[Question #13672] HSV testing, new information

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1 months ago
Dear doctors,
Here are my testing results for herpes. 
They are not from the US if that matters.
IgG HSV 1,2   1,3 ( pos from 1,1)
IgG HSV 1,2   1,3 ( repeated the same test)
Saliva culture HSV (no type) detected 30%
Later (6 months in total, more than 2 years after the thought exposure):
IgG HSV 1    negative 0,02  (pos from 1,1)
IgG HSV2    negative  0,0 
IgG HSV 1,2  negative 
IgG  HSV 1   negative 
IgG  HSV1.   negative 
Never ever any symptoms 
The virolody doctor in the virolody institute where I did the last IgG saw this all and said that the first positive IgG were a mistake.  She thought I didn't have HSV although I told her about the positive saliva culture. I also wrote to you and Dr. Hunter Handsfield said that he tends to believe my type specific IgGs that were all negative. And that some tests falsely detect other distantly related viruses,  some are wrong for chemical reasons and testing saliva would be unreliable. Swab has to be taken from lesions (which I never had).Terri Warren said that IgG can miss 30% of infections but was sceptical about my positive culture because of the number 30%, could not say anything definite about my case. Recommended Western blot but I am not in the US. 
I like reading other responses here on this site. Doing this I came across different Information. Dr. Handsfield: "PCR is accurate from any fluid" Dr. Hook: " You don't need a lesion for a swab". Other sources say a positive culture is almost never false. Mine was not a PCR as far as I remember,  but a culture on cells.
Has the medical knowledge on the subject changed in the meantime and what does it mean for me? 
Thank you very much.
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Terri Warren, RN, Nurse Practitioner
1 months ago
Good morning, the better tests for herpes antibody now miss only about 2% of HSV 2 but still 15% of HSV 1.  That doesn't really relate to your situation, but I will note that the older tests had many false positives, at least those in the US.
In terms of the positive culture.  I've never seen any kind of swab test, PCR or culture, ever give a percentage positive so this is not something I know much about.  However, in the US anyway, about half the adults are infected with HSV 1 and in other countries, that number is far higher.  What country are you from?  I can look that up for you.  Also, since HSV 2 is rare orally, if there was virus there, I suspect it was HSV 1, not HSV 2.  
I doubt we will ever get to the bottom of the saliva culture issue, but perhaps if I know the prevalence of HSV 1 in your country, we can try to make some assumptions?   Also, have you ever in your life had a cold sore on your lip or inside your nose?  If yes, then we know you have HSV 1.
Let me know where you are, OK?
Terri
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1 months ago
Dear Terri, thank you very much.
  No, I never had a cold sore anywhere as far as I can remember. 
I lived in several countries. Without referring to prevalence statistics, what does it look like to you according to the info I provided? 
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Terri Warren, RN, Nurse Practitioner
1 months ago
Honestly, I cannot know what's going on here - a positive culture from saliva but a percentage?  That makes no sense to me.  And in terms of the HSV 2, I think you are likely clear, but I'm less certain about HSV 1.  No matter where you live, you can always send blood to UW for western blotting and I could help you with that if it is important for you to know about HSV 1.   The problem is that most antibody tests aren't very good at picking up HSV 1 - they are much better about HSV 2.
Terri
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1 months ago
So practically my HSV1 status is unknown despite testing?
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1 months ago
Based on my exposure history I am 99% sure I don't have HSV2.)
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Terri Warren, RN, Nurse Practitioner
1 months ago
well, that's good.  
And yes, there is simply no way to know, based on what you've written above, whether you have HSV 1 or not.
Terri
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