What Type of Herpes? Had a Swab Test

I asked for a swab test for herpes a couple of weeks ago, despite a visual diagnosis from the examiner that I certainly wasn't displaying herpes symptoms.  Well, the lab called to tell me it was positive, but they never indicated the type. I didn't think of it until speaking to my partner -- who I believe I got it from -- and he mentioned that he gets lip cold sores on a regular basis (and that he never had any genital herpes symptoms, nor did his last girlfriend who he was with for four years). A couple days before my symptoms appeared