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Western Blot Question

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Hi, I have been struggling to get properly diagnosed for 2 years now.  It's a long story but I have nearly constant symptoms both oral and downtown.  Anyway, 3 times I have had a negative IgG test for HSV 1 and 2.  2 were just "negative, <0.9" and one test showed my levels of 0.23 and 0.19.  All of these tests were over 1 year after symptoms started. 

But the point of this post is this...if someone else had HSV1/coldsores for sure as a child, but had been symptom free for a long time, and now no IgG to it, would your Western Blot be positive anyway? I am interested in doing the Western Blot but not sure how much info it would give me if it could just be from cold sores as a kid.  On the same vein, when people say "well if your IgG is negative you don't have HSV," I am confused because I for sure had cold sores as an adolescent and I thought that would make my IgG postive now for HSV 1 anyway. So I am not sure how accurate the test is for me.

Also, if your IgG test is negative, does it mean you aren't making any antibodies or just that the test is falsely not detecting them?

Thanks for your input.  And yes, I DO wish I could just accept I don't have HSV and move on but my symptoms are a huge struggle daily and no one has been able to attribute them to anything else.  Definitely been tested for lots of stuff and also antivirals do seem to help the severity although not frequency.  So I do feel like a crazy person and it's AWFUL. I used to take zero meds and never go to doctors!!

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Hi @TreeHugger44,

Sorry to hear this has been such a struggle over the past couple years. Definitely sounds frustrating and the false negatives and false positives of IgG and IgM tests are common problems people have for getting a straightforward result. What kinds of symptoms are you having specifically?

And to answer your question, yes, the Western Blot is the gold standard for herpes testing, so it will give you a definitive answer on whether you have HSV-1, HSV-2, both, or neither. The only thing it won't be able to tell you is *where* your site of infection is (an active outbreak and a swab would tell you that). So that may be the only gray area that would still be gray if you get a result that you have HSV-1; it wouldn't be able to tell you if you have it orally like you've had since childhood or if it's also active genitally. If you get a result of HSV-2, however, then there's a 99% chance that your site of infection is genital (since only 1-2% of all oral herpes cases are HSV-2).  

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Thanks! My symptoms started with a frequent and constantcycle of itchy genitals/butt followed by bumps on my butt which are burny/stingy, red with tiny fluid filled centers.  But many individual bumps, not clusters. Frequent sore throats at the same time with occasional ulcers in back of throat or on gums, but they are small and not always there.  Very very itchy nostrils and face and eyelashes.  Tingling lips and irritated corners of mouth, irritated/tingling genitals.  Sometimes feeling like my chin is being stabbed with thumbtacks, then ends in tiny bumps appearing with a tiny fluid filled center.  Clearly not a coincidence that it's the face and butt at same time but no one can explain that.

 Working up everything and was just negative for....everything. Thyroid, lupus, lyme, celiac, IgA deficiency, varicella (I am immune but show no current infection based on IgM), STD's, all negative. 

I am scared to do WB for it to say HSV 1 and I still won't have an answer.  But why do I have no IgG to HSV1 now if I clearly used to have regular full on cold sores?

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