Understanding blood tests for herpes

1. PS: Is “You’ve been exposed to the Hsv1 virus” just another way of saying one “has herpes?”
   Or is there a distinction?

   thx again

2. My results was this:
   Negative 1.90

   I don’t what that means. Is it Positive or Negative for HSV. I need help for the answer. Thank you.

3. y doctor told me i had herpes in the past but i never had any symptoms orally or in my v

4. Can a positive Hsv 1 diagnosis be the underlying cause of my female hairloss?? And could it effectively be auto immune related??
   Never had any obvious outbreaks

5. Doctor–thank you. This article was much better than most. I have read extensively on the topic of STD testing and the estimations from various supposedly authoritative sources as to how long it takes after possible exposure to HSV2, (and therefore how long you should wait to be tested), vary wildly. The average recommendation seems to be 3-4 months. I’m wondering where your “3 to 6 months” advice was derived from–if there is some reliable research on this topic I’d love to study up on it. (For the sake of argument let’s assume an individual knows exactly when he/she was exposed, which I know is usually not the case). I get the impression the true answer is nobody really knows for sure. And the difference between 3 months and 6 months (for the IgG antibodies to be detectable) is quite a spread. Any reading you can suggest would be appreciated. Thanks

6. My girlfriend had some odd bumps on her vagina and had a blood test which came back “Dubious” I’ve never heard of a test result like that . We live in Belgium and i went for a blood test also, my doctor said i have hsv anti bodies. I asked how many and he replied 4125. i asked if that was high and he replied yes very. Normal is 250

   I’ve done some research and nobody seems to have results like we have (I’ve tried scanning Google for results similar). WTH??

   none of our tests were type specific IgG

   Am i going crazy here or does it seem that the tests here are ridiculous and we should get re-tested??

7. Informative …. Just one question that I can’t see an answer for. The window period is 3-6 months …. Is that after intercourse or from first outbreak if that occurred… I.e when do the antibodies start getting produced ? Do the body fight infection instantly or only when it becomes non-dormant ?

   Thanks

8. Hi, I just went to the doctor to get my blood test results and she explained to me that it shows that my body recognizes herpes but I kept asking her if I have it and she was going around the bushes on me. So my question to you is exactly that. Does that mean I do have it or not? please help me

9. I’ve had HSV since 1978. Before starting a sexual relationship with my current man, I informed him of this. He said his previous gf of three years also had it. But chose to have unprotected sex as he had done with her for years earlier.

   Then he says he’s having tingling symptoms and goes and gets tests. Now, I am concerned I’ll be blamed for this if it comes out positive, but couldn’t he already have it from being exposed before?

10. Hello,
    Thank you for your informative post.
    My three month old son was recently exposed to hsv1 (kiss on the cheeks from someone with active ulcer on lips). I am terrified about the dangers of CNS infection. He is asymptotic at the moment. Would you recommend any antibodies check or wait for the 14 week window and check for IGG?
    Thank you in advance

11. So now I’m confused. I was tested for both HSV-1 and 2 in Sept of last year because I was pregnant. HSV-1 came back positive with no symptoms my entire life. HSV-2 was negative. My husband and I have been married 2 years. I am again pregnant and this year the test came back negative with absolutely no markers at all. How is that even possible?? If his ex had HSV-2 does that mean he’s infected even with no symptoms or positive tests?

12. Hello,
    Today I received my test results back for my HSV 1-2 IGG for my (1) my result was 4.99 and (2) my result was 4.97 dies this mean I’m positve for herpes. I’ve never had any type of break out and 1 week after this blood work I had a pep smear done. I receives those results and my cultures came back negative for all including HPV….Wouldn’t something have shown up before with my previous peps far as any warts. I’ve never had any type of cold sore or warts appear and I’m clueless to this results
    Because according to the guidelines. 0.90 is negative, 0.09-1.10 Equivocal and > 1.10 Positive so I’m thinking 1.10 and above is definitely positve and I’m scared.

    1. Why did you have the test and did doctor explain hsv 2 not always genital

    2. Why did you have the tests and did doctor tell you hsv 2 isn’t always genital but according to your tests definitely positive

13. I want to emphasize that the difference between type 1 and type 2 are increasingly unclear and should be understood, but not used to draw dramatic distinctions between them that in truth, do not exist. Both types are a hassle, both can have serious health effects in particular circumstances, and neither type warrants ending a relationship or ruling out having a relationship with someone. Type 2 recurs more often genitally than type 1 (60-90%, compared to 25%, http://jcm.asm.org/content/39/9/3321.ull). But 25% is a lot, and it could be higher for type 1 because it has been studied so much less than type 2. Type 1 carries similar risk as type 2 in terms of dangers of perinatal transmission. Type 1 sheds asymptomatically orally with a high frequency in sufficient amount for transmission (http://www.ncbi.nlm.nih.gov/m/pubmed/17703961/?i=6&from=/11154417/related). Type 1 carries a greater risk for ocular herpes which can be serious even in adults. Accordingly, the medical community is increasingly concerned about a projected type 1 genital epidemic, http://m.jid.oxfordjournals.org/content/209/3/325.long?view=long&pmid=24136792#ref-13.

    We all need to stop blaming the other type as somehow worse than our own type, and accept that we have been living with herpes as a parasite on out nervous system since we were chimps. And pray the vaccine comes out soon (http://acsh.org/news/2016/03/10/a-vaccine-for-herpes-erupts-in-the-news/ Maybe type 2 carriers are more lucky because we are closer to having a vaccine for 2 than 1!). Take medication if you or your partner has bothersome symptoms, and AVOID CASUAL SEX. Herpes is one big reason to limit the # of sexual partners in a lifetime and not have sex unless you are serious about someone. Condoms do not protect fully against herpes and no one uses them for kissing or oral sex.

    Finally, anyone receiving a low positive for type 2 by ELISA (index up to around 5.0) should get confirmation via western blot. The commonly used ELISA has been improved but still suffers from too many false positives. You have to send your sample to University of Washington for the western blot, by your doctor should be willing to order it. See http://depts.washington.edu/rspvirus/documents/hsv_western_blot.pdf

    1. Where do gential herpes appear on women do they go on labia majora where pubic hair is or inside vagina on mucosal areas ….and do they always hurt

14. Dear Dr. Gunter,

    I hope you are having a great day. I got tested over a year ago with the IGG and it was negative. I have not had sex or kissed anyone in over a year. I just got tested and my IGG is still negative but my IGM is positive??? This is the first time I got the IGM. To me this does not make sense??? My IGM was 1.33. I had a bit of a cold/flu when I took it as well. Can you get HSV from a sauna or hot tub? I was at hot springs the week before?? Should I just not pay attention to the results? I am very scared and confused because I have had no sexual contact of any kind and have had no lesions ever. The midwife that called said the IGM showed that I had a current infection.

    Thanks Kindly,

15. Hi. I went to the doctor to get tested for herpes, my tests came back negative, which is to be expected I suppose as it is only 9 weeks post exposure and tests take up to 3-6 months to turn positive. Though my tests came back navigate my index value was higher than normal, 1.02. ( . 1.09= positive) I’m very aware that this number could be raised if it’s an early infection, but my question is, what else would cause that number to raise? If I am actually negative for herpes.

16. What happens when a person test positive for herpes on one test but then negative in another test what does this mean?

    1. Was it blood work & what we’re your index values the numbers from blood work they say index values of 3. 5 are usually negative or false positive

17. she had no signs of any issue but needed to find out for sure

18. if you test positive via a blood test for the antibody but the pap smear proves negative, do you still have the herpes virus and can you pass it to a partner?

    1. You cannot diagnose herpes by Pap

       1. so is having the anti body a definite proof that you have herpes virus? and can you pass it to your partner?

    2. Docs say that they diagnosed via outbreak also have been told that alot of people test positive for antibodies but just cause you test positive for hsv2 doesn’t always mean genital

       1. thank you so much for all your information

       2. Why did u have blood work done in the first place or did you have an actual outbreak ….I hope for everyone’s sake there’s a cure soon

       3. because a man my friend slept with said she burned him so she went to the doctor to have all tests run in case he gave her something.

       4. Did she get her results back yet ? Cdc doesn’t even recommend hsv testing

       5. she did and they said she had type 2 but no outbreaks

       6. What was her index value was it high

       7. they never told her an index

       8. Well even though she had blood test and was positive that alone isnt enough to say you have genital herpes

       9. that’s what I told her, so she feels a little better about it but will be very careful

       10. Did her doctor also tell her that I mean the only real way is to diagnose with a culture then do hsv testing to determine the type …was.this the first time being tested she could have these antibodies for a long time …

       11. yes she is aware that she could have had the antibody for a long time with out knowing

       12. Did doc say you have genital herpes

19. Ok…so I have been dating this beautiful lady for 4 weeks now…and we have been really close to being intimate with each other…she asked me if I would mind going to be tested to all std’s….I said yes…not a problem…just got my results back…and if I’m reading this correct I’m positive for both strands…I do have cold sores/ fever blisters…so I expected that to be positive. ..we have already talked about that…not a problem. ..but when the 2 strand came back positive I was floored. ..I have never had any kind of blisters or sores on or near my penis….even being 50 yrs old…I’ve never been one to go from woman to woman…so stressed about this…I have a feeling that this will be a straw to break the camels back…unfortunately. ..I have already developed feeling and so has she…I’m planning on handing her the results and being total honest. ..any help would be greatly appreciated

    1. What did test results sayou for hsv2 sometimes you can have false positive depending upon number cdc doesn’t even recommend hsv testing hsv 2 isn’t always genital maybe you had it someplace else what did doctor say

    2. What was the index value of hsv 2

20. I just got the hsv igg test done I tested positive for hsv 1 and 2 I have so much questions but still no answers I have never had a out brake and no one that I have been with have never had one I know that as a child I had cold sores but nuh since I have been on adult. Can I still test positive for hsv 2 if I have only been exposed to hsv 1

    1. What was your hsv 2 igg

21. I too am very confused. I tested positive for HSV 2 from a culture take from a lesion but the IGG test was negative. Shouldn’t I have antibodies in my blood if I have the virus. If I take another IGG test in 3 months and it still negative is it possible the culture was a false positive?

22. Everything else I have read says igG antibodies will be present within 6 weeks of initial exposure… What is your source for it taking 3-6 months for antibodies to be reliably tested

23. I hope this post, if you can please take a sec to answer this I would appreciate it very much. I have always had a chaffing rash on my leg for yrs that has been almost impossible to get rid of. 2014. I got a sore from a YMCA pool. I went swimming and a brown spot around my knee turned neon green. I scratched it and the brown spot went away but it became a sore, that itched and spread…Please not in 1984 after a accident that almost killed me I was given a lot of blood. I lived but they gave me hep c. I found out in 92. I was mortified. By 2014 I was dying literally, this was prior to the final treatment out. So..at this point in 2014, I have Hep C a rash on the inner leg and 4 spots of a different rash on my left leg…and I am dying. A Doctor..bless his soul, ran every test known o man and put me in Ribbovirin, Savaldi AND Interferon, He saved my life but I was left with Stage 4 cirrhosis. My immune System is in the dirt, 2015 I was in the ER 10 times getting IV antibiotics, steroids and Rosephin for a cold…….there is a reason I am saying this, my internal med Dr who is separate from the liver is the one I have talked to about this rash. 2 Dermatologists haven’t a clue what it is and gave me laundry soap with out dyes.. Last week after being sent to a Cancer Center for Hemocromotosis, After I was diagnosed with Anemia with an iron level of 1000 . I received a call from the IM Dr saying..you have herpes.. I almost passed out, crying hysterically I had to go to the Office pick up a script and a HIV test result. Please note I haven’t had sex since May 16, 1989. I was then called in a 850.00 tube of an ointment for my herpes but I didn’t have HIV all of this after being put on 200k in drugs for the Hep C. I have been put threw hell and you are saying this test doesn’t mean anything??? Do you have any idea how many STD tst I have had since 1992?? I feel so used, mistreated and horribly misdiagnosed. I cant tell you how damaging it is to tell a person they have something and they don’t..how how many people on this post alone are frantic over the possibility of having herpes only to find out it almost looks like you are saying most people could have it but really if they could of gotten it after slobbering as a toddler how can it be called a sexually transmitted disease. Could the fact that a lot of money is being made off of the “thought” of a person having a “Disease”. his is sickening to think the people who took an oath to help their patients are only concerned about how much money they can made off their patients. Very sad

24. Why did u have the test to begin with and they say just cause your positive for hsv 2 type doesn’t always mean genitals

25. I was diagnosed over 5 years ago and have never gotten a breakout in any area on my body….does this mrani need a 3rd opinion?

26. Hi my name is Krista I ve been diagnosed with herpes ever since 10-26-2015 .I am only 18 and don’t know will there ever be a cure for herpes or is there this ain’t fair that bcuz my ex cheated on me by Rapin underage girls that I have suffer with herpes I have type 2 genital herpes to be exact

27. Hello,

    You say it is possible type1 occurs at the genitals and type 2 in the mouth.
    1. Does the same apply for herpes zoster? It is often on the skin, can it occur in the mouth or genitals too?

    2. When somebody gives you type1, and that guy/girl has it on the genitals. But type1 is often in mouth, then, do you have a higher risk to get it on the genitals too?

    3. assume you have type1 but it exposes itself somewhere else than the mouth. Is it possible the virus transforms to another type? If your “type1” is exposed at the genitals, is it possible the type1 is transforming itself to type2? Or are they competely different virusses?

    Regards,

28. Hi sir, I am 28 male from India. Suffering from legs pain and genital pain rectum pressure when prolonged sitting or standing and burning frequent urine. My hsv 1&2 igg is positive. And igm is negative for both. So I am confused between igm and igg. Igg positive mean I have hsv ? Please help

    1. Even I had same problem I tested for igg which came positive with 1.31 value again I retested after two days which came to 0.82 .now I am confused whether I have virus or not

29. 10 years ago, I tested positive for genital HSV, but didn’t know which kind. I just got the blood test to see if it’s HSV1 or HSV2 and neither came up as positive. Did I get a false positive or heal, or did I get a false negative blood test after over 10 years of infection?

    1. Was it a blood test 10 years ago and did you ever have an outbreak

    2. Was it a blood test 10 years ago

       1. It was a culture on an asymptomatic white head my boyfriend at the time found in my genital region.

       2. It was a culture swab on an asymptomatic white head my boyfriend at the time found in my genital region.

30. HSV 1 IGG Type specific AB out of range >5.00 H.. What does that mean?
    The Dr. said it only indicates a past history of fever blisters/ cold sores, and not generally considered sexually transmitted.

