[Question #4899] HSV1and2

25 months ago
I am a female and in April 2018 I was diagnosed with genital HSV1, I received oral sex and vaginal sex , about 2 weeks later I got really sick and broke out down there, I went to the doctor and was then diagnosed with hsv1 genitally, by swab and had blood work done. That was my initial outbreak. In August I felt a bump close to my anus,nothing like my initial outbreak, got tested and the test was negative for both,in October I felt another bump, close to my anus got tested it was also negative for both, now in January I felt rash like symptoms around my anus went and got tested again and it came back positive for hsv2and negative for hsv1, I am very confused and looking for possible answers.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
25 months ago
Hmmmm.  Have you had an antibody test like an IgG blood test done to see if you were positive for HSV 1 AND 2?  Have you had sex with anyone new between April 2018 and now?  And when you say you got tested again, was that blood test or swab test?  And what was the number associated with the positive HSV 2 result?

Terri
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25 months ago
I had a blood test done in July 2018 showing I was positive for hsv1 negative hsv2, no new sexual partners. I was test via swab of lesion in August and October both of those testing negative for both, January 22nd I broke out around my anus, that was tested via swab once again, and it’s showing “HSV 1DNA,QL PCR negative” and “HSV2 DNA,PCR positive”
25 months ago
Following up.

I just looked at my medical history and back in July 2018 it shows antibody positive for hsv 1 and antibody negative for hsv2. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
25 months ago
So have you had partners between April of 2018 and January?  If yes, you could have been newly infected during that time.  The other answer is that you could have a false negative IgG test for HSV-2. The IgG test Mrs. 8% of infections compared to the gold standard Western blot. The other option and I think it's a real longshot is that the swab test was mistyped.  I have seen that happen in the past but very rarely. You might consider doing an IgG test now to see if it is positive for HSV two or you could consider obtaining the herpes Western blot. If you have had no sex partners between April 2018 and January, then I would lean toward the IgG test missing your HSV-2 infection.

terri
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