I have had oral herpes symptoms for decades, but never any genital herpes symptoms or exposure.  On recent bloodwork, HSV-1 was negative, but HSV-2 was positive (STDCheck.com was the order, draw taken by LabCorp).   Can the HSV-2 be causing my oral herpes?  Can I be confident that I only have oral herpes with the HSV-2 positive test, or could I be a silent carrier of genital herpes even though I've never had symptoms?  Is there additional testing that can be done to rule out a potential false positive of the HSV-2?  When I looked online, STDCheck indicated they use IgG for testing, not IgM.  Thank you.  

A couple of things could be going on here.  You could be misinterpreting oral symptoms as HSV 1 when they aren't.  Canker sores are not HSV 1, but cold sores are.  The other thing that could be going on is that routine IgG test by LabCorp miss HSV 1 infection 15 of the time, compared to the gold standard western blot.  The LabCorp test has few false positives for HSV 2 but maybe 2-3 out of 100 positives are false, so if you want to know for sure, you could do the herpes western blot to be certain.  ---

How can I be sure to order a western blot for HSV 2?  Which lab offers it?  When ordering it is unclear which type of test is being conducted (IgG, IgM, western blot).

The western blot is done only at the University of Washington in the US.  You need to order a kit from them, 206-685-6066, and then any clinician can order the test and draw your blood and ship it off.  I can also help you with that at westoverheights.com.  If you are accurately positive for HSV 2, then you are both infected and potentially infectious to others.  ---

I think you meant oral HSV 2 is rare, correct?

Yes, I did mean that, that's for catching my error---

Hi Terri,

Yes, that is possible.  Very unlikely that it is causing your lip symptoms and not at all genital, but possible, yes---
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