    What does all this mean?

31. Dr. Jen If I got tested and my swab was negative and then got a blood test for a igg and a igm antibody and they are saying that it is positive.. does this mean I am positive or should I get a different test done?? I’m super confused..

32. Why did you get tested were you having symptoms?

    1. I was having cold sore on my lips all my life and was never tested, wanted to make sure it is a herpes (HSV1), but turns out I have both… hoping that it was an error…

33. I was tested positive for type 1 and 2 within 2 days of blood drawn. Is there a chance that it was false positive? Should I repeat the test to make sure?

34. I am a healthcare professional and I feel that your statement about if a provider offers you an IgM test, you should get up and leave because they don’t know what they are talking about is harsh. I am sure that in your clinical experience as a physician, you have learned new aspects of medicine that you may not have known before but that does not make you incompetent or a bad physician. Medicine is always evolving and changing. It is impossible to know everything.

    1. IgM tests for heroes have never been recommended nor are they in the CDC guidelines.

35. My partner is Igg positive for HSV 1 & 2 (2/29/16). I tested Igg negative for HSV 1 & 2, but my culture was positive for HSV 1 (2/1/16). Am I correct in thinking that my Igg HSV 1 test should soon be positive? Can I clearly say that I did not have the disease prior to this outbreak? Further, is it possible to determine whether I contracted the disease from him or vice versa? My husband is presuming I have contracted the disease and given it to him.

36. About 5 years ago I had a positive culture for hsv2. Last year, I broke up with my partner and I went for an std check after learning he had cheated. Anyway, I forgot to tell my nurse that I didn’t need checked for hsv2 because I already had it. Well my blood tests came back, and my doctor told me I was fine and I was negative for stds. I told him no im not of course because I had been tested positive for hsv2. So he looked up my records and realized that I was right. He said there were no antibodies found in my blood. Not for hsv1 or hsv2. I asked him what that meant and he didn’t know. My nurse told me I was lucky because it meant I didn’t have it bad enough for my body to fight it off. I have looked everywhere online and I cannot find another story like mine. Even my doctor is confused. Do you know what could cause this? Or what it means?

37. Cold sores are recurrent. My kids mother, son and daughter have them 3 to 4 times a year. Hvs-1 So you are wrong about that.

38. Hi Dr. Jen

    Just to confirm, it takes at least 3 – 6 months for the body to create antibodies for hsv2? Thanks.

39. What if I took blood tests 5 months ago and they testes me positive for herpes and I still didn’t het any sighs of it that came back it doesn’t make sense I don’t even get cold sores.

    1. Was it positive for hsv 1&2 and why did you get tested ?

40. My obgym just told me I have type 2 thru a blood test I’m 14 weeks pregnant could it be a false positive??

41. Hello Dr. Jen,

    I am a 26 year old male and as long as I can remember, I have always had mild canker sores, usually on the inside of my lips or gums. Probably something associated with common HSV 1. I have never shown signs of genital herpes or out breaks other than the canker sores my whole life. Recently a partner of mine showed signs of what may be genital herpes about 5 months into our relationship. We do have mostly unprotected sex and perform oral on a normal basis. My previous partner has showed no similar signs ( she was my partner for over 2 years). The symptoms for her have just shown up as of late. I had never been tested prior for HSV so I did a few days ago. The results were quick and as follows:

    HSV 1 IgG , type spec – Result: 40.70 / Flag: High – on an index Negative (1.09).

    HSV 2 IgG, type spec -Result: <0.91 / Flag: NA – on an index Negative (1.09).

    I wanted so insight on what these results may mean for me personally and my relationship with my partner?

    Thank you.

42. Cultures aren’t always accurate , did you have an outbreak …many things can resemble herpes . I would get a 2nd opinion why did you get a culture to begin with ?

    1. Cultures don’t typically have false positives, false negatives yes

       1. You can have a false negative or a false positive has happened ….

43. I was tested for herpes by culture and blood, the blood came back negative and culture positive can this be wrong? ? I want to DIE PLEASE HELP ME UNDERSTAND? ? I was only with one person and I am freaking out.

44. I am a follower of your blog. I know you have very lucidly answered or commented on blood testing for Herpes. My very close friend has gone through some traumatic times recently. She was tested negative for IgG but +be with IgM at 6.11. I am not sure where she got it as she feels that her husband is monogamous. Embarrassed to ask. She did suffer from small pox few years back. Question is IgM antibodies are created for all kinds of disease or this is herpes specific. Your answer is appreciated. Seasons greetings and merry Christmas.

    1. They say igm are useless always igg and even depending on value they can show false positive

45. Have you ever had cold sores on your mouth I know its frustrating hearing oh well you have hsv 2 and they want to jump automatically to genital herpes have you talked to your doctor about this .then they say you can have no symptoms and still spread virus through asymptomatic shedding but mostly you spread it through break outs …CDC doesn’t even recommend hsv testing …so did your doctor say its genital

46. Ok so question. I just got my results back HSV 1 was 50.70H and HSV 2 was 14.20H. What exactly do these results mean?

    1. Did you ever have outbreak ? Did they tell you had herpes genitals not necessarily does hsv 2 always mean genital

       1. No I have never had an outbreak at all. I looked back at my past HSV test and they were negative. Now I did notice that this time it was HSV 1/2 IGG and the last time it was HSV 1/2 PCR… I’m not sure of the difference. The MA called and was just like doc wants to just make sure you are aware. So at this point I don’t really understand what this means.

       2. She was probably thinking the medical assistant that you knew that you had hsv 2 and its amazing cause some people will say hsv 2 is always genital but not true and why did you have test done any way …I am a nurse myself and also why did you have previous pcr test ?

       3. I only got them done because they were part of my well women visit. It’s included in the STD testing.

47. If you passed herpes to other people is it normal for them to vomit. Also if you have had herpes for about 20 years…but never got a herpes test…could you also suspect it’s herpes from a low white blood cell count. If you have other symptoms such as cold sores in mouth and genitals…and coupled with a low white cell count…could that be herpes? And finally, there’s something seriously wrong with your peers. It seems as though they’re in denial about it and are afraid to test for it…it’s almost unethical. I told a doctor every symptoms and she negated everything I said and told me to see a psychiatrist for depression. She tested me for syphillis which was negative but she talks me out of hsv tests. What is going on??

    1. Wbc having no relation to hsv 2 were your sores cultured and also have you ever had blood work and it showed positive hsv 2 although they say hsv 2 is genital you can also have it somewhere else

48. Hi Jen, I feel like I’m in a nightmare situation. I am 30 and I suspect I got hsv2/and or 1 from childhood sexual contact obviously not my fault. But the other individual was child also. I have all typical symptoms. Genital lesions and mouth. The nightmare is I have lived with my family my entire life and they’ve had cold sore outbreaks. My brother has really bad skin..appears to be acne all over body. His doctors just give topical creams for acne. However they recently discovered his white blood cell count was low and they’re monitoring. I was in the ER for low hemoblogin and I asked them about STD possibly causing infection related to my cold sores. She said she’d know from the white blood cell count. My white cells came back fine. So my question is: can I determine if I’m fine based on my white cells. And can we determine if my brother may have it based on his severe skin outbreaks and low white cells? Now my sister claims she was actually tested for all stds at a check up and everything came normal and clean. She also gets cold sore outbreaks on mouth and face. In addition she gets bad eye infections claiming she can’t see. They all also experience strange episodes of vomiting …except for me. It just seems like something hits them and attacks their body periodically and they have these vomit attacks. This is my nightmare that they’ve been infected. I can’t get tested now myself for safety reasons because my mom is violent and I still live at home as stated. But do yoy think there’s a connection here. What does my brother white blood test suggest? My sisters negative results and my lower white count? Is it possible this is something other than herpes despite my genital lesions?? I need a miracle…

    Thank you.

49. Hi Dr. Jen,
    My gf got her first cold sore after 38 years. I used to get them but haven’t had one in 8. Her doctors have put the blame squarely on me; that I was shedding and infected her. They are running a test that they claim will determine if her antibodies are old or new. This sounded preposterous to me that they could test for this which led me to your site. Is there any test that can do this? I’d gather if an IgG came back negative that could suggest a recent infection.

    Also, she didn’t get hers where I used to get mine. If I had a silent infection, would kissing her cause an outbreak on a different part of her face?

    Thank you.

50. Dr. Jen,

    Is there a difference between PCR test and IGG test? I have recently had some risky encounters . I’m not showing any symptoms but I would like to know if I have been infected. I heard that it can take up to 6 months for the antibodies to show up in a test but I feel like I don’t have the time to wait that long. Would a PCR test help detect infection earlier?

51. My western blot said positive antibody for hsv 1&2 interpretation said evidence of past infection with hsv 1&2 never had outbreak and always tested positive for hsv 1 low range and never had cold sore ? The only thing I had was shingles 1 year ago ….this is very frustrating but I read if I you test positive for both could be oral vs genital only diffinitive test is cx of lesions if you have out break anyone else have this problem and they say western blot doesn’t cross react with other herpes family’s

52. Your values are negative are your outbreaks inside vagina or outer lips cause herpes don’t go on outer lips just mucusy areas and yes many things can cause clear blisters was it a cluster or just one

    1. They are on the outer lips. It looked like just one and very small.

       1. What about the culture that came back positive? What do i make of this?

       2. Everything I have read says you can still have HSV 2 on the outer lips and inside the vagina. Why do you think if my sore is on the outer lips they don’t go on the outer lips?

       3. They do not go on outer lip labia majora but yes inner lips and vagina they like mucosy areas and it would most likely be a cluster did they say it was genital herpes

       4. They dont go on the labia majora where the hair is any gynecologist will tell you that only on labia minora lips and inner vagina

       5. ok. The sores are on the area where there is hair, not on the labia minora lips or the inner vagina. The dr said I was positive because the HSV 2 culture came back positive. When I had my first outbreak in Aug I had several sores, about 8-10. These too were not on the labia minora or inner vagina. The dr did examine them and couldnt tell if they were clustered. This is when she broke open one and cultured it and you already know what my Igg value came back as. So I am confused and really dont know if I have HSV2 or not.

       6. I was always told that no they don’t go on labia majora where hair is I’m a nurse but what was your hsv 2 igg and when you say outbreak what did they look like did they crust over and were they pain ful also I would get a second opinion

       7. My Igg was .24. When I had the outbreak the sores did not crust over, they just went way after about a week and did not hurt. The only discomfort I had was an achy feeling around the area and near the anal area. I had no pain and the irritating feeling of hair growing back after shaving.(maube because the sores were rubbing against my underwear) i shave the entire area including the anal. I thought I had a UTI and a yeast infection which is what I was initially diagnosed with the day before I went to my dr.(went to urgent care) then I find out I am positive for HSV 2.

       8. .24 is negative it sounds contact dermatitis and also have u had any more breakouts and also when does it happen around period ….I don’t think u have herpes I would get a second opinion

       9. You can get HSV on the outer lips of vagina, the same way you can on out
          Lips on the mouth. The virus passss through mucusy areas but does not necessarily recur there. The nerve channels can mean sometimes people get outbreaks on other parts of there face or groin area. It’s sounds like HSV to me, but a second opinion can help.

       10. Very rare you would get them on labia majora usually labia minora or inside vaginal area …I mean now a days doc look at a blister and say yes herpes with out knowing for sure there have been false positive with culture too I would always get a second opinion for sure especially with an incurable std many have been misdiagnosed which is a horrible feeling I suppose anything is possible but I would go for tests

       11. I have had three outbreaks. The first was in Aug. the second in Sept and the Third Oct. The Sept and Oct outbreak was one sore each time exactly one week before my menstrual cycle.

       12. When you say sore you mean blister ? And also usually in cluster something doesn’t sound right

       13. Could it be HSV 1? My husband gets bad cold sores all the time, but I never thought you could get HSV 1 in the genitals from oral play.

       14. Yes you can but most likely only when he has a cold sore also hsv 1 prefers lips cause they lay dormant in a certain nerve I personally don’t think you have hsv 2 regardless of what swab culture says why don’t you get another igg test for hsv 1&2 or western blot

       15. Yes you can get hsv 1 on genital during oral sex but most often when one has a cold sore out on lip .also they say hsv 1 out breaks don’t occur as much as hsv 2 . did you ever get a second opinion

       16. I have not gotten a second opinion yet, but will soon. I just find this whole experience odd. I never even had any itching or tingling in the area I had the sores. To answer your earlier question, yes they look like a blister, the fluid is clear, no blistering that I can tell.

       17. Did they look like a cold sore I personally would get more tests hsv 1&2 igg also cultures aren’t always accurate there has been misdiagnosed false positive

       18. I mean no clustering that I can tell.

       19. Are they tiny fluid filled blisters , if they come back get a second opinion from different doctor ….and have lab work done hsv 1&2 igg …how often do you get these do you have sensitive skin does your partner have hsv 2

       20. It was just one small blister, no clustering that I could tell. I have had one small blister In Sept and Oct, both exactly one week before my cycle, but I also fully shaved both times too. My husband does not have HSV 2.

       21. Yes something sounds strange like I said usually after you contract it u have symptoms 2-14 days after I personally myself go to another doctor when you get another and don’t say anything about what other doctor said and see what they say maybe a folluculitis …just seems strange honestly no pain no other symptoms just a very small blister

53. I got tested for HSV Type 2-Specific Ab, IgG
    My result was <0.91
    Index 0.00-0.90
    Negative 1.09
    They couldn’t tell me anything about my results, only that It’d be wise to retest at a later date. Can anyone help me understand these test results. Am I positive or negative? Do I have it or not? A guy I was previously with has it, and has symptoms and all. He claims he’s either gotten it from me, or his ex of whom he supposedly didn’t hook up with until I was already out of the picture. He’s saying that he’s either gotten it from me or her but it’s been since the beginning of September when we had relations and I have no symptoms at all. I’m worried that he’s had it all along and might’ve passed it on to me.

    1. I got tested for HSV Type 2-Specific Ab, IgG
       My result was <0.91
       Index 0.00-0.90
       Negative 1.09
       They couldn’t tell me anything about my results, only that It’d be wise to retest at a later date. Can anyone help me understand these test results. Am I positive or negative? Do I have it or not? A guy I was previously with has it, and has symptoms and all. He claims he’s either gotten it from me, or his ex of whom he supposedly didn’t hook up with until I was already out of the picture. He’s saying that he’s either gotten it from me or her but it’s been since the beginning of September when we had relations and I have no symptoms at all. I’m worried that he’s had it all along and might’ve passed it on to me.

