[Question #6242] Igg Negative

15 months ago
Hello, about 5-6 years ago I was told by a doctor that I had ghsv1 after developing what appeared to be skin ulcerations in the area of my clitoris. These lesions appeared within 24-48 hours after vaginal and oral sex. One year later I experienced another similar outbreak in the same area. No other outbreaks have occurred and I do not take antiviral medication and I have not been sexually active since my diagnosis. I have met someone with whom I would like to be intimate. Due to my fears I went to have an Igg test done at a walk-in lab. My results came back negative for HSV1 with my results being 0.86 in a negative range of <=0.90. My HSV2 results were 0.13 with negative range also <=0.90.  Equivocal index would be 0.91-1.09 and positive index is >=1.10. Does this result mean that I was misdiagnosed initially? If I am positive then why the negative result on this lab? Also, I have read that if positive I would only be shedding an average of 4 days per year. Is this accurate?  My initial question is of great importance to me as it has caused me so much anguish over the years. Am I HSV positive????
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
15 months ago
How were you diagnosed initially? I'm guessing it was a swab test if it was typed?  HSV 1 genitally in normally very inactive and your data on the shedding rate is accurate. 
The IgG test misses 30% of HSV 1 infections compared to the gold standard western blot.  I would encourage you to try to get those records and see exactly what was done.  It is very possible that you actually do have HSV 1 genitally, that the IgG test missed it (and you have a high negative which could suggest a missed positive), and that you are having very close to no recurrences. 
To compare your risk of infecting someone:  a person who has oral HSV 1 and has 6 outbreaks a year is shedding virus on about 25% of days (25 out of 100 days) and could transmit HSV 1 by giving oral sex to someone quite easily, given those numbers.  You, on the other hand, are giving off virus on about 1% of days, after being infected this long, if you are indeed infected.  The risk of your transmitting is tiny tiny.

Terri
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15 months ago
The initial test was done by swab and they told me within a few minutes that I was positive for hsv1 but that it had not yet “hit my blood stream because it was so new”. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
15 months ago
a few minutes???  There is no test that I am aware of that is a swab test that can type the virus in minutes.  There is something called a Tzanck prep that looks for a particular type of cell but it most definitely cannot type the virus.  Do you think it is possible for you to ask your doctor more about the specific test that was done? It seems unlikely to me that this test would be out there and I wouldn't know about it.  I would greatly appreciate it if you could find that out.
But I do know that they could be wrong about the HSV 1 antibody test - it could be old infection and the antibody test missed it.

Terri
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