[Question #5267] Question about Herpes testing and typing

24 months ago

I noticed red, raised bumps and blisters on my penis, which I thought was a herpes outbreak, even though I have never had one and regularly test negative for antibodies (IGG). The nurse at Planned Parenthood who took the culture said it "didn't look like typical herpes."  The result came back positive, however it didn't determine the type. PP said their Herpes cultures do not EVER determine the virus type.

I wanted to know the virus type and took 3 steps to find it out.
1. Attempted to get another culture, by that time, my lesions had healed enough so it was no longer possible.
2. I got tested for antibodies (IGG) but the results were negative for both type 1 and type 2.  This is not surprising because it takes the body a while to produce antibodies.  Rather than wait 3-4 months to get another antibody test:
3. I got a Herpes PCR blood test, which came back negative for both type 1 and type 2.

Is it more likely that the culture was a false positive or the PCR test was a false negative?  Is PCR from a blood test less accurate than PCR from a lesion?  Since Planned Parenthood said they were able to reproduce a virus but they couldn't determine the type, is it possible the positive was for another type of herpes virus (like Epstein Barr or shingles, which can also produce outbreaks)?

I suppose I will wait 4 months from the time of the original outbreak and then get another IGG test.  Is there any other way I can determine the virus type?

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
24 months ago
PCR is for swab testing, never blood testing.  You would almost never have virus in your blood and the PCR looks for virus not antibody.  If the swab test was for HSV, then it would not confuse this with another herpes virus, like EBV.  You can retest in 6 weeks and see what you get - some people seroconvert at 3 weeks, some 6, some 12.  And remember that the IgG test misses 30% of HSV 1 and 8% of HSV 2 so if you continue to test negative and want to know the type, you should get a western blot after 12 weeks (and I would guess it is HSV 1 under those circumstances.)  What a shame that that Planned Parenthood is not following the CDC STD treatment guidelines and always typing positive swab tests.  You might print that out and send it to them so they can update their practice guidelines.  it leaves people like unnecessarily confused.  And if you get another outbreak, have that swab tested elsewhere and get it typed.