Oral Herpes and testing?

I was tested in January and June of this year for herpes 1 and 2 via Herpes IGG testing, both came back negative (1 and 2) both times the tests were done.

I have gotten a recurrent canker sore-looking thing on the side of my tongue, and I currently have a sore throat. What is the nature of herpes? I've read so many mixed information on how oral herpes behaves. Does it recur outside the mouth, or inside the mouth? Can you get recurrent herpes only on the inside of your mouth/throat? I have read on some sites that people can get herpes sores on the tongue, throat, inside of mouth...and some sites say that oral herpes only occurs on the lips, face, nose. What have you seen with your exposure through your patients?

I'm just not sure what to believe! Due to my testing, I don't believe I have it...but I want to make sure the lesion in my mouth is due to a canker sore and not something else. All the mixed information is making me question my status, especially with this canker-sore thing in my mouth. I've gotten it twice in 4 months.

My long-term partner is negative for herpes (1 and 2), so if these new lesions in my mouth are due to herpes I have no clue how I could have gotten them! How easy is it to get herpes aside from kissing??

The last time I was tested for herpes was, like I said, June...do you think further testing is necessary? Thank you for your time and responses!

[Terri Warren, RN, Adult Nurse Practitioner]

Herpes rarely occurs on the inside of the mouth only.  With first episode infection, I have definitely seen sores on the inside of the mouth as well as the outside, but I've not seen it on the inside only.  Sores on the inside of the mouth are generally canker sores which are not caused by herpes, though herpes can be SHED from the inside of the mouth.  

The antibody test for HSV 1 misses about 1 out of every 10 cases, so it isn't a perfect test for oral infection.  But that's true not only for you but your partner as well.  And since you've been tested twice and have been negative both times, I think that should increase your confidence in the test results.  

It isn't at all easy to get herpes in/on your mouth other than through kissing.  Do you notice any relationship between the sores in your mouth and what you eat?  I ask, because sometimes people can make that correlation.

In summary, I would believe the test results.

Terri

[k4webm]

Thank you for responding so quickly, and for the information. It's nice to be able to ask questions to a real expert, rather than relying on conflicting articles.

With the antibody testing, is that with all the antibody tests? I believe the test I took both times were Herpes Select IGG. Would that include that test as well?

Do you happen to have any information/experience with herpes of the throat? I cannot seem to find any information on that. Is it likely that someone could get recurrent herpes in the throat? Would it be obvious that there were herpetic lesions there, or could it be as simple as a sore throat? I've also read that intraoral recurrent infections tend to reappear only on the keratinized surface of the mouth, what does that mean?

Since you believe that I would be confident in my test results, I'll leave the further testing for another day.

[Terri Warren, RN, Adult Nurse Practitioner]

Yes, the results that I describe are for IgG testing.  The western blot is slightly more sensitive for HSV 1, however.  

You could certainly have something as simple as a sore throat from some other virus or a bacteria.  And we are seeing a lot of that in the clinic a this time of the year.

Terri

[k4webm]

Great, thank you! I just have one last question, the sore throat that I was having (I was afraid it was due to herpes) looked just like this:

http://i.ehow.com/images/GlobalPhoto/Articles/4760020/110683-main_Full.jpg

Does that resemble anything like oral herpes?

[curious1231980]

Also, if I can add to my last question, how long does it take for a herpes blister to develop and burst? A couple of days? What do the blisters look like?

[Terri Warren, RN, Adult Nurse Practitioner]

I'm sorry, I don't look at pictures from people online.
Terri

[k4webm]

One last question, and then everything will have been answered! I went in yesterday to get a herpeselect test done, and the nurse practitioner who helped me said that the golden rule for testing was 6 months from possible exposure.

I'm confused because I read from your posts and also the cdc website that it's 3-4 months for a conclusive answer? Which time window is accurate? Thank you!

[Terri Warren, RN, Adult Nurse Practitioner]

the vast majority of people make antibody by 4 months, a small percentage might take longer, but not commonly.  

Terri

[k4webm]

I got my test results back and they were negative at 3 months exposure...should I retest in a month to get conclusive results?...or is 3 months enough time to get piece of mind?

[k4webm]

Also, here are my numbers:

HSV1 = .29
HSV2 = .05

I'm just a littler concerned because the last time I was screened (June 2, 2009), my numbers were:

HSV1 = .11
HSV2 = .04

Even though my most recent test was negative for both, my IGG for HSV1 was higher the second time around. Does that leave reason for some cause for concern?? Should I retest in another month to get more accurate results?

[Terri Warren, RN, Adult Nurse Practitioner]

the actual numbers are not important in this case - they are compared to a control value, so they will differ from draw to draw.  I think you are fine.  People who are double negative (no type 1 or 2) make antibody faster, but again, the test is not perfect and we do wait 4 months.

Terri