[Question #1718] Conflicting Herpes Results

76 months ago
Dear Doctors,

I'm writing because I've had a series of confusing herpes results and I was wondering if I could get some clarity. 
It all started December of 2014, I had what appeared to be a genital ulcer, not your typical herpes blisters. It was painful when I urinated. The doctors office did a culture and it was positive for HSV1. However, no oral sex was had with my partner at the time. He took a blood test and showed positive for HSV1 and HSV11. I took valcylovir and it cleared up.  I had no other breakouts, but continued to take suppressive therapy because I feared passing it on.  I had a blood test done in July 2015 and it showed negative. I thought the negative result may have been due to the medication. In may of 2016 after sexual intercourse with a condom I developed another small ulcer. It wasn't as painful as the last episode, but I went to the doctor two days later, had a culture done and it came back negative. Later in may 2016 I had another blood test done. I was off the medication at this point, the blood test was positive for HSV1. I have not had another episode of ulcers since. I had accepted that I had the virus and stayed off the medication from July 2016-Jan 2017. Now I have a new partner and went to get all STD testing done once again. I started seeing my new partner in January of 2017 just four weeks ago. At this time I started the valcyclovir again to avoid transmission, so I've only been on it for about 4-5 weeks. As of today 2/6/17, my IGG blood test came back negative for both HSV1 and 2. I'm so confused by all of these results. Can the use of valcylovir for the last 4-5 weeks affect my blood test results, two years later? My doctor advised me that I do not have HSV, and does not advise any further testing. Is this an accurate conclusion, or should I assume I have it and get retested without any medication in my system at a later date? Please help, and thank you in advance. (btw - i don't have any information on viral loads etc. it just says 
76 months ago
Sorry, correction to the question. I was off medication from July 2015-Jan 2017
Terri Warren, RN, Nurse Practitioner
75 months ago
So the problem here is likely not the medication effect - the HSV 1 antibody test misses 30% of infections compared to the gold standard herpes western blot antibody test.  We know you have HSV 1 from the swab test - a typed positive swab test from a genital ulcer is definitive.  And BTW the antibody test gives an index value, not viral loads.  If you are taking medication to avoid transmission, that's fine, pay no attention to this last test result.