[Question #928] HSV

88 months ago
Hi, recently I went saw my gyno for discharge and burning.  I was diagnosed with BV and a yeast infection.  This double infection has happened before and I am prone to BV, usually getting it after a new sex partner.  However, I have not had any sexual contact since August 2015 and went to the doctors for the symptoms in May.  After taking the medications I found 3 lesions that were extremely itchy. They also became extremely painful when wiping after using the restroom.  I called my gyno and made an appt.  She said it sounded like HSV but didn't look like a classic herpes sore.  We did a swab test anyway and it came back negative.  Then I went in and did a blood test, also negative.  When I asked what it could be she had no explanation and said to me that the blood test may be a false negative due to being too soon after initial exposure.  I read this on your site too.  However, to me 'exposure' would mean when I contracted the virus, which would be Aug 2015 (if not prior).  The way she explained it to me would mean initial exposure is the equivalent of initial outbreak.  I'm just wondering the validity to this since that, to me, would mean that blood tests aren't reliable unless someone's had an outbreak.  
Terri Warren, RN, Nurse Practitioner
88 months ago
I'm a little confused about this.  So to be clear - you have had no sexual contacts since August of 2015.  And then in May, you had an antibody test done that was negative for both HSV 1 and 2.  Do you know if the swab test was a culture or  PCR?  How long after you noticed the lesions did you have the swab test done?  Were the lesions still fresh? 
IF you were infected with HSV 2 in August, with about 95% certainty, that would have shown up in the blood test.  With 70% certainty, if you were infected in August or before with HSV 1, it would have shown up in the blood test.
Your lesions do sound somewhat worrisome for herpes, but if that's what it is, and it likely isn't given your testing, it would be HSV 1, not HSV 2.  I would say if you get it again, you need to have it swab tested right away, preferably using PCR, the more sensitive swab test.