    2. Your result is negative I don’t understand why they didn’t tell you negative that’s what the lab says on your report

54. What were your index values ??? Can’t dx without actual symptoms an outbreak

    1. The actual data below is the lab report. My Igg IV was .24. When I was tested, I was having an outbreak. If I am negative what else could this outbreak be? could it be HSV 1? I also had a HSV 2 culture done and that came back positive. So if the Igg came back negative, why did the HSV 2 culture come back positive? could the culture be a false positive? Since my out break, I have had 2 more right around my menstural cycle, but only had one sore each time filled with clear fluid. could this be something else?

55. Yes your results are negative mine were hsv 1 15.40/and hsv 2 igg 13.40 ??? Three years ago hsv 1 2.45 and hsv2 negative only thing I had was shingles last year …..doc said can’t rely on tests only if you have outbreak …got retested with herpes select waiting for results but have heard alot of false positives as it could cross react with other herpes families such as shingles I don’t know but really confused never any cold sores

56. Aug 28 I was diagnosed with HSV 2. My Igm value came back 2.93 and my Igg value came back .24. From what I have read the Igm value should not be looked at to diagnose HSV 1 or 2, but rather use the Igg value. Here is what the lab report says.

    HERPES SIMPLES VIRUS TYPE 2 GSA, IGG BY ELISA

    Note: REFERENCE INTERVAL: HSV 2 Ab, IgG (ELISA) 0.89 IV or less …….. Negative – No significant level of detectable IgG antibody to HSV type 2 glycoprotein G. – 0.90 – 1.10 IV ……… Equivocal – Questionable presence of IgG antibody to HSV type 2. Repeat testing in 10-14 days may be helpful. – 1.11 IV or greater ….. Positive – IgG antibody to HSV type 2 glycoprotein G detected, which may indicate a current or past HSV infection. – IV=Index Value Rarely, recent primary infection and unusual strains of HSV may result in false negative findings. Responsible Observer: (IF)

    My value came back .24 If I am reading this right, does this mean I am negative for HSV 2?

    1. Typing this twice I requested hav 1&2 igg hsv 1 15.40 and hsv 2 13.40 never had any cold sores just shingles last year on my arm 3 years ago hsv 1 2.45 and hsv 2 negative I am waiting for herpes select test I got from quest but I heard lot of false positives and may cross react with other herpes virus such as shingles I am a nurse and this is driving me crazy then they say they can only diagnose if you have outbreak then go from there

57. 6 mos? what do u make of websites like medhelp advising people that 3 or 4 mos is conclusive?

58. Dear Dr Jen, I feel like I have struck gold in finding you.
    I see that you do not form the Igg antibody until 3-6 months. I just have had a HUGE scare bc I had one encounter with a man who has herpes exactly 2 months ago. My Dr. called me with a positive Igg blood result. I have never had a herpes outbreak. Am I to assume that I have been harboring this virus or I just may have fallen in the window in a peculiar circumstance?

    Thank you kindly.
    Nervous DDS

59. I had sex in June a week later was positive for hsv2 never had an outbreak how can this be. My blood came back positive they never told me anything just gave me a script and sent me home in tears

    1. Same here but no meds… shameful medicine.

60. Hello, i have a question that maybe you have the answer to. If my child had the 6th childhood disease, and she tests for herpes will her test be positive because she carries that strain?

61. Dr. Jen, I have a question. iIjust recently ggt diagnosed with herpes simplex but what I’m confused about is that I have had several surgeries and never have I been told that I had this disease and then on top of that I feel like if the doctor thought I had it why wasn’t I given any kind of medication or anything. so iIwant to know is there any other disease that can be read as herpes on a blood test?

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63. Dr Gunter,

    I recently started dating a girl who had an outbreak that appeared to be hsv. Upon testing it was determined that she was positive based on the igg test. However it was determined that she has hsv 1 and hsv 2.

    My question is if there is any way to know if she is igg positive for both or just one or the other? Is it possible she only tested positive to the igg antibodies based off of hsv1 and that hsv2 was contracted within the last month while she was with me?

64. Since blood tests take 3-6 months after exposure to show n positive, can a doctor diagnose herpes (regardless of if they can specify the type) before the 3 months by oral and genital inspection?

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66. Hi. I was tested for HSV 1 and HSV 2 in Sept 2014. My doctor said I tested positive for both but when I got my results, my numbers for HSV 1 were 4.2 which is positive, but for HSV 2 it came back .9 which says equivocal. I waited 5 months and was tested again. Same results. The test used was the IGG test. So now I’m confused. Do I have HSV2 do I not? I’ve never had any type of outbreak. This has become a nightmare…..

67. I’ve always had cold sores as a child into adult hood especially when i get sick or overly stressed. My question is. I’ve never had genital warts. My blood work showed positive for hsv-1 (>8) and negative for hsv-2 (<2) so why would my ob/gyn want, o prescribe valtrex when im 36weeks

68. I was diagnosed with herpes almost four years ago, I went to the hospital and showed the doctor my rash and straight away she said it was definatly herpes and then lectured me for what seemed like forever. She took a swab but I never recieved the results, she just gave me a prescription and sent me on my way. My partner at the time (still my partner) was tested and his tests all came back negative, and he has never showed any symptoms of infection. I had not slept with anyone other then him for probably 7 months before the rash appeared.
    I have never had any outbreaks or rashes since then… Do you think a misdiagnosis is possible of the nurse seemed so certain when she looked at it?

69. Thanks Dr. Gunter for this useful article.

    I live in a country where only the non-type-specific IgG test is available.

    Can you clarify something: do you agree that the non-type-specific IgG test will reliably tell me about HSV-1 and HSV-2 ONLY, as opposed to cross-reacting “with another herpes virus, such as CMV (which a lot of people have) or varicella zoster (which almost everyone has)” as you said in your article about IgM? In other words, does the non-type-specific IgG test have the same cross-reaction problem as IgM or not?

    Secondly, you referred to the non-type-specific IgG test as “useless” but in fact if you have a negative non-type-specific IgG test result, then that is actually of equal usefulness as a negative type-specific HSV-1 and HSV-2 IgG, correct? In the case of a negative result, is there any reason why they would not be equivalent?

    If the answer depends on which non-type-specific IgG test, please elaborate so we can check with our local providers to see what is available.

    Of course it’s better to have the type-specific assays, but for many of us who only have access to the non-type-specific assays I think it would be very useful to establish when they are useful.

70. I 2003 I developed symptoms that were diagnosed as “generalized” vulvodynia…electric sensations, raw feeling, burning plus pain with intercourse and frequent symptoms of UTIs where there was no bacterial growth. I thought I’d been tested for everything. I received an HSV test for IgM HSV AB 1&2 which was positive but a subsequent IgG test for both was negative. How do I convince my doctors to test me again?

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73. Tested positive for type 1 and 2 through blood test (unsure what test was used. I just asked for a full std screening and everything came back negative except herpes 1 & 2) but never had sores on genital or cold sores. How likely is a false positive or confusion of type 1, that may be acquired as a child through kissing or toys as you mentioned, for type 2?

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78. Could you contract genital herpes from Brazilian waxing?

79. It’s been 6 months since last sexual encounter, I went for my HSV IGG HERPESELECT SPEC AB test I received the results with:

    HSV 1 IGG HERPESELECT SPEC AB: 0.18
    HSV 2 IGG HERPESELECT SPEC AB: 0.68

    <0.90 is negative, so I tested negative on both test, but does this mean I still carry the virus and can infect people?

80. Today I got my Herpes report and Herp Simplex Type 1 turnout to be positive with a value of 11.3

    I rush to nearest dermatologist as I had rashes on my inner thighs and last week veins swollen on my penile skin and he said it is fungus not a herpes.

    I don’t understand why after seeing in report doctor said it is not herpes it is just a fungus. I decided to visit another doctor for 2nd opinion and he told me rashes you are not herpes but on report you have herpes so you should be treated.

    I am a married man with a 6 months old baby girl and I am worried about my life, my family health. Before these symptoms developed I also had a unprotected sex with my wife.

    2 weeks back I just received a blow job from a service girl which results in my life worst medical situation.

    Please help me out. Should I separate my cups/mugs, cloths everything?

    1. And tell your wife that while she’s the fresh mother of your baby, that you were out getting blowjobs from prostitutes…allow her to make an informed decision about you.

81. Thank you for the post. I’m doing research because I’ve been to 4 specialists and no one can figure out what’s wrong with me other than I’m very sick. Ruled out cancer yesterday with a biopsy (thankfully). So, Occum’s razor and all – I keep thinking that maybe the simplest answer is the best. This started with the doc thinking I was having an allergic reaction to one of the herpes viruses (not shingles) due to a horrific rash on my upper body with fever. They started me on anti-virals. Then one thing lead to anther and I have a lesion on my lung, my lymph is whacked out, my spleen is abnormal and all inflammation markers are very high and anemic and abnormal bilirubin. They told me to stop taking the antivirals and it got worse so I started taking them again and things are improving. I’ve had skin biopsy, lung and lymph biopsy, and twenty three vials of blood drawn for testing. (7 for cultures). In all those test results I don’t see anything related to checking for the herpes virus – which was the first diagnosis. Maybe all this crap is truly related to herpes? I don’t expect any diagnosis from you but would just really appreciate your input – should I press them for a test for herpes 1 and 2???? Will it make a difference in treatment? I’m in the land of “we know there’s something very wrong but can’t figure it out!” My docs are great and trying hard. They seem to be frustrated and deeply concerned. They’ve starteda referral to Mayo. In the meantime should I ask them to pursue this? Or is it u related??? Thanks so much. You can reply to my email if you prefer.

    1. Donelle, hope you’re okay. Sounds like leukemia.

82. I’m just curious as to what it means when my blood test came back with the number 12.04 or something that number seemed extremely high since the margins for everything else wasn’t that big but I was positive for hsv 2 and I’ve been told it’s Probly that high because I’m in the middle of a break out but I have never had any lesions anywhere and my Dr just did a pelvic exam and didn’t see any lesions the same day I was blood tested so I’m very confused I feel like I have a yeast infection but that’s all

83. Dr Jen
    I recently started an intimate relationship with a guy. We used protection the first time together. A see later he tells me that he has herpes type 2. I get tested 2 days later. A week later I get the results. It comes back positive for type 2 antibodies. Does that mean I have type 2 or just came in contact with it? Its very confusing. I’m goin to get tested again by my ob/gyn instead of my pcp. The test showed up 7.93 on the test for type 2. What does that mean?

    1. Because you may or may not get a reply, I will tell you what I know after researching this and having a positive result myself – there is no such thing as just “exposed” and that’s the end of it. “Exposed” means infected if you have tested positive for the antibodies. 7.93 is not what is considered a low positive. That’s pretty definitely positive I hate to say. Mine came back >5 for IgG antibodies for HSV2 and that’s all I got. They consider low positive results where you may want to be retested as something below 3. I am planning to get retested anyway with Western Blot since I do have a factor with my blood plasma situation which may have skewed the test and Western Blot is deemed to be the definitive gold standard on this.

84. Thank you for writing this article it is very informative. I was diagnosed with HSV2 almost 2 years ago & have been taking Valtrex daily since my diagnosis. My IgG Ievel was .97. This was with a IP Herpeselect 1 & 2. After reading many of these posts I realized how low my IgG levels were. Should I get retested?

85. Question: In 2012 I went for a Pap smear and decided to get test for STDs, I never receive a call nor a voicemail to call them back because something came up positive, went to see my gyno plenty of times since to get my depo shot and still no word about me being affected with anything. During 2013 I lost my assurance but paid out of pocket for my depo and the appt. at the beginning of the year my insurance is back in affect and I was thrilled to get my pap done and to get tested. When I asked to be tested she made the causal comments well you will always come back positive for herpes… MY HEART DROPPED AND I JUST STARTED CRYING. I did not know what she was talking about she said they call me and if my doctor call me I will step away at work and take her call especially knowing I just had work done. I cried and demanded no one called me it’s been two years and I could have affected someone I demanded for a retest. I called everyday for the results. The whole week of the wait game killed me inside I never had a outbreak just shave bumps and ingrown hairs, only pimples around my face nothing that look like the Internet ugh. My result finally came back in and they were negative… ?? Confused cause you can’t get rid of them and hurt if my file was somehow tainted or misdiagnosed. I’m still lost and very hurt to think I may have this or the system is flawed.. Have you heard of something like this because I still don’t show any signs.

86. My wife recently tested positive for HSV 2. The IgG test showed a positive of 3.1. She has never exhibited any symptoms and nor have I. I have heard many people recommend getting a Western Blot test when the IgG result falls in the 1.1 – 3.4 range as it could be a false positive. Should she get retested using the Western Blot test?

    Thank you

87. Dear Dr. Jen,

    Since the beginning of pregnancy , my wife had been tested twice (ELISA) for HSV type-2 IgG and IgM, both results shown IgG negative and IgM positive (2.0 and 2.5 S/CO). The first test was done in week 9 while the second one was done in week 13, now is week 19 of pregnancy…

    Does this mean my wife is currently infected with herpes type 2? Is it going to affect our baby? And by reading the above comments, we believe we need to order a further PCR test to confirm the infection, isn’t it?

    Thank you in advance.

    Dylan

88. Hi Dr. Jen,

    I tested quite high for both types 1&2 40.23 and 9.95 respectively. I only tested routinely after my very first sexual encounter. After testing, I had some discomfort in the genital area, mostly itching, no sores and I never had any cold sores on my lips.
    I know that type 1 prefers the mouth area and 2 the genitals. I’m not sure if this is a silly question but is it possible that someone could have type 1 genitally and 2 orally?

    1. Yes, you can have type 1 in the genitals (50% of new outbreaks are type 1 on genitals) and type 2 orally. That is 1 reason why blood testing has limited utility.

89. Dr Gunter, what words of comfort would you offer someone who has tested positive for HSV2 and who might be totally freaked out by the results….assuming that they have been asymptomatic and should not have been tested in the first place?

