Confused about results

[herpnerve]

About a year ago, I asked to get swabbed for HSV. I had no visible symptoms (no blisters/lesions) but had some nerve pain and asked the gyno to test me. I was supposed to get an answer 1 week later but it took 3, which now I wonder if it’s because something was mislabeled. So they ended up telling me I have gHSV1.

Fast forward to 2 days ago, I asked for a blood test to include herpes because I wanted to make sure I didn’t also have type 2. The blood test came back negative for both type 1 and type 2 (FYI I would’ve acquired HSV a year ago at this point, plenty of time for antibodies). I understand a swab is more accurate than a blood test, but what are the odds something got mixed up in the initial testing and that’s why it took so long to get back to me? I also asked for another swab while there this time around so maybe if it comes back positive for HSV1 that’ll give me more clarity on this situation. I’ve never had an outbreak though and my gyno said I should visit a PT for the nerve pain, what if she was right and the nerve pain is there because of my super tight muscles and not HSV like I had thought? 

Any advice as to how I can seek more accurate results without ever having an outbreak? 

[herpnerve]

FYI my boyfriend knows of my diagnosis and I’m still planning on taking the precautionary measures, I’m just confused

[Ishmael]

There's a not tiny chance of getting a false negative with an IGG blood test. I think it's somewhere in the ballpark of about 8%, but it's been a while since I looked at the actual stats. I'd get tested again. If that's also negative, then consult with a doctor about a Western Blot. 

[Tk2019]

The person who gave it to me kept getting a negative blood test and telling me he didn't give it to me. It had to be him. I started breaking out a few days after we had sex, had not been with anyone else in months, and tested negative for antibodies as well. There's a possibility my blood test was wrong I suppose. I just don't trust them at all. But I do not believe I had it before him because any time I try to stop or decrease my antivirals I break out.

[makepeacewithit]

The IgG tests are not as good at positively identifying HSV-1, whether it is new or established, the test misses 30% of the cases. If you DO get a high positive HSV-1 score with IgG blood testing you can believe it, but the problem here is that with such a high incidence of "total misses" the lack of a positive result for HSV-1 on IgG isn't a gold standard answer. It's unfortunate, and it happened to me that the IgG test never identified my HSV-1, and also gave me a false low positive for HSV-2. 

A positive swab or a Western Blot are going to be the only truly reliable tests for you with this.

[Ishmael]

On 7/20/2019 at 3:45 PM, Tk2019 said:

The person who gave it to me kept getting a negative blood test and telling me he didn't give it to me. It had to be him. I started breaking out a few days after we had sex, had not been with anyone else in months, and tested negative for antibodies as well. There's a possibility my blood test was wrong I suppose. I just don't trust them at all. But I do not believe I had it before him because any time I try to stop or decrease my antivirals I break out.

There's nothing here that indicates that it had to be him. You can get your first outbreak years after getting it and that outbreak can be triggered by sex, including with a negative partner.