How do you detect gHSV-1 when you already have it orally?

[Melissa]

So my boyfriend has oral HSV-1 and he’s been having reoccurring symptoms of having it genitally too but they are mild. His symptoms are pain during urination, and a few minor bumps. How do you go about testing for it genitally at this point? The bumps he gets don’t break open with fluid so a swab couldn’t be done to detect it. 

His family doctor did a blood test for antibodies and it came back positive for HSV-1...his doctor clearly doesn’t know much about it as he said “Good news! It came back positive for HSV-1 so you don’t have it genitally. Only HSV-2 is genitally and HSV-1 is oral. 🤦🏼‍♀️🙄. He’s not sure where to turn at this point but he needs answers. I have it genitally (I contracted it from him) and had a severe outbreak so getting results was easy and therefore I am unfamiliar as well.

[mr_hopp]

Hey @Melissa! The short answer here is that you don't. The only way to tell if you have it genitally as well is to actually have an outbreak that is swabbable. But even with minor bumps, you can try to get the area swabbed. If the bumps are from herpes, then it should be shedding enough virus that would be detectable even without open sores. (And wow, he needs a new doc who knows the basics!) 

[Melissa]

Thank you for the response @mr_hopp. I’ll pass that information onto him. I know, he said the same thing! New doctor, pronto!

[TBarr]

I have had 2 ID doctors say you have to have fluid. However read the NUH studies on drug testing and placebo groups they involve swabbing daily and sending in results for viral shedding 

the nurse at the clinic acknowledged this and conducted the swab 

 

Ask u of wash virologist and they will tell you while it is a lot easier to get send of fluid if your pain is the greatest with a bump then this is when you have the most virus even though a bump is not a lesion It can be swabbed andbif done when bump first forms then tends to indicate it is not hetors

again placebo studies where people swab daily is a key to that fact 

[TBarr]

Did he get the University of Washington Western Blot? This will really confirm he is HSV2 negative 

[TBarr]

BTW the official line is that it is very rare to be orally HSV1 and then contract HSV1 genitally from some else as the virus meets antibodies before it can get to nerve cells