    1. About a third of the population has HSV 2
       Most people never get an outbreak
       If your blood test is positive for HSV 2 and you have never had an outbreak you don’t know if you carry the virus in your mouth of your genital tract
       AMong people who have outbreaks, most only have a few in their lifetime
       The only time it can cause real harm if it you catch the virus in the last trimester of a pregnancy
       When you see a person walking down the street with a cold sore on their lip do you consider them an outcast, or just a person with a cold sore that will go away in a few days

       Hope that helps

       1. Thank you for that sane comment. I really needed that right now.

       2. I made this comment, (Thank you for that sane comment. I really needed that right now.) Please change my name to just Will. I didn’t realize my full name would appear in the post. Thanks.

90. Why shouldnt you take a positive IgM serious? its still an antibody..so doesn’t that indicate infection? now if it determines genital or herpes, an infection is present correct? Also if IgM is present what does that tell you in general about your body?

    1. The IgM test is unreliable. It cross reacts with other antibodies. Unreliable tests have no place in medicine.

91. There is evidence that common blood antibody tests for HSV2 may be of poor accuracy, including high false positive rates in some low-prevalence populations:

    Performance of focus ELISA tests for HSV-1 and HSV-2 antibodies among university students with no history of genital herpes
    http://www.ncbi.nlm.nih.gov/pubmed/17457239

    Asymptomatic Sexually Active Adolescents and Young Adults Should Not Be Screened for Herpes Simplex Virus
    http://archpedi.jamanetwork.com/article.aspx?articleid=1692335

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93. Hello I have a,few questions I tested postive for hsv-2 antibodies I’ve never had any outbreaks on my genitals or penis I’ve been to 2 Dermotologist and my reg care physician plenty of times about if I have herpes or not they insist I’m fine and that sometimes type 2 can be from an oral form? My doctors and Dermotologist said I’m lucky should I be concerned or try to move past this and count my blessing?

94. good morning Dr September 1st 2014 the doctor told me that I had HSV 1 as of now its been four and a half weeks I haven’t had any outbreaks no lesions nothing the doctor hasn’t offered any kind of medication I’m concerned if I have it or do I not have it because i thought by now at least i have some kind of outbreaks can you please help me ?

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96. I was unaware that i experienced outbreak while i took a bite from my brother pizza. Then he continues to eat that same pizza. Is he in risk? Can i test using blood test?

97. Dr jen,
    I have cold sore and my family does not have it.as a result i was unaware in first couple year that i have coldsore. I was having an outbreak and took a bite from my brother pizza, and he continues to eat it after i took a bite. Is he in risk?

98. My wife recently had a herpes outbreak and accused me of infidelity. She has been my only partner since we met 20 years ago. After her accusations I tested negative via IgG blood test, and took a second test to rule out a false-negative. The second test was negative for both HSV1 and HSV2. Over the last 20 years we have regularly had unprotected sex. Is it possible for her to have had a dormant infection for 20 years without infecting me, or is it more likely that she was exposed shortly before her outbreak?

    1. Hi. Last week, I was diagnosed with HSV1 and HSV2. My doctor did the IGG blood test. When I received my paper work, the range levels were a bit confusing for HSV2. The range it gave was : 1.1 is positive. My range for HSV 1 was 4.2, but my range for HSV2 was 0.9. I’m so confused. Should I be retested for hsv2? Mind you, I’ve never had a genital breakout. I know that doesn’t mean anything, but I’m so confused.

99. I had a sex with a new girlfriend recently (unprotected) and all seemed fine. She started getting sick and ended up going to the doctor where they did some testing, and the tests came back that she had genital herpes. I was devastated. I recently got tested to see if I have anything or was infected. I’ve never had any issues or symptoms. still to this day, is there a possibility I have it and passed it to her??? I’ve never had any blisters, legions, or sores. I haven’t had any of the symptoms. What do you think ? I’m scared and nervous hoping my blood test and urine test come back clean…..any advice??

    1. I would try to remain calm. To be honest you don;t know if you even have it. I found out I have it and never had an outbreak of any sort. Make sure you take the IGG test. I took the IGM test for the past 3 years and it always came back negative. I took the IGG test last month and it came back Positive for type 1 & 2. My doctor said I could have been living with it since high school and I have never had any type of outbreak. Same for her as well. You really never know until you have the IGG test done or a culture from an actual outbreak. 20% of the people that have type 2 will never experience an outbreak is what my doctor told me. I hope this is the case go forward for me. It just blows my mind that my ex of 6 years who I have been having unprotected sex with for the past two years tested negative. So I have no clue how I got it and when.

       1. My results came back that I have both types….ugh. What do I do now?? My doctor didn’t really give me any helpful information at all. I’m scared and don’t feel like myself anymore. How is this possible??? I’ve never had any cold sores, outbreaks, genital warts or any symptoms related to any of the types of herpes, but I tested positive for both??HELP…can I kiss anyone anymore??? Will I give some oral herpes because I’ve kissed them…this is all confusing and very depressing.

100. You mentioned in a much earlier comment that you would post about the culture test for herpes. I can’t seem to find the post. Can you give a synopsis please? Thanks!

101. I tested negative in 2012 on my IGM test. I took another one last week and it was negative however the IGG test was positive for both I & 2. What does this mean? I have only had two partners since 2011. Both tested negative. I have a friend that claims the same thing happen to her and said her doctor said it was because she got the chickenpox vaccine. Is that true? Why are all my IGM test coming up negative? As a kid I always got cold sore on my nose. Is it possiable its been dorment in my system for all these years. I have never had a genital outbreak so I have no clue of when this could has started or gotten transformed to me.

102. Dr. Jen, I tested positive for HSV2 antibodies in April of this year (10.x was my numerical test value). Since 1998, I’ve had 3 partners, all of whom have “tested” negative. I say “tested” because I’ve seen the paperwork of all 3. The paperwork for 2 of them looks similar to mine, meaning that the results stated that they were negative for HSV2 antibodies. The numerical antibody value for each was .1

     The 3rd however, her results were stated differently. Instead of HSV#, her results stated she was negative for HCV, and she claims that her doctor states that they use HCV to refer to Herpes Simplex Virus instead of HSV. At the time of the conversation, since I didn’t know any better, I bought it….until earlier today, when I read that HCV is used to refer to the Hep C Virus.

     My question is this: Have you ever known of a lab or doctor to refer to HSV testing/results using the monitor HCV?

     1. Good lord man, sounds like you got gamed. She took a hep C test not an HSV test.

103. Oh now I know. I thought when I get to be tested or “screened for everything”, I will now if I acquired herpes or not. Yesterday I was planning to have a screening test on Friday because I am afraid, the symptoms are occurring to me now. But, thank you so much I understand now what to do.

104. I am confused, I received my Labcorp results today, my HSV 1 IgG Type Spec result was <0.91; HSV 2 IgG, Type Spec result was <0.91 Both say <0.91 Negative. However on the next page, it has another entry that says HSV, IgM I/II Combination 0.98 High, What does this mean? How can I be negative for both individually and be high on the combination? Can someone please explain?

105. Dear Dr. Gunter.,
     Here are some links (not spam) that better explain my prior question…

     http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2648390/?report=classic
     Key quote: “Consideration should be given to raising the cutoff index value for defining a positive test result.”

     and another…http://www.ncbi.nlm.nih.gov/pubmed/16314775
     key quote: “Selectively raising the ELISA index value defining HSV-2 positivity from >1.1 to >or=3.0 either among HSV-1-positive men or among those without a history or clinical evidence of genital lesions increased the PPV to >or=93%”

     In the latter, I fit into both categories (hsv1+ and no evidence of lesions). Unfortunately, my results did not provide a specific number- only saying positive, so I wonder if I get tested again, with numbers, and if that number is between 1.1 and 3.

     Anyway, the point is you know more about this than me, and your opinion on the above papers would be much appreciated. My doctor initially told me this test was unnecessary, and if I had googled around beforehand and seen this post I would have agreed with him and probably wouldn’t be freaking out. So, for anyone else reading this, don’t make the same mistake! Thanks again
     Joe

106. Dear Dr. Gunter,
     After an rash outbreak (diagnosed as penile candidiasis and/or reaction to a topical steroid by a doctor), paranoid me went out and got a herpes (ELISA) blood test: IgM -, and HSV1 + and HSV2+ as well. I’ve had cold sores since I was 7 (and am 35). I know igm is worthless, just reporting all the results. I take it to mean my rash is not herpes, but that I do in fact have HSV2, a fact I find devastating and of which I was unaware- my sexual history would seem to preclude acquiring HSV2. (I understand I could have HSV2 in oral form too). Wald et al conclude that only 20% of people infected are actually asymptomatic, the rest just being uninformed. Anyway there are two things I would like to have clarified…

     1. Does the number on your HSV2 test matter- some forums I’ve found indicate that a low number (close to but not below 1) dramatically increases the chances of a false positive. Wald’s paper and other resources seem to place the likelihood of a false positive at extremely unlikely or almost non-existent. This is a scrap of hope and so it is perhaps the only way the results are wrong- so i want to believe it however unlikely. Please tell me if this idea has any validity.

     2. What are the causes of a false positive HSV2 IgG test? Could mishandling in a lab affect the outcome? The paperwork only said ELISA method- but there seem to be several types. Is anyone more accurate than the others?

     I have been in a monogamous relationship for 2 years, we always use condoms, and I’m confident there’s been no cheating. My previous sexual history is the similar. But now my head is spinning as to how I could have caught it, if my gf gave it to me or I to her. I know this isn’t the end of the world, but I feel absolute certainty will help me accept the situation more maturely. I will not be able to take the WB for about 6 months, and so wonder if it is worth it to get retested at another lab. Thank you for your time.
     Sincerely,
     Joe

107. Dr. Gunter,

     Is it possible to show a negative PCR swab for both HSV1 and HSV2, negative for IgG HSV 2, a positive IgG HSV 1, a negative IgM test, and still be told I have HSV 2? I had a very small lesion and bump (both of which cleared up within 6 days without any scabbing, no other symptoms). I had the swab done within 12 hours of it appearing, again, coming back negative. In my paperwork from the clinic, it showed nearly nonexistent levels of HSV 2 IgG (0.01), but a 5+ count for HSV 1 IgG, yet in his diagnosis he states I tested positive for HSV 2 in the blood test. Is this a mis-diagnosis? And what is the normal time antibodies take to appear in a blood test?

     I’ve since scheduled an appointment with another doctors office for a second opinion and assistance with analyzing my lab results.

     Thank you and hope to hear from you soon.

108. I recently tested for herpes here in Zambia and I was found positive with type 1 and 2 IgG but my husband only tested positive for herpes type 1 only what does it mean . I have never other sexual partners except him?. I am distraught and my husband thinks I am cheating .

109. im currently having treatment in malaysia, its ozone therapy along with other natural treatments, my Igg count is falling by the day and will soon be down to zero, would that mean the virus is dead once at zero?

     1. There is no treatment regimen that involves measuring IgG counts. That is nonsensical. The IgG measures immune response, not the level of the virus.

        1. Well I mean I’m having blood tests every week and the antibodies (IGG) are falling as the virus is being killed by the treatment

        2. Dr. if Igg lever was 36 in the first test and in the second test it becomes equivocal after taking antivirals, does it suggest HSV has become dormant or immune systems’s response has become weak?

110. Hello Dr. Jen:

     Almost two years ago I had complications from a procedure that resulted in an infection of my lower lip. The hospital did a IMG test which they said came back positive for herpes. They also did an IGG test that came back negative. The laboratory where the results were analyzed said that a second test had to be performed but the hospital ignored the recommendation and also hid the test and results from me. I found out about the test after going through my medical record. I have never in my whole life had an outbreak so last week I got tested again. This time the test was the herpes select I/II IGG. Both came back negative. What does it mean??

111. I have herpes simplex IgG i want pragnent what should i do

     1. I want pragnent i did my blood test it was herpes simplex positive 2,71 anti phospholipid igG positive 23, 4 and cmv positive 20,1 what should i do please thanks.

112. Dear Dr. Gunter,

     If you would be so kind as to read my story and answer a couple of questions I will be forever grateful.
     2.5 years ago I was diagnosed visually by a doctor in Mexico as having hsv2. I had about 3 outbreaks since the initial one, all very minor that looked similar to small mosquito bites, spaced out over 5 months. I have not had an outbreak in 2 years. I recently had a hsv1&2 IgG ak blot blood test done here in Munich, Germany that came out negative for both.
     I contacted the University of Washington, told them what I just told you, and they wrote the following to me.

     “I can’t speak German either, but we don’t put much stock in IgG antibody tests for herpes anyway. They are not the same as a WB. If you want clear confirmation or refutation of an IgG, order the Western Blot. Or, if you have a new outbreak, get a clinic to swab the lesions for a PCR (best test) or viral culture.”

     What are the chances I received a false negative result from the IgG blood tests?
     Is it fair for me to believe I don’t have hsv1&2 or should I get the western blot done when I get back to the US?
     Is there another std that would have had similar symptoms as hsv?

     Thank you very much,

     Bob

113. Hi. I have herpes 2. I am 9weeks pregnant and i am having reccurrent genital lesions. What are the risks that my baby will get this virus while in my womb? What can i do to prevent this. Is it advisable to take antivirals at this time? Thank you.

114. I just had a doctor tell me that if my hsv1 blood test came back positive for antibodies, that it might mean that I “don’t have the virus” because my body is “fighting it off” with the antibodies and I will “never have herpes”. The guy seemed like he was full of it. I’m no doctor, but I’ve spent a lot of time reading up on this and I’m pretty sure that you develop antibodies because the virus is in your bloodstream… yes? And once it’s in your bloodstream, it’s not going anywhere, even if you never break out. Yes? Should I trust what this doctor is saying? I don’t have my results back yet. I’ll be sure to ask what kind of test they’re using too. Thanks for your writing on this, so nice to finally read something coherent.

