[Question #3833] can someone have herpes and have negative lab test?

34 months ago
Had a weekend encounter with someone from my past.  A few days later came down with flu like symptoms and then burning, itching and a vaginal discharge.  I have never had any signs, symptoms or outbreaks of either oral or genital Herpes.  Also have not had any sexual contact with anyone since my husband passed 7 years ago. I went to my gyn who upon examination told me it looks like Herpes.  Sent me for blood work which came back IGG negative for HSV 1 & 2.  IGM screen & titer came back positive for HSV 1 & 2.  After informing my partner (who has a history of cold sores but never any signs, symptoms or outbreaks of genital herpes) he went for blood tests a month later and all came back negative.  Is it possible he does have Herpes and it's not showing on labs?  We are very confused by the conflicting labs and I feel horrible accusing him but don't know how else I would have contracted Herpes.  Thank you for help with this matter.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
34 months ago
What should have been done is a swab test of your genital area rather than an antibody test or in addition to an antibody test. The IGm test is unreliable and has many false positives but it is impossible to know if this time it is a false positive. The only way to know if you contracted herpes is to do another antibody test 6 to 8 weeks after the encounter and see if your IgG test is now positive. Was he the giver of oral sex to you? Have you ever in your life in a cold sore on your lip? The IgG test, in this case for him and you, has a 30% chance of missing and HSV one and infection.

Terri
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34 months ago
Thank you for your response.  It was mutual oral sex.  Have never had a cold sore until right after this encounter when I had the flu-like symptoms of backache, fatigue and fever (which only lasted about 24 hours).  I assumed it was a fever blister.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
34 months ago
If you have never had a cold sore previously, it is certainly possible that you acquired new infection from this partner. You report that he does have a history of cold sores but that the test from his blood appears to have missed his antibody which is common with this test

Terri
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33 months ago
so if my tests are accurate, having oral sex with a partner who has a history of cold sores (even if he doesn't have an active sore at the time) can give me genital herpes?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
33 months ago
Yes, that is correct.  Almost all of my patients who received oral sex and got genital herpes said their partner had no cold sores at the time they received oral sex though they had a history of cold sores (some did not but eventually tested positive for HSV 1).

Terri
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