[Question #3109] HSV 1 or 2

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90 months ago
I have reason to believe I was exposed to HSV. (A partner’s previous partner is having an outbreak and blood work was NEGATIVE for HSV 1/2)  I was tested with the IGG type specific blood test. It showed as negative for HSV 2. I get cold sores, so I know I am HSV1 positive. What is length of time it takes for antibodies to appear in blood? I believe my exposure was about 8-9 weeks ago. 
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Terri Warren, RN, Nurse Practitioner
90 months ago
The recommendation is to wait 12 weeks from a concerning encounter to get a final antibody test.  At that point, we believe that the IgG test misses about 8% of HSV 2 and 30% of HSV 1 infections so it's quite good for HSV 2 but not perfect.  Did you have an unprotected encounter or were condoms used?

Terri
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90 months ago
it was unprotected.  So Even at 10 weeks post encounter I could get a negative igg test...Next question, what is the likelihood of a person with HSV1 (oral herpes) infecting a partner genitally, without a cold sore outbreak? Does “viral shedding” happen that way?
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Terri Warren, RN, Nurse Practitioner
90 months ago
I would say that the odds of you becoming positive between weeks 10 and 12 are really small. 
If a person has HSV 1 orally, they shed virus on about 25% of days swabbed in a research study.  So yes, if someone with oral herpes gives oral sex to someone else, even without a cold sore, they can infect a partner.

Terri
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90 months ago
Great. Thank you! Finally, why would a dr not swab a lesion/ulcer? (Not me, I’ve never had an outbreak) Everything I’ve read said that if you can get a Culture it is the best way to Id herpes and tell what type it is
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90 months ago
If 2 people have HSV 1 orally can they re-infect each other genitally?
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Terri Warren, RN, Nurse Practitioner
90 months ago
I cannot imagine why a clinician would not swab a lesions - it is the recommendation that that be done of any suspicious skin lesion.  If two people have HSV 1, it is extremely unlikely that either of them would acquire HSV 1 genitally. 
Terri
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