115. Im confused ive been tested by via culture several times n it was negative but was tested once by blood test n was positive so do I have herpes or not da place who did my cultures said its more accurate.than bloodtest

116. Dr. Gunter,
     I am 29 years old and I had a cold sore on my lip for the first time on April 12, 2014. Then within the next couple of days I started getting several sores on my tongue and gum. The swab test came back positive for HSV1. I am married and have an 18 month old baby. I have avoided kissing my husband and baby since I started suspecting that it’s herpes. I don’t think my husband has it, but he recently gave blood to be tested for antibodies, which we are still waiting for. My symptoms on lip and gums have cleared up, but I have not been able to get rid of the sores and lesions on my tongue for a month now. New ones keep reappearing over and over. Since my swab came back positive for HSV1 I have been put on Valtrex. I took one twice a day for the first 6 days and then switched to 1 a day. I tried 2 a day for 3 days about 2 weeks into the outbreak when it wasn’t going away and after that I still had lesions. On the 4th week the lesions increased in the amount so the doctor told me to take Valtrex twice a day for 7 days and the lesions were not getting better and more were developing, but all only on my tongue. Today the doctor told me that my antibodies test showed positive only for IgM and not for IgG after a month of basically a continues first outbreak. He told me to start taking a new medication today, Famvir, one twice a day for 7 days. He said my course of this outbreak is not very typical. It’s been basically continues for over a month, with the exception of the first 10 days when it was on my lip and gums, it has been exclusively on my tongue, and it’s not responding to Valtrex. Do you have any thoughts or suggestions? I have been very crying and worrying about this every day and this horrible stress and anxiety is probably making the outbreak worse. I want to kiss my child and my husband and I want to get this outbreak under control. I am so scared to infect my family that I have been isolated. I use plastic silverware and plates, I keep my towels and toothbrush separate, and I try to avoid all contact. Am I ever going to have a normal life again with my family? I feel completely helpless! Also, we wanted to start trying to have a child this summer and I don’t know how this is going to affect us now. Please address the pregnancy issue too if you can. Should we hold off?
     Thank you for your help in advance.

117. I want to get marriage with my boyfriend and we did the blood test first. When we have the result he looks afraid with my resul

     My result :
     Hsv 1 igg is positive , igm negative
     Hsv 2 igg is positive , igm negative
     I never have outbreak on my lips or my genital

     His result :
     Hsv 1 igg 300 , igm negative
     Hsv 2 igg negative , igm negative
     But he had been outbreak on his lips n his genital

     What do u think about our problem? Now we postponed our marriage bcz he is afraid
     Thanks for the answer

118. Hello Dr. Jen,
     I read this article some time ago when I was searching for answers after having sexual relations with someone who is HSV2 positive. He tested HSV2 positive in 2011. I recommended that he get tested again because he never had an outbreak or ANY symptoms. His test results came back last week negative for both 1 and 2. His doctor sat down with him and told him that it is possible to test positive and not have it. We are both really confused. Is it possible for the antibodies to lay dormant YEARS later? He has been taking Valacyclovir everyday for almost a year now. Is it possible that the medication interfered with the test results? Does he have this, or what?

119. I believe firmly in my heart that the stigma associated with this virus is what has prevented accessibility to concrete information. People will never stop having sex no matter what i believe.

120. and i know for a fact that i’ve had cold sores, at least two in my lifetime…does this mean that this could have been the herpes 2?

121. I just went to the doctor about a weird redness on my penis and after looking at it by two doctors they both said, “nope-doesn’t look like herpes!” I asked for a blood test and he said that a blood test would only tell you what you’ve been exposed to not where it is… A doctor in the past told me that I had antibodies to herpes 2 but never did a swab… I’m totally confused…. i wish this would have been explained to me in the past for I wouldn’t have been going through so much damned angst over the last 3 months.

122. Let me get this straight?! You can test positive for herpes 2 and it not necessarily be in the genitals? AND if you had some weird rash but the doctor didn’t swab it then it might not be herpes?

     1. Yes

        1. i am absolutely mortified right now. I just went into the doctor with a weird area of redness convinced it was herpes based on a recent sexual encounter…What’s funny about what i read earlier is that my doctor told me the exact same thing that you wrote above.. that just because you test positive for herpes—-which he said he’s certain i would simply because i’m human–does not tell you where it is. I was most concerned for my partner and the doc said that if he’s ever been sexually active the likelihood that he tests positive is likely as well. He said that the only way to know for certain is to swab an active lesion if one presents itself and visual inspections are not confirmatory either.

123. I tested positive for the non-type specific herpes igM test back in December. I tested again last week the igM was still positive 1.40 but I had my ob do type specific and both hsv1 and hsv2 came back negative. The test was HerpesSelect. How likely is it that the igM is a false-positive? The reason for that question is because shouldn’t the igG antibodies be present for either one by now? Also is it possible for the igM to pick of varicella virus, from past vaccine or the outbreak itself (honest answer)? Lastly, do I have herpes or not? Apparently the obgyn’s I have been to are not knowledgeable enough to give me a clear cut answer and explanation.I ordered the western blot test from the University of Washington, they are sending me the test kit. I spoke to one a few of the lab scientists and was told disregard the igM if the igG is negative i don’t have it. and given the last sexual encounter before the December test was late august. The igG should have been present by now to test positive. Do you agree?

124. Hi Dr. Jen – I’m very confused about my recent herpes blood test result. It started as me being suspicious that my boyfriend may have gave me an STD. I recently had an IUD placed and we began having unprotected sex. Since having the IUD and my body adjusting to it, my period has been irregular and I have had light bleeding cycles that lasted 14 days. Wearing a pad everyday for 14 days ended up causing some irritation on my skin. Since I was uncertain whether this was just irritation or whether my boyfriend had given me an STD, I went to my doctor to get tested. My doctor examined me and did a swab test, as well as sent me for blood work. She told me the swab test would be more accurate, that blood tests for herpes are not very reliable but I insisted to have it done. So, my lab work came back first and was negative for type 1, but positive for type 2. I was devastated with this news. Fast forward the following week at my follow up appointment, I learned that my swab test results were negative. My doctor told me she would not diagnose me with herpes, she is saying that I have herpes in my blood according to my lab results but that it doesn’t mean anything…I’m confused. She says I was “exposed” to it, but that I do not have it….but yet it will be in my blood forever? I thought the blood tests were specific? The lab results appeared to be specific about which type, but she said it doesn’t mean anything. I have never had anything like this, this is something recent from my boyfriend and I don’t have a clear picture on what it all means. How could I have this in my blood and yet not be diagnosed with it? Can you help me understand how blood tests for herpes works, and is there any literature that describes what it means to have herpes in your blood, but yet not have it?

     Sincerely,
     -Confused

125. Gesh, wish I had read this before I did the “screen for everything test.” I’m 58 soon to be 59 and embarking on entering back into the dating scene. I am devastated at my results and even more confused about the results for HSV. I have not been a very sexually active person in eons and discover this at my age is, words just can’t describe. After reading your post — I am totally lost at what to believe or not believe. I just found out my results today and immediately went for another test. Where do i go from here and what am i to believe at this point? Totally devastated right now.

126. dr guntner, I had a small sore close to me genital area , did not know what it was my dr. gave me some cream and ordered blood tests the sore went away but the blood tests came positive igg 66.5 and igm1.22 my dr. prescribed medication called valacyclovir 500 mg twice a day for a period of 6 months and told me i contacted herpes not recenttly but in the past , she is the dr. but I am already taking medication for hyperthyroid and for blood pressure and this new antibotic makes me a litle nervous according to what i deduce i probably do not even need this medication..I really would like to know your opinion. thank you very much. MARIA

127. Hi. I want to have a baby now but i have concerns about having a genital herpes. My husband has it. And i got infected (i had painful genital ulcers) after we got married more than 3 yrs ago. I usef to get these lesions evrry month. Maybe every 2-3 months this past yr. So we consulted an OB recently & she tested me for igm hsv 1 &2. Resulted after a week, result says hsv 1 igm negatv, hsv2 igm positive. So i was prescribed acyclovir 200 mg 5x a dsy for 5 days then went for blood test again as my OB ordered. Result was igm for hsv2 + & igg neg. I was adviced not to get pregnant yet as this will harm my baby during pregnancy and delivery. I neeed to be enlightened about this. Pls help me. I really want to get pregnant asap.

128. I have a question, for IGg type specific test for hsv-2 by looking at your numbers could it give you an idea around about the time you were exposed based on how high the number is? Say if it is a bit over 3.00.. Could that tell you anything about when you acquired it?

     1. No, many things make IgG go up and down.

        1. Okay. Thanks, Dr. Gunter.

129. I have a question, for IGg type specific test for hsv-2 by looking at your numbers could it give you an idea around about the time you were exposed based on how high the number is? Say if it is a bit over 3.00.. Could that tell you anything about when you acquired it?

     1. The level of IgG does not provide any information about when the disease was acquired as the levels can rise and fall. This test should be thought of as a positive or a negative.

130. Hi dr. Jen,
     I am pregnant 13 weeks. When i was pregnant 9 weeks I found my hsv2 test igm is positive. 1 month later i do the test again and found the igm is negatif, igg is positive. Is it dangerous for my baby ? Does it effect to the baby ? Because i read some articles in internet that said can effect the baby. Can be blind or serious infection. I’m so worry.

131. Hi Dr. Jen, really nice article. I would like to know, what would you advise if person has recurrent genital ulceration for 5 months and his HSV2 and HSV1 IgG are negative for 3 occations. (done at 1st month, 3rd month and 5th month). HSV PCR also negative. He would like to know if this is a “false negative” results?. kindly help me to solve this puzzle. (lesions are small erosions and ulcerated, and were never vesicular )

132. Dr. Gunter,

     In your second point you state “Blood tests take 3-6 months to turn positive after exposure because it takes 3-6 months for your body to make IgG antibodies in response to an infection.” Does this mean “exposure” literally or does this mean from the first outbreak? For example, if I was exposed to the virus from a partner several years ago, but did not have my first outbreak until recently, is it possible that my IgG blood test taken during this first outbreak would be negative due to the fact that it was taken “too early on”? Or should this IgG test be positive because I was exposed more than 3-6 months ago.

     Thanks for the help.

     1. I am wondering the exact same thing. Thanks for the question. Looking forward to the answer!

133. i underwent a torch panel test just a month after i delivered my baby who has died of a hydrops fetalis ilness. My Ob has requested me to have the test, i was reactive in Herpes 1 lgG (2.850 S/CO. and reactive in CMV lgG >500.0 U/ml… I keep on researching about herpes and so worried about the results i read in the websites… And still confused of how to have been positive in Herpes if i had only one bf since then who is my husband now, and that is also true with my husband…please help me..i am so confused

134. 3 weeks after a sexual encounter my partner told me they were positive for Herpes 2 after having blood work done. No symptoms. They suggested I see my doc asap and get tested. I did the next day, took a blood test and results came back negative for both. I had no symptoms. Now I have itching on my buttocks, thighs. After researching Herpes prior to getting my results I’m not paranoid that maybe I do have it and my initial blood test simply didnt reveal it. Possible? I plan on getting tested again. Not sure how soon I should wait. It would sting if a positive result came a month or two down the road.

135. Hi Dr JEN GUNTER

     I DEEPLY SEEK YOUR ADVICE!

     I had some genital itching and due to being positive in chlamydia in past , was skeptic of some other associated std’s so I went for a panel check up including all the available std’s test.

     I came positive for hsv1+2 igg , in september 2013…. shocked!! reading 9.5

     never had a break out ever except itching or a ofter basis and one single spot i noticed , just once and it went away after i went to dr. and he suggested me some meds for herpes as he thiniks im positive.

     In november i went for tests again , and came positive again , hsv1+2 igg with reading of more than 10.8

     i had only one partner in past ,, she got tested and she came negative… i am very surprised, but she is only hsv1 positve.. she is in australia and have good labs over there than India..

     I wanted to make sure of what is going on as herpes is highly contagious!!!!

     i kept wondering if she dont have it , how do I ?? and I noticed i have my test done in 1+2 form rather than individual so i went back to get separate tests and I came negative for HSV1 igg+igm and also HSV2 igg+igm

     I AM VERY CONFUSED WITH THIS LIFE, GOD IS PLAYING..
     i am very happy to see this but I want to know is it possible or just a mistake

     coz the last two tests , hsv1+2 and hsv1 , hsv2 are done from the same labs and the best we have available in India , as per what I know.

     Now the lab guy recommends me to get a herpes PCR, is that any good ??

     Also can I post my blood sample to get tested in the university of washington anyhow.,,

     PLEASE ADVICE

     Thankyou for your precious time

     1. I still have that genital itching with no physical signs and any other severe symptoms , but its been going on for long long time say about 8months now and its a very low level little itch which goes away the moment you touch , happens on a regular basis, and i have already use some anti fungal creams too!!

136. My sister had Genital lesion which was diagnosed as herpes type 2 9months ago
     She was taking medication for that purpose which was recurrent
     Right now she is pregnant since 9weeks and we are confused if we are suppose to take precaution regarding the infection since her recent blood test results were
     Hsv1 and 2 IgG positive 1.68 and Hsv1 and 2 IgM negative 0.32
     Please tell me if I should ask her to take medication for herpes as soon as possible

137. Pingback: My top 5 posts from 2013 (it’s all about the lube) | Dr. Jen Gunter

138. Thank you for this fantastic post! I am a health educator working primarily in sexual health, and I’m happy to see accurate, matter-of-fact information available, especially considering the myriad or myths and social stigma that exist around HSV.

     A clarifying question for you… how frequent are false negative results with the IgG test? I understand that it can take up to 6 months to have detectable antibodies for the IgG test to register, but how frequent are false negative results <6 months post possible exposure? Thank you in advance!

     1. I was recently diagnose with the virus hsv 1-2 I need more information as I have not yet got an out break my dr did the igg test. I just need more information if I could give this to my kids or husband. I am really scared and I feel like my whole world has ended. At the time of the test I also had BV could this play a roll on my blood work coming positive? Should I get a 2nd opinion my dr did not explain n e thing she just said don’t worry continue your life and walked out of the room.

139. About 6 months ago I got test for stds cause my ex cheated. He is the only one i have ever slept with and he denies having hsv 2. Which I tested positive for. I had the hsv2 IGG test. I recently got a culture test done during my pap, just to be sure cause I have had no symptoms. The test came back negative. I can’t a real straight understanding which test is more accurate. Or if one could be wrong? Should I get the blood test done again? If i tested positive on the blood test does it mean that I really have hsv 2 and can i still spread it?

140. Hi, I had a sore swabbed and it came back positive for type 2. Then I had the type 1&2 specific done and those came back positive. My 3rd test a PCR blood test came back negative. What test should I believe to be true? My doctor said the PCR DNA test came back negative because the virus was out of my blood and turned to antibodies and won’t show anymore on a PCR. Is that true?

141. Hi Dr Jen, please advise if I should hire a maid that has been tested positive on hsv type 1 IgG. The maid duties also involve taking care of my 18 months old son and cooking for my family. Please help..

142. Just had newborn 2 days ago scared she may have contracted it doctor checked buttt everythang all came back OK how long do it take to notice herpes symptoms in baby’s.

