Hello. My 21 year old daughter had a single lesion on her labia. I took her to the gynecologist who did a culture test of the sore. It was negative for herpes. Her blood IGG tests for type 1 and 2 were also both negative. She has been with her boyfriend for the last year and is confident he hasn’t cheated. Neither has she. He also had a negative herpes simplex 2 IGG AB  inhibition test. Do you feel she can be confident that she does not have herpes? Her boyfriend said the doctor tested for all STDs. Does this test include type 1? I appreciate your advice. 

I don't know if the testing he had done would have included HSV 1 - has she ever had cold sores?  HSV 1 can be transmitted from his mouth to her genitals through oral sex.  If the swab test was negative, that's a good thing, but knowing his HSV 1 status would be a helpful piece of this puzzle.  Let me know.---

Thank you for the response. She has not had cold sores and is HSV negative for 1 and 2 per her bloodwork. I was thinking the HSV1 is the mystery since it could have been contracted via oral sex. He has never had cold sores either which is good. I feel the clinic he went to didn’t test for HSV1 since they were telling him it wouldn’t prove anything. We may need to pursue that. Out of curiosity , do you feel his negative HSV2 and her negative swab can rule out HSV2 at least, or would you still have concerns for a false negative there? Thank you again. 

The thing is, someone who has a new infection is definitely going to be negative on the IgG test because not enough time may have passed for the body to make detectable antibody.  To complicate things further, the IgG test misses 30% of HSV 1 infections, even if someone waits long enough to test.  She should retest about 6-8 weeks down the road and see what her status is then.  And it would be helpful for her partner to test as well.  70% of those infected with HSV 1 would say they don't have symptoms of herpes so asking about symptoms may not be accurate in terms of accuracy.---

So if he had a long standing HSV1 infection it could still be missed when he goes to get tested due to the 30% inaccuracy rate? Also…Is the same true for the IGG for HSV2? Is that also not as reliable or can they consider his negative results for type 2  to be reliable? I appreciate the clarification. 

Yes, it could still be missed with the IgG test, correct.  The IgG test for HSV 2 picks up 92% of HSV 2 infections, compared to the gold standard western blot, while the IgG for HSV 1 picks up only 70%.  The problem with the HSV 2 test is false positives, which is not the problem here, I don't believe.---