old female. I have got my STD and HIV done. I have attached my reports for your reference. All look clear, but herpes simplex virus IgM and IgG are 3.5 and 4. I have no other symptoms. Please help.

#

Hello,

Welcome to icliniq.com.

  • The results showed that you have both immunoglobulin M (IgM) and immunoglobulin G (IgG) positive to herpes simplex virus (HSV 1 and 2).
  • With this information it is difficult to differentiate whether it is type 1 HSV (less likely to be genital) or type 2 (more likely to be genital).
  • This could represent that you were exposed to type 1. Because, most of us are exposed to it and can have positive antibodies against it without any symptoms or lesions.
  • This may also mean that you were exposed to HSV 1 or 2 in the past and have the immunity or have recurrent infection, less likely since you do not have active lesions.

Investigations to be done:

1. IgG HSV1 and IgG HSV2 to check for immunity against these subtypes individually.
2. The IgM antibodies may still be positive with progressive fading acute infection.

Preventive measures:

1. If you do not have active lesions or are not pregnant, there is no indication for treatment.
2. If you have active lesions, avoid unprotected sexual contact. It may however still transmit even if you do not see active lesions, since they may be hidden in the genital tract.

Regarding follow up:

For further clarifications consult an internal medicine physician online.---> https://www.icliniq.com/ask-a-doctor-online/internal-medicine-physician

Hello doctor,

Do I need to start any medicines at least to control these? Because, count 4 and 3.5 looks high. I am much tensed. My periods are due soon. Can this count be high because of it as well? Please guide.

#

Hello,

Welcome back to icliniq.com.

As I said earlier, do not get tense.

  • First we have to figure out whether it is type 1 or 2; it is mostly HSV 1 and could be due to previous oral lesions, usually on lips.
  • Try to get the tests I recommended. It will allow us to differentiate (this is just for your satisfaction); otherwise we do not recommend treatment unless there are active lesions.
  • Let me know if you ever develop any and I will treat you promptly.
  • Pregnancy is another indication for treatment.
  • Chronic suppressive therapy decreases the number of recurrences of herpes among patients with frequent recurrences of HSV infection more than four episodes or years.

Revert back after the tests to an internal medicine physician online --> https://www.icliniq.com/ask-a-doctor-online/internal-medicine-physician

Hi doctor,

Honestly my fiance's report too has IgG 3.5 where as IgM was in range. Other STD and HIV tests are negative. He was sexually active before as well. My doctor has prescribed Acivir 400 mg thrice for five days for my fiance as well but said will stretch till 14 days. So far, I have no symptoms and it has been third day. I am scared. Will it lead to HIV? What if I have to marry someone else? Will I be able to have a normal sex life ahead and can start family? Will it get spread by kissing?

#

Hello,

Welcome back to icliniq.com.

  • It would be helpful to know which antibody is positive for your fiance. Is it HSV 1 or HSV 2?
  • Also as I recommended earlier it would be very helpful to see which type you have either type 1 or type 2. If you both have the same subtype then it is highly likely that it was transmitted between you two.
  • If it is different subtype (serodiscordant couple - one is positive and the other is negative) they you can still transmit the other subtype. For example, yours is HSV 1 and he is HSV 2 then you both can transmit it to each other through any type of sexual contact.
  • Kissing may transmit it with oral lesions; similarly females are more likely to harbor ulcers in unseen areas (like cervix or vagina) and can transmit it as well.
  • Regarding treatment, you can use Acyclovir or Valacyclovir if you want but it will only suppress the virus as long as you take it, once you stop taking it the virus will surface again. It does not go away and only hides. That is the reason that we treat patients with active lesions or they have more than three to four episodes a year.
  • It is the delivery that makes things difficult if you have active lesions; that is an absolute contraindication to vaginal delivery since the new born can have serve eye infection and blindness.
  • In case you get married to someone else, they will not know that you are HSV 1 or 2 positive unless they look for it. As I mentioned earlier, most of us have HSV 1 and it is very common.
  • It can be even transmitted between mother and child if you kiss your child on the lips to show extreme love and affection while having very minimal lesions on the lips.

For further information consult an internal medicine physician online --> https://www.icliniq.com/ask-a-doctor-online/internal-medicine-physician

Thank you doctor,

I will get the tests done for both of us. Is it fine to get them done now when we both are taking Acivir? Or do we need to wait for last dose? Also if no symptoms persist in future then do we need to get tests done in regular intervals and take medicines?

#

Hello,

Welcome back to icliniq.com.

  • You can get now; it should not be a problem. If you have an acute infection we might see IgM dissolving.
  • For treatment it has to be taken daily to suppress the virus from emerging and causing lesions and transmission
  • Again we do not recommend testing for it unless lesions are seen or close to delivery of a baby with active lesions.

For further doubts consult an internal medicine physician online --> https://www.icliniq.com/ask-a-doctor-online/internal-medicine-physician

Hi doctor,

Please find the reports I have attached. I have got the tests done. What do you interpret? As mentioned earlier, I am on Acivir 400 thrice a day. Today is 6th day. Also when this test was done I have started taking it. What next? Is this HIV?

#

Hi,

Welcome back to icliniq.com.

  • From the results (attachment removed to protect patient identity) it seems like you have HSV type 1.
  • As I mentioned earlier, it is the more common type and a lot of us are exposed to it; even if your mom had IgG Ab to HSV 1 she can transfer it to you.
  • It is not the usual culprit in sexual transmission. Your IgG HSV 2 is negative which is the most common form in sexual transmission.
  • You can continue taking the Acyclovir for total of 14 days. It should suppress the virus for short term.
  • Remember that if you have any lesions you would have to take it again for 5 days. Your HIV test was negative same as in the previous reports.

For further information consult an internal medicine physician online --> https://www.icliniq.com/ask-a-doctor-online/internal-medicine-physician

Hi doctor,

Should I still ask my fiance to get his test done? Though I am taking Acivir but still I am having dry chapped lips. In fact it is paining too. I have got a crack on the side of lips and applied Boroline. Please help.

#

Hello,

Welcome back to icliniq.com.

  • The cracked lip is not a sign of HSV infection, so you are good there.
  • I like recommending Petroleum jelly or Vaseline, they are the best in this situation.
  • Yes, I would recommend that your fiance should also get the same testing and in fact he should also get IgM for both HSV 1 and HSV 2 separately.
  • Share the results with me when they are available. Take care.

Revert back with the investigation report to an internal medicine physician online --> https://www.icliniq.com/ask-a-doctor-online/internal-medicine-physician


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