143. Hi Jen, in the summer of 1988 when I was 19 I had fevers, bad headaches, lethargy and lots of what I thought were canker sores inside my mouth. Soon afterwards my girlfriend at the time got the cold sores on her lips. So I assume that I gave that to her. When I went to the doctor that August they said I had Mononucleosis. But how would that account for the internal cold sores I had? I haven’t had any cold sores for many years. And never none as plentiful or panful as that summer. I just took an HSV test thinking maybe now I am “immune” (in terms of getting symptoms) but it came up negative. Can you make sense of this?

     Thanks

     Joseph

144. Hi Dr Jen,

     Just throwing it out there for anyone with information.

     I’ve never had any sexually transmitted disease. I’ve been sexual for about 6 months with someone who recently got tested where the results came back positive for HSV2 genital herpes. We’ve had sex approximately 15 to 20 times in the six month period. What are the odds of me being positive? I’m getting the blood test and urine results back in 3 days.

145. Dr. Jen,

     I realize that you stated IgM HSV tests are useless, but my PCP, who took over a week to tell me about my equivocal IgM HSV I/II combo report (hes done), argued that I had been exposed to at least one HSV within the past 4-6 weeks based on the equivocal finding. My question: how INaccurate do you believe this test to be? I am worried because I had unprotected sex with a girl I have been dating this past weekend and I just got these results yesterday; I am worried that she may be infected and I’m supposed to hang out with her tomorrow and I dont know what to do.

     Thank you in advance for your time and consideration, I dont know where else to turn…
     Dan

146. Is their a difference between the PCR blood test and the Type Specific IgG test. According to one site, “The PCR blood test can tell if you have genital herpes even if you don’t have symptoms. The PCR test looks for pieces of the virus’ DNA. This is the most common test used to diagnose genital herpes and is very accurate.” – http://www.webmd.com/genital-herpes/guide/genital-herpes-diagnosis

147. Hi Dr Gunter, I was recently diagnosed for HSV 2 igG positive, June 2013 to be exact. 2 weeks before the OBs my bf was with me. We live in different countries. He went back to Canada and did his test only last 2 weeks and was tested negative. We did everything oral, vaginal and anal sex continuous for a weeks. He went home and return 2 weeks later and we did it for another week continuous. Is it possible that he has it and the test didn’t show it just yet? We are on to a breakup because we dont think its possible to be with each other again.

148. I want to ask. I have been in a relationship for 2 years and 7 months. I have never had any symptoms of herpes but 3 weeks ago I got sores down there and swollen lymph nodes. I got a blood test 6 days after the symptoms started. The blood test was negative. Can I have herpes in my body for , lets say, 3-4 years without having any antibodies??

149. I am concerned. My gf had sex in June with a man possibly infected with hsv2. I started having symptoms in early July and they continue now 4 months later. I’ve not had any OBs not has she. We both tested negative on IgG testing. But that is a 4 month mark. You say 6 months! I’ve heard 3-4 months a lot. I am still suffering the pains associated with type 2. I swear its herpes but my doctors say no. I’ve tested for everything! I have hsv1 and wonder if that would stop hsv 2 sores. But why would I have all the pains without outbreak? I’m so lost. If this is hsv 2 God help me cause its been a off and on painful experience for 4 months!!

150. Hi Dr. Gunter. Much to your point about misinformation existing with doctors today, I have simply experienced this problem firsthand. Consequently I have had to depend upon my own research for answers.

     Given that Seroconversion doesn’t occur until at least 2 months (depending upon individual) after Primary Outbreak, what is your opinion about the potential for internal disseminated infection when the the virus is able to get into your blood (Viremia) at the time of Primary Outbreak, e.g. accidentally breaking blisters and getting the fluid on one’s tongue while having various open wounds such as bloody gums, cuts in the anus, etc.?

     I’ve been suspecting disseminated infection with organs, blood vessels, etc. simply because there wasn’t anything to really “quarantine” the virons during this Seronegative period. Moreover, I consumed antibiotics for 4 days about 1 month after Primary outbreak (dog bite), and went through Herpes Associated Erethyma Multiforme, as described by the Dermatologist. But I also understand that infection during this period is a 2-way street. Tissues have to have the right receptors to allow the virus to bind.

     Thanks for your time.

151. Hello i recently had a positive Hsv1 and 2 of 8.0. The igg came back for hsv1 mild detected and second for just detected. What are the odds that this was a false positive? Why did both tests come back with the same score? I have never had any symptoms of this and the last person i was sexually active with i was active for 2 years and the last time was 6 months ago or more. Please help ! Should i be retested?

152. Dr Jen, is it possible that I tested positive (IGG Herpeselect AB >5.00H) where contact occurred ❤ weeks ago, 19 days?

     Or is it more likely I have had the disease all along?

     I have been asymptomatic. Thank you.

153. “You could be carrying herpes type 1 in the mouth, the genitals, or in both places”

     Research suggests that if you have HSV1 orally, then you cannot get HSV1 genitally, as you can not reinfect another area of your body once it has shown itself in the site of preferrence (eg: Oral or Gential). It is really important that doctors and researchers get information correct! This can really impact on one’s sexual identity and development, and we are relying on those that a re trained to give us the right and accuarate information.

154. Herpes is running rampant and health care professionals are afraid to deal with it. I recently took my 2 year child the see a pediatrician at childrens hospital expressing concern that he contacted HSV 1 from drinking from my cups. He displays all the signs that I have when I get an OB. The doctor told me it is common and dont worry about it. I stressed that I wanted a blood test, she said even it it were positive they would NOT treat him so it makes no sense stigmatizing him because she is almost certain it will be positive. I told her it is ruining my child health as she is getting swollen lymph nodes throughout his body and dry, blisstered lips. And I think it may have spread to the eyes, still this doctor was apprehensive and convinced me not to test her as she will be stigmatized. Now isn’t that amazing, a disease so common yet so stigmatized even by physicians…very sad! And she was not the only doctor eho expressed reluctance to test my child. This stigma has to go, this disease is not just a cold sore on te skin but it effects the nerveous system where it lives and causes other health problems such as autoimmune diseases. Its a shame that a disease so ancient has not evolved in the minds of the people it infects. God Bless us all.

155. Herpes is running rampant and health care professionals are afraid to deal with it. I recently took my 2 year child the see a pediatrician at childrens hospital expressing concern that he contacted HSV 1 from drinking from my cups. He displays all the signs that I have when I get an OB. The doctor told me it is common and dont worry about it. I stressed that I wanted a blood test, she said even it it were positive they would treat him so it makes no sense stigmatizing him because she is almost certain it will be positive. I told her it is ruining my child health as she is getting swollen lymph nodes throughout his body and dry, blisstered lips. And I think it may have spread to the eyes, still this doctor was apprehensive and convinced me not to test her as she will be stigmatized. Now isn’t that amazing, a disease so common yet so stigmatized even by physicians…very sad! And she was not the only doctor eho expressed reluctance to test my child. This stigma has to go, this disease is not just a cold sore on te skin but it effects the nerveous system where it lives and causes other health problems such as autoimmune diseases. Its a shame that a disease so ancient has not evolved in the minds of the people it infects. God Bless us all.

156. Here’s my situation…First, I am 58yrs old and had shingles on my face, head and eye about 8yrs ago after the ending of a very stressful divorce. My marriage of 21yrs was with a woman who told me after we were married that she actually had herpes 2 but she assured me that she knew when she was contagious and back 20+ years ago there was not much information about herpes. After the divorce and many months of unprotected sex with many women I decided to get tested for every STD that was known. The test came back with a positive for herpes 1 and 2. About a month later, another Dr from the same office looked at the results and told me I was not positive for herpes 2 (not sure what my scores where at that time). Just recently, I decided to get tested again for any and all STD’s and once again the results were positive for herpes 1 and 2. This time I asked for a copy of the tests…Scores for HSV 1 IGG AB is 2.81…..for HSV 2 IGG AB is 4.54. The nurse told me I was positive for both HSV 1 and 2. Let me also add that I have never had any symptoms, outbreaks or any other signs of being positive for either 1 or 2. My gf for the past 8yrs was also tested and her results were positive for HSV 1 and negative for HSV 2…we have had traditional, oral and anal sex during the past 8 years and she still came back as negative for HSV 2.
     Can my shingles outbreak cause the IGG score for HSV 2 be positive?
     Is the score of 4.54 for HSV 2 after being exposed to the virus almost 30yrs ago from my ex-wife really a positive result or is it just an indication that I was exposed many years ago and that I am not contagious to my partner?

157. What do the levels of the Igg test mean such as 7.07 or 7.48?

158. i just recently fouind out my partner and i are both positive for hsv2. my levels were at 1.91 and his were a 2.46 now i know for a fact the month before we met 2 years ago i tested negative for everything. so i know its been sometime in the past 2 years i got it from him. is there any way to know by the amount of levels in his blood to find out about how long he has had it so he might can think back and figure out who gave it to him????? im just more concerned for his mental well being. this is the hardest thing i have ever come across in my life and i think i am over analyzing it

159. Dr. Jen I have been very concerned and worried for the past few days. Two months ago I made an appointment with my Gyno. I had been having changes with my discharge. It had a different/bad smell, it would sometimes have a watery consistency, before or after my period and after sex it would be pinkish and smell not so pleasant. It would also be very itchy down there at night. My first thought was BV, but the panic set in when two little bumps appeared on my pubic bone area. I thought that they were probably ingrown hairs from shaving. I tried popping them, sometimes nothing would come out except clear liquid kind of like a pimple or blood because I ripped them due to the popping. After they healed they went away. A couple weeks would go by or a month and maybe one would appear again, one was on the outer lips of my vagina, once again I assumed it was an ingrown hair and tried popping it (which hurt ALOT) even though they never really had white heads like pimples or resembled anything abnormal like with puss spewing out. I have never had an outbreak that looks like the images people post of herpes online. They have always just looked like pimples or little pink fleshy warts (but not really like a wart because the center looks like a pimple) and there’s never been more than two at a time (no clusters).
     So before going to the gyno she had me get some blood work and a urine sample done. When I went back to her office a week after the blood work had been done she told me that I came back negative for herpes type-1, but I came back positive for herpes type-2. I felt like crying, I was scared and in shock. My doctor had told me that it’s not a for sure thing I have it since she’s had patients in the past that have not had sex and yet their blood work came back positive for herpes type-2. But I have, so obviously I’m going to panic. She said to come back in two months to get my blood test again just to confirm. She did a pelvic and pap test and told me that everything looked normal that she didn’t see anything that looked like or resembled herpes after I had told her and showed her the pumps. My results came back and I had BV, so she prescribed me metro gel. I took the recommended dosage amount for a week. All the symptoms went away.
     A couple of days ago I spent the weekend at my boyfriends. We had sex twice, on Sunday night and Monday morning (with a condom). I used the restroom to pee afterwards and Monday morning I took a shower and after having sex I peed again. It wasn’t til that afternoon when I was back at my place that I started to feel burning and itching down there, especially in my vagina and urethra/clitoris. My vulva was also very swollen . Everything felt very tender and raw (maybe because of all the scratching?). I’m not sure if it was because of the back to back sexual activity or if maybe i had an allergic reaction to the condom. I know that the condoms he uses (trojan ultra thin) can cause allergic reactions. So those were my first guesses. But after the itching and burning has continued this whole week I’m not so sure anymore. I bought Monistat 7 and vagisil creams along with vagisil washes in case that it’s a yeast infection. I’m on my third day using it and it has eased some bit, but I just got my period so I can’t continue the medication. I’m hoping it’ll get better once my period ends as I have read that it does from other peoples experiences.
     I’m just very worried that it has something to do with the herpes, it will be two months next week. I’m very scared to see what the results will be after I get my blood work done again. Is it possible for the results to have shown up positive for herpes as a result of having BV (Bacterium Vaginosis) at the time? And can I have herpes even though I’ve never had an outbreak or have symptoms like those of the images I’ve seen on the internet? Another thing is that I’ve gotten sick twice in the span of 6 months with extreme throat and neck pain I thought i had the flu or strep throat which isn’t a shocker since I work at a school but my results came back negative for both. Could these have been symptoms or signs of herpes? Thank you for your time and help!

     1. did you get a reply on this?

160. Hello..I am a 45 year old female. I’ve never had any outbreaks since childhood, my mother has had lip outbreaks since I can remember. I just within the past 2 weeks went into my dentists office for a new bridge and he had to take impressions so he had to stick that big metal plate thing in my mouth that was two weeks ago…one week ago I went back and he had to take another impression with that metal plate in my mouth…by the second week exactly 3 days after going to his office I noticed a tiny pimple or what I thought to be one on my bottom lip…anyhow needless to say I panicked and being that I knew about cold sores from my mom I ran to walgreens the very next morning and bought some abreva…it kept scabbing and liquid would seep out a tad then re-scabbing but stayed the same in size…I believe I managed it quite well…anyhow that started on a friday…by monday I went to the dermatologist and I insisted on a blood test because I feel I may have been exposed at my dentists office and I am just horrified at that fact and I asked her if the blood work comes back and I am negative for antibodies or they are too high or something is there a chance that I can find out if my outbreak is due to being recently infected or will I never quite know that answer…..:( it would be tragic to me because I haven’t even been with anyone sexually in over 5 years. thank you for your help…and thank you for your informative site. Also are there any clinical trials being done to help find some sort of vaccination or possible cure for this dreaded disease?

161. And the results were hsv2 and never had an outbreak

162. If u had sex with a new partner and then get tested two weeks later after haveing sex with that person and the results are positive when they come back does that mean u got it from them or your previous partner because I remember reading that It said it take 3to 6months for a positive results to come up

163. Hi. I am 28 years old female and has 7 weeks pregnancy. I got my IGG and IGM levels tested for herpes. IGG came postive for both HSV1 and 2 but IGM came negative for both. Will it harm my baby? I never had any outbreaks as such and really worried for my baby nside.

164. I am very confused in 2004 I was told I was positive for herpes from a culture done. In 2005 I got pregnant with my daughter so they retest me by doing blood work…all test came back negative but was still not happy with the results due to the one positive test and that I would get a pimple like thing almost every month. I haven’t gotten them as often now because my period has been off. I have always been told its a cyst or a pimple but never truly confirmed which or if it actually is nothing to worry about. My issue is that I am now 8 weeks pregnant and the pimplr is back. It tingles when it is coming out n a little sorre but usually the next day you can barely tell its there. It feels very hard like there is someting undrr the skin like a small pea sized ball but never blisters. Usually during a papsmear they don’t even notice it until I point it out…what could this be if not herpes? Don’t want to pass this on to my baby so what yo do or think….lost???

