Anyway, on to my question: My blood test came back with an HSV 1 IGG, TYPE SPECIFIC AB index value of 1.60. The doctor who gave me the results said it's nothing to worried about, and that I likely got exposed to oral herpes in my childhood (My mom had oral herpes so I wouldn't be surprised). But could that actually be possible with such a low index value? Could my IgG be 1.60 if I've had it for over a decade, or would this be indicative of a more recent infection?

(The doctor refused to perform a follow up blood test after a month to see if the values changed, or might've been a false positive - citing that once I have it I have it, and that this is a true positive and that it won't change. They claimed that it's low due to herpes being inactive, and would read higher during an OB, but otherwise will stay 1.60, and therefore another test is unnecessary. They also said that oral herpes can come and go between my lips and genitals too.) < This is additional information, but I would really like an answer to the question above, and advice on what to do next. 

Thank you.

Your IGG for HSV 1 could certainly be a true positive, even with a low index value of 1.6.  Absolutely.  I see it all the time.  The testing for HSV 1 by IgG is just not as good as one would hope.  I disagree that an outbreak would make the number go up. 

I would also disagree that HSV 1 can go back and forth between your mouth and your genitals.  Once you have HSV 1 in one location, it is highly unlikely that you would then get it in a new location.  Is it possible to get oral and genital herpes at the same time?  Yes.  You could kiss someone who has an oral infection and then get it orally and if they gave you oral sex, you could also get it genitally, at the same encounter, or very close to the same encounter. 

Have you ever in your life had a cold sore on your lip or in your nose?  if yes, then this is why you are positive for HSV 1.  If you have never had a cold sore, then we cannot know if your infection is oral or genital, until or unless you have a lesion that can be swab tested at one of these locations. 

Though a false positive for HSV 1 at this level is uncommon it can happen.  If you want confirmation, I would suggest obtaining the herpes western blot for clarification.  This is done only at the University of Washington, in the US

Terri

 

I did answer this, in the first line of my reply, but I will answer it again for greater clarity.

Yes, you can have an index value of 1.6 that represents an infection acquired in childhood.  Some people simply have lower index values.  It means nothing if it's a true positive.

The cuts in the corners of your mouth could be angular cheilitis or herpes, without a swab test, it isn't possible to know for sure.

I see no reason not to swab something that a patient is concerned about - what's the downside?  I don't get why they won't swab test it, but there's really nothing I can do about it except to encourage you to find another provider who will agree to do it.

Terri

Yeah, I dunno why they won't swab anything for me. They (3 different doctors) say they won't swab it because it "doesn't look like your typical herpes". I wish they would though, because healthcare works for, and are there for the public, so even if just to calm my anxieties over it, as it's seriously putting me in a downward spiral, I wish they'd just do a swab test for me. I really don't care if I have oral herpes, it's not knowing whether these groin pains/fissures are ghsv1 or not that is depressing me. 

In the event everything clears up by the time I get in for a swab, which I've scheduled  for next week at Planned Parenthood (who refused to swab my hemorrhoids/fissure last time, and will probably do so again...) do you think it's possible I can ask the doctor to let me take the swab home to do myself and drop off at a lab, when I see something that looks like an outbreak? Or do you know of other resources where that may be an option to me?

 So I was able to see an infectious disease specialist and got another IGG test done. I still came back negative for HSV2, but my HSV1 levels decreased from 1.60 to 1.21. (I was expecting an increase to be honest.)

3 - Do you think I should assume I have GHSV1, due to the discomfort I've been dealing with? Or should I just conclude it's OHSV1 from a past exposure?

(My concern is how I disclose this news to partners, as I'm not sure what to say. I don't know anything other than I'm low positive for HSV1)

Thank you.

An IgG test done at 12 weeks is just most accurate. You can order your own IgG test, you know, online.  You don't have to wait for a clinician to order it for you.