165. So I just came out of a bad relationship and was dealing with a bv infection so I told the DR to test me for stds and I came back positive for herpes2….. I have never ever had a break out or any systoms. The only thing I have ever had is the discomfort of bv and a yeast infection ….no blisters no soars nothing. So how can I have herpes with out ever having them?

166. I have type 2 herpes. When I had my first breakout and tested positive. I was depressed and my nurse said that in the 2 week window it had to be the partner that u were with. Which matches the time line. He has gotten blood tests results and they all came negative and still negative. I did not have a partner before tht more then a yr. how is he still negative. I know I got it from him. I’m confused

     1. i experienced the same thing Lonyy, but i was tested postive for HSV type 1 but the guy whom i slept with told me that his test came back negative. He also had the blood test.

167. Im so worried:( for many years ive been having recurrent bumps
     Since recently since i started to read online and realize it cudv been herpes all this tome i get them more often n very painful on my genitals 😦 i usd to only get them with my period….i ended up being preg two years ago and it wss ectopic and i lost a tube. How can i get pregnant with herpes and just one tube left? My boyfriend is sending me to get some blood work done soon bcus he wants us to start having unprotected sex so i can become pregnant. How will this work? I bet he will leave when he finds i have herpes (d symptoms r clear). I remember years ago (im nw 22) i had large swollen lymph nodes
     With fever n flu and weight lost and bumps there. (Prolly was my first outbreak) Isnt it obvious that i have it?

168. Dr Gunter, I have been married for 35 years. I broke out this week with the most painful blisters on my left labia. My Dr. swabbed and also drew blood. Not sure what blood test, but I will ask when she calls with the results. My two questions are, can this have been dormant 35 years and If my igg blood test comes back negative would that mean a more recent exposure? My husband swears he has never had sex with anyone else since we were married. I have no reason to doubt him either.

     1. The swab came back HSV1, my blood work is negative. They said to re-draw blood in 4 months and my husband should get a blood test for 1 and 2 now. Does this mean I was exposed as a teenager kissing and some how It manifest on my genitals?

        1. Not sure if you will ever check this but… My husband came back positive for hsv1 he rated an 8. In 35 years he has never had a sore on his lips or his genitals. So go figure, why after 35 years did I get a horrific break out that took almost 4 weeks to heal and 3 weeks worth of meds? There is no rhyme or reason to this disease I now have the stigma of having a STD!
           .

        2. Moderator please change my name to 35years to the reply below. Thank you

169. Hi Dr. Jen. Confused of this whole thing. Female, 42, blood testing in January 2013, positive for Igg, HSV was 5. Negative Igm for both HSV1&2. Is this 100% or should I have a 2nd blood test done and is 6 months after the initial test enough time? Any chance this could be a false positive? In denial with this. Can’t move on with my life, i feel “dirty”. Thank you!!!

170. Hi Dr. Gunter a question, I tested positive for HSV 1 and 2 and I only had a break out in my buttocks, tighs and an area near the anus, that’s all, never in my genitals, this is genital herpes as is only in my skin??? herpes in the skin will tested positive to type 2? thanks.

171. Hi Dr. Jen,

     I was just told by my Gyno that I tested positive for HSV2 using a “herpes IGG antibody test” (her words). She told me that the test only indicates positive or negative for HSV 1 and 2 and that there is no number associated with it.

     I have never had an outbreak or symptoms and was only tested as part of a routine std screening. Do you recommend the Western Blot test as a follow up?

     M

172. I just found out yesterday that I tested positive , Im not really sure if it were 1 or 2 ! But I have been with the same partner for four years we broke up for about 4 months in 2012 and he dated another female in which i didnt ! We ended up sleeping together while he was with this other female and I then became pregnant with my son. Im not really sure if they tested me for this when i went to the ob ! So i thought he had cheated on me at some point since we got back together and have had our son. He says he hasnt done anything since he dated the other female which he states is the last female besides me he has been with ! So my concern is , if he really hasnt done anything with anybody else and he did contract this from this other girl …. could my son have it ? He is 15 months , He turned one in March. Ive never noticed anything on him..but if I havent been with anybody and he swears to me he hasnt then could it have been before i got pregnant and now my son could be infected ! Im wanting to take him to the health department and get a blood test ? Is that possible …What does everyone think ?

173. I’m confused won’t you antibodies in your body anytime you fight off any type of infection? So how does one know why this antibody is really there and what it is really fight off????

174. I had an IGG test that had HSV-1 IGG test result over >5 which seemed odd as the possible exposure was about 3.5 months earlier. I also had a positive HSV-2 IGG test. All of this surprised me. Then I retested using a different lab and I was negative for both IGG < .91. So, what now? As I have always tested negative, I am assuming that the lab messed up on the positive result (?), if they did, than some poor slob who is positive got the wrong results. Have you heard of these errors happening?

     1. I am experiencing a very similar discrepancy issues between HSV test results all from the same blood test lab, LabCorp. All but one of the blood drawings and tests were done within the past month (June 2013) and one (the initial one) was done back in 2008 in July. It was the 2008 test results that revealed presence of the HSV 2 antibodies in my system. Since then I’ve been on Valtrex and, thusfar, have had no further outbreaks. What’s confusing is that the more recent tests conflict with the original results (in various conflicting ways amongs themselves!).

        I’m not sure what to believe, though I’m pretty darned sure I have HSV 2 because of the two outbreaks I had back in 2008. My outbreaks match those of what was depicted in pictures of HSV 2 outbreaks that I found online which was enough corroberation for me.

        I’m looking into getting retested yet again, but this time with Quest Diagnostics, a more reputable blood testing company with a much better record of accuracy, as well as faster turnaround time in providing results… or so I’m hearing from multiple reliable sources. We’ll see.

        I’d love to know what your thoughts are on this perplexing dilemma. Thx!

     2. I have a question did u ever say anyrhing about the positive results from the other lab to them if so wat were there response

175. I have a question… I have a friends couple who did the test because she had genital lesions. Her test where negative but his herpes 1 test where very high. How is that she was the one with “simptoms” and he is the one “positive”? Are the test accurate or what should they do to know for sure?

176. Thank you, Dr. Hunter! As a recently (mis?)diagnosed HSV carrier after a episode of blood-test-me-for-everything-just-because-doc, your article here has provided some relief to the “mental gymnastics” going on in my head. I have had oral herpes since childhood however no symptoms of genital herpes so I will be going back to my doc for a type specific IgG test armed with some of the insight you have provided here. It’s not as bad as my mind has made it seem and to be honest I was very stigmatized to it all until I read this.
     One question though with the following which I am confused by…

     “5) A positive IgG also doesn’t tell you where you have the virus. This is very important, because 50% of new genital lesions are due to herpes type. Basically, if you test positive for herpes type 1 and negative for 2 that does not mean you don’t have genital herpes. You could be carrying herpes type 1 in the mouth, the genitals, or in both places. Recurrent sores on the mouth are more likely to be type 1 and recurrent sores on the genitals are more likely to be type 2, but that’s more likely not always. If you only test positive for type 2, that could have been an oral infection.”
     Does this state that unless one has a genital herpes outbreak, one would not know if they have genital herpes or not regardless of type? Unmuddle my acrobatic brain..

     Thanks again!

177. Would planned parenthood be a good place to go for an accurate test?

178. i am confused, my doctor did a ‘recent exposure test’ and a ‘past exposure test’. but.. i am not seeing any info on that anywhere online.

     1. There is no recent exposure test. Your provider probably thinks the IgM test tells you that, but it does not (see the post). YOur provider does not understand herpes tests if he/she believes there is a test for recent exposure.

        1. OMG! Dr. Gunter. I had a test performed 2 weeks ago and the doctor told me it showed I’m positive for both hsv1 and hsv2. She said I had always had type 1, but that type 2 wasn’t there 6 months ago, so it has to be the result of a recent exposure. Does it mean I’ve have always had type 2?

179. Pingback: IgM blood test for herpes. Just say no. | Dr. Jen Gunter

180. I tested positive for hsv1 but negative hsv2. I did the igm blood test. I recently had an outbreak on my genital area. does this mean Im positive for hsv2?

     1. An IgM blood test means nothing, so you have to disregard that result.

        1. Dr. Sara, why did you say igG blood test means nothing?

           I have never had an outbreak. I got myself IgG tested for reassurance purposes.

           My HSV1 igG results came back at a 12.80 High and my HSV2 igG results came back 1.39 High.

           Is there chance that the HSV2 results are so close to the “negative” 0.91 level that it could be a NEGATIVE reading?

        2. Igm are not reliable but igg is on some tests and depending on the lab you used tests vary …mine were hsv 1 2.51 then 3 years later 15.50 then another lab hsv 1 3.21 hsv 2 greater than 5 waiting for western blot …had shingles a year ago ? Cross reaction also doctors say tests mean nothing only diagnose through symptoms

181. Hi have not had any lesions I had a blood test done and tested positive for hsv2 3,6. I was wondering if should have my ob/gyn do a test instead of my physician?

182. Dr. Jen, thank you for your article, unfortunately I’m still very confuse….This is my story. .I was dating someone that has herpes type 1 & 2, he did not tell me about it until he had a break out. I felt violated and hopeless, we had only been intimate twice, once on May 11th and again May 13th. On Friday May 17th he told me he had it, so I went immediately to the doctor for blood test that same day. May 24th the results came back positive, for both 1 and 2 and with a high index of 1.8 is that possible? in 15 days??? I do have Shingles since I was 30 I am now 43. Could there be a false positive due to the shingles? I only had unprotected sex only one time and I’ve never had a break neither in my lips or genitals. Thank you so much for any help with this matter. I’m truly having a hard time coping.

183. My husband and Ihave been married for 5 years. We were recently tested for all 3 types of Herpes. I tested negative for all 3 and he tested postive for Herpes Type 1 IgG but tested negative for the other 2. While we were at the Pathologists, he explained that my husband has had it for a while but his anitibodies fought it off and it has been dormit in his system. Since I tested negative, is it a possibility that I will be infected?

184. Hi Dr. Gunter,
     My daughter presented with genital herpes Type 1 lesions about 8 months ago (viral culture confirmed the positive and a negative for type 2). Serum blood tested negative, but realize it was too soon for accurate results. So about 7-1/2 months later and no further outbreaks, we did an IgG Type 2 test which resulted in Negative. Planned Parent hood does not test for type 1.

     My question is: Does she have Type 1 genital herpes?
     How contagious is Type 1 genital herpes?
     Could that outbreak have been a singular occurrence?
     Should she retest blood serum for Type 1?
     How accurate are the viral cultures of the actual lesions?

     I ask because she thinks she must limit her future dating to men who are also HSV positive who may even have recurring outbreaks.

     Your insights on these questions are very much appreciated.

185. You mention that IgG takes several months to show up. Is there any data/literature on this? (what is the standard deviation? I imagine it could only be measured via intentional infection of animals followed by duration to seropositive result?)I came back positive for HSV-1 (HerpeSelect type-selective test), first value was a 5, second value a month later was a 7. First value was 2 weeks after a risky sexual encounter. I think this is genital HSV-1, doctor is unsure from examining me clinically, but I want to know whether to be cautious with future sexual partners. Unfortunately I was never tested before so it’s unclear if this is an antibody developed 20 years ago as a child…

186. Hi. Me & my husband are in a dillema right now. We want to have a baby badly but we have concerns about having a genital herpes. My husband has it. And i got infected (i had painful genital ulcers) after we got married more than 3 yrs ago. I usef to get these lesions evrry month. Maybe every 2-3 months this past yr. So we consulted an OB recently & she tested me for igm hsv 1 &2. Resulted after a week, result says hsv 1 igm negatv, hsv2 igm positive. So i was prescribed acyclovir 200 mg 5x a dsy for 5 days then went for blood test again as my OB ordered. Result was igm for hsv2 + & igg neg. I was adviced not to get pregnant yet as this will harm my baby during pregnancy. I thought i can still get pregnant & just be given precautions during delivery like antiviral at 36 wks & c sec if i am symptomatic during delivery. I neeed to be enlightened about this. Pls help me. I really want to get pregnant asap.

187. Furthermore, when I asked my provider for the IgG level, they responded me that there is no level for the HSV tests.

188. My tests came up positive for IgG HSV1 and negative for IgM and HSV2 – six weeks after encounter/exposure. Can the igG antibodies develop that quickly and show positive and there by making the IgM negative? or this means it could be more than likely a pre-existing condition? Pleas let me know.. Thanks.

189. I had an outbreak of what was swabbed & PCR came back showing HSV 2. I have been a faithful wife to my husband of 15 years. It’s been horrendous for our marriage & he has had 2 blood tests, both negative. I hate him & hate myself. My doctor shiwed me stats of HSV in Australia. I told him I didn’t give a shit about statistics, i’ve slept with 2 men in my life, both virgins- Dr asked if I had a penchant for virgins. Same Dr told my husband I was obviously cheating. I asked him how I got it & he told me it was through sex & that I just needed to get over it.
     Tonight I have come home and my daughter has used my towel to dry herself. I have irrationally spent last 30 mins crying for fear she has contracted it. I was very very ill with my first outbreak, in so much pain, lasting 4 weeks. I have told my husband I am never having sex with him ever again, or anyone else. I wanted another baby, and now all my dreams are shattered.

     1. I understand how you feel. Iam in the same situation..

     2. Old comment, but..WHY would “All your dreams be shattered” and you not be able to have another baby? At the time of your post, your were positive and he was negative. Ensure you both get the correct test, like a Western Blot-and see the results with your own eyes. Maybe your husband is the unfaithful one (my bet) or it was/is dormant in one of your bodies all this time (second bet). You don’t state if it is the Igg or the Igm that your husband took. Your doctor is/was a total asshat. Your daughter will be fine. Take reasonable precautions, consider Valtrex, supplement with L-Lysine and forget it.

190. Hi Jen,
     I am about to do a PCR blood test for Herpes for experimental reasons. I am positive for HSV1 and 2 according to the antibody test and also had lesion swabbed to confirm HSV2.
     The biggest lab locally does not do the PCR blood tests as they state that viral cultures are not present in the blood, only antibodies and they just do not feel they would be doing the right thing by offering this service.
     I red somewhere that there is some PCR DNA test that looks for presence of a virus waste products in the blood and that is somehow different from and ordinary PCR test. What is your opinion on that?
     Another question, would the PCR blood test for viral culture show the positive results straight away after you’ve been infected.

     1. Was there any follow up on this please?

191. A 2 week old newborn tested weak positive igm but negative igg and all other blood work, spinal tap fluid, swab tests, etc tested negative for herpes. Mother, father and brother were all tested and results were negative igm and igg. Newborn did not show signs of herpes rash but pediatrician asked for bloodwork to be done and parents complied. Hospital refused to allow opportunity for newborn to be retested. Is it possible the original test was a false positive? And if the original results were correct should newborn show signs of a positive igg in the future if tests were redone?

     1. There is no IgM blood test, so the scenario that you give is not biologically possible to explain.

        However, let’s take a hypothetical case where a baby is born and within a few days is suspected of having herpes encephalitis

        Infants get herpes encephalitis at birth (acquire HSV at birth) when the mother is having her first outbreak as these often occur without symptoms. Meaning she contracted HSV, is shedding the virus, but has no active lesions. This is the most likely scenario for neonatal herpes as viral shedding without lesions is very common. The mother then does not yet have protective IgG antibodies and neither does her newborn as they take 2-3 months to produce. IgG antibodies do cross the umbilical cord, so that is why primary herpes is much more devastating for a baby exposed at birth than secondary herpes where the mother has IgG antibodies to pass on to her infant.

        The baby would be expected to be negative for IgG by serology for herpes as would the mother (however, re-testing at 1,2,3 and 6 months should produce a seroconversion for both) is the lesions the baby had were herpes (of herpes were the cause of the encephalitis). The diagnosis of herpes in the mother and the baby would be made by PCR. The diagnosis of herpes in the infant would be confirmed by PCR either from lesions or from the spinal fluid and if it were close enough to delivery, the mother could have a vaginal swab done for herpes PCR. However, by 2 weeks there is a chance this too could be negative and so re-testing the mother for antibodies to see if she seroconverts would ultimately prove where the herpes came from.

        In this scenario if the baby tests negative for herpes by PCR then that is unlikely to be the cause of the condition.

        1. Thank you for the quick response. The baby tested negative for herpes on the PCR using both spinal fluid and blood but the doctors forced parents to keep newborn in hospital and treat as if newborn had herpes/HSV 1. Hospital would not discharge newborn unless parents complied with the antibiotic treatments. Mother has tested negative for herpes virus as well.

           Is it possible the original igm test was incorrect? Is there a false positive rate on that test is for a newborn? Pediatrician informed parents the positive igm was a result of bloodwork that he ordered on newborn.

        2. There is no IgM test that is reliable, so in this hypothetical situation the IgM means nothing. I can’t imagine designing treatment around a unreliable test.

           PCR is pretty much the gold standard for diagnosis, so….

        3. Thank you so much. You were very helpful.

        4. Keep in mind my all comments are all based on a hypothetical scenario and not medical advice.

           There are a myriad of other variables to consider not presented in your hypothetical case. For example, the accuracy of the lab doing the PCR.

192. Dr. Jen,
     I have been married for two years. I heard rumors that my husband had herpes, but he assured me the rumors were false. I went and got tested anyway, and it came back positive. He immediately went and got tested, and it came back negative. The VA doctor wrote up a paper for him that stated that he “showed no immunologic response to herpes”. I also heard them on the phone tell him that the herpes test was negative. I haven’t been with anyone other than him, so how could this be?

     1. Were you negative for type 1 or 2? You could have gotten HSV 1 (cold sore) as a kid. What Dr Jen has been saying is that there are test that don’t tell you which HSV type which makes the test worthless.

     2. it can be dormant in the body for long periods of time

193. You mentioned that igg non specific tests are useless. What if someone thought they had been exposed to either type of virus, had this test done at the 6 month mark and received negative results. Would that suggest that the person has infact had no infection of either type or would there still be a risk of the person not producing enough antibodies for that test to pick up? I would think a non specific test would show a false positive before a false negative, is that correct?

194. Pingback: Can Oral Herpes Be Spread to Genitals? | Planned Parenthood Advocates of Arizona | Blog

195. A professional lab testing is much needed for accurate blood testing without any stress and Any Lab Test Now offer a best blood lab testing in Waco TX. Thanks for giving this information. Great post!

     1. What lab & what test i truly think all thses hsv tests cross react with other herpes family

196. This is so helpful and I am so grateful to you! I am amazed at the lack of information about herpes and even worse, the amount of misinformation given about herpes by doctors. It must be true, the more you know, the more you know you don’t know! Still waiting for your viral culture post please and thank you…… 🙂

197. Pingback: STD Awareness: Oral Herpes | Planned Parenthood Advocates of Arizona | Blog

198. I am really conflicted about getting the test. in 2007 I had a strange symptom, like a crater on the shaft of my penis. it didn’t hurt and it cleared up in a week or so and has never returned. As my girlfriend ay the time (we are still together) was a virgin I didn’t think it was anything to worry about. I was also working abroad in a country with a poor medical system so didn’t go to a doctor.

     However, in 2011 I read an article about herpes and I’m now terrified that’s what it was. I haven’t had sex with my girlfriend since and I’m terrified to in case I give it to her. I haven’t told her because I am terrified that she’ll leave me and I also don’t want to scare her for nothing because I have since spoken to health professionals who have told me there is no way to know what it was, and that based on my sexual history they think it’s unlikely to be herpes, hut not impossible.

     We are both in our early 30s and she is hinting about marriage and kids, but how can I consider that if there is a risk I could infect her with something? This is ruining my life. I would give anything for a test that could identify if I have a genital infection.

     1. if you had something she could catch from you, and she was susceptible to it, in all those years she doubtless already developed the antibodies. if you want to know your status for sure, you can both be tested for hsv. but she could have already had hsv1 from childhood exposure to cold sores, or hsv 1 or 2 from oral-genital contact from someone before you. same with you. you are stressing out for nothing.

     2. It’s in your best interest to disclose to her your fears. If not, it will continue to stress you out. What you shoul do before is to visit your doctor / clinic and get a confirmation by testing. Once confirmed you will be in a better position not only to know your status but what you will disclose to you girl.

199. My GYN offered the IgG to me in addition to other STI testing after my divorce about three years ago. I really wish I’d never had the test; it showed me as positive for HSV 2 and then I was left trying to figure out just how long I’ve been carrying it around. I did tell my ex-husband, just in case, but I wasn’t prepared to track down all my past sex partners to let them know.

     Like the people in the NEJM study you linked to, I appear to be asymptomatic. There is really poor information to help one understand what “symptoms” are, though. As noted in the study, people need to be very clearly educated on how to tell they are experiencing symptoms of HSV or if it’s something else. I’m frequently questioning what the heck is going on now that I know I have the virus: Is that little bump an ingrown hair from my last waxing, or is it a lesion? Is that a “tingly” feeling in my upper thigh? Is that a pimple on my rear or something else? It’s really sort of maddening.

     Question: In your original article that you linked, you mentioned that HSV is transmitted via bodily fluids. In the reading I was doing on the CDC and U of Washington sites, I thought it noted that it is transmitted skin to skin. Which is correct?

     My current partner was informed and he tested negative. He doesn’t care about the HSV, and since we’re in a long-term, monogamous and committed relationship and all other tests came back fine we don’t take any special precautions. So being HSV positive doesn’t mean that one must give up on all sexual relationships, although it does present a lot of complications. I still worry that I will inadvertently infect him, especially since I have no way of knowing when I could be shedding.

     1. Lanalee…..I feel the same way. I wish I would never have been tested because now I am really confused. I only tested because I heard people can carry herpes for years and never know it. I have never had any symptoms…and I tested high for the antibodies.

        1. How high was your antibodies? Did you ever get retested ? I heard the only definitive test is the culture

200. When the results come back “equivocal” (four months out from “last contact”), what is the ideal amount of time to wait before retesting?

     1. It takes up to 6 months for IgG to develop

        1. Hi Dr. Jen what this means I am so confused so what is the best blood test to do? I find out my partner has genital herpes and as usual he did not tell me! and this is the brief I have my first contact with him on may 11 then again may 13, he told me he has the virus on the 17 so that same day Friday the 17 I did a blood test and by Friday the 24 I got my results positive with a very high index of 1.8 how come is that possible in such a short period and as off today I have not have an outbreak, also the two places I did the test they told me I got the virus recent? I am so confused and very depress about this so confusing blood test. thanks for your help.

        2. That’s what I’ve always read too. But just today I got a third IgG (type specific) come back negative, when the two previous ones came back equivocal.

           Swab test of oral lesion Oct. 18th – positive HSV1 (first infection. Previous IgG tests were all solid negative at routine 6 month STI/STD testings).
           IgG test Feb. 18th – equivocal
           IgG test Apr. 5th – equivocal
           IgG test Jun. 26th – negative

           How likely is it for the IgG test to give a false negative, especially 8 months after the initial infection which was diagnosed with a swab test, and when earlier IgG’s were equivocal? Did someone just botch up the blood test last week? I’ve been taking 500 Valtrex daily since the initial outbreak to prevent recurrences in the first year. I’ve been hoping to get off the Valtrex once the antibodies show up, hence why I keep retesting.

        3. Hello Dr. Jen:

           Almost two years ago I had complications from a procedure that resulted in an infection of my lower lip. The hospital did a IMG test which they said came back positive for herpes. But I have never inu whole life had an outbreak so last week I got tested again. This time the test was the herpes select I/II IGG. Both came back negative. What does it mean??

        4. Does this mean Dr. that next outbreak will take 6 months?

        5. So Dr Gunter if it takes like 6 months for the igg to develop then we have to think of our sex partners before that? Because all my results for years have been negative and I have an affair just about 1 month ago and now I got a positive test for hsv2😭 is that possible?

        6. Is it true that you can test positive for hsv 2 and it not be genital. If you want to know if you have genital herpes with no sx would a blood test be the way to go or only if you have sx

     2. same thing happend to me it says i am (P) for type 2and EQUIVOCAL says to retest at a later date it was 1.81 its says early infeection, whats that mean . but i never had sorres on my mouth or genitals or my butt , what i do have is psoriasis on my lip and nside my ears kness and elbows , my

        1. I would think 4 months out it would be positive or negative I think you are negative retest to put your mind at ease …why did you test in the first place & I’ve always heand 3 and under you usually are truly negative …best of luck

201. Now I’m super confused! What about viral culture obtained from a new oral or genital lesion? Those should be reliable, because then you are getting an actual sample of the virus. Right?

     1. I guess I talked myself to the answer!

     2. A test from the lesion is a different thing than a blood test. I will post on lesion tests later this week. A viral culture is not the necessarily the “best” test for a lesion. Stay tuned.

        1. Dr Jen , I would like to ask u is it normal to have re accruing ob,s every week from November 2012 to may 2013 on weekly basis ? I was diagnosed positive in 2009 through a swab and 3 weeks ago swab was taken again and it came back negative , I am so confused , Cld this be something else ? What else Cld this possibly be ?

        2. i to have had this virus for 20 years but have been told it is shingles and have been treated as such and i to am now asking myself is it something else

        3. I need your help desperately, my wife and I have had cold sores for years but never anything on the genitals.Recently while drinking too much we both had oral contact with a woman who now has said she has been tested positive for the virus. Why has my wife and I never has any sores or pain in the genitals and now this other person has. Does having the same virus and or antibodies prevent us from giving it to each other in the genitals? I have asked are OB/GYN all the way to the CDC hot line and can not get a clear answer. What are the implications of continuing to have contact with the other person? Please help, you seem to have the most in depth material.

        4. Did you already post about the lesion swab test, because I didn’t find it anywhere

        5. Dr. Gunter, I had a lesion 2 weeks ago and was going under extreme emotional and physical stress, I suffered from anxiety and that week I was having a lot of problems that were digging on my stress and making me very depress an emotionally unbalance, at first I thought that the lesion I had was because of the shaving however, I went to the doctor and she did a culture on the lesion and also got blood work to check for herpes. When the doctor called me the next day she told me that the blood work came out positive for herpes type 2. I immediately ask my partner, who I’ve been dating for the last 3 years and whom I always had unprotected sex since the last 2 years and more, and he didn’t have any lesion however he told his doctor, who works in the Same office as mine, about my situation and asked the doctor to test him, he got tested 3 days ago, which is a week after I got tested (not to mention again that my doctor called me with the results the next day), and his doctor still haven’t called him, which it worries me because the doctors always say that if they don’t call means everything isok, but yesterday I got a call from my doctor by mistake, and after asking questions about my herpes andmy bf’ s tests ( he got a urine test something I didn’t get) she mention that the culture on the issue was negative, I asked her how come she didn’t tell me and she just said that anyway the blood work came out positive, but she still prescribed me valtrex for 10 days which I haven’t finish the treatment yet and I believe it helped me with the lesion. Now I don’t know what to do the doctor hasnt call my bf yet which most likely should mean everything came out negative and I don’t understand how…. when me and ny bf being together for many years and having had unprotected sex since then, I am full of questions but I feel my doctor is not giving me answers or is . Not to aware . Of this topic, what should I do? Can you please give me an advise? I feel really lost, I haven’t had any intimacy with anybody else than my bf since we start our relationship, and I don’t understand how could it be possible for me to be positive and him probably negative, please help.

        6. I’m having trouble finding someone locally who will test a swab I took directly from the lesions. Everyone wants to perform an antibody test around here. Are there any labs I can send a sample to myself reasonably for PCR or something? What is the link to your other article on this? I took the sample carefully using a sterile BBL Collection Swab transport tube a day ago and it’s in refrigerated storage now.

        7. So what is the explanation for a positive culture and a negative IGg for 6 years.

           I was diagnosed with HSV2 in 2008 and since then I have NEVER come up with a positive specific IGg test. I have gone through 2 pregnancies and have been tested about 7 times and it has yet to come up positive. What does this mean?

        8. Plz do the hospital said I have lesions but never gave me no pillls

        9. Where do gential herpes appear on women do they go on labia majora where pubic hair is or inside vagina on mucosal areas ….and do they always hurt

     3. Viral Culture obtained form new lesion (oral or geneta) is also accurate. If its you 1st time of getting HSV infection then IGg antibody count might not be present in you blood. So its better to take Viral Culture and be confirmed.
        🙂

202. Excellent! Thank you.

203. Now I understand how the lab managed to run one of those bogus antibody tests for malaria on me! (The doc ordered the right thing, they didn’t offer it and substituted the closest thing they had. I couldn’t understand why it was even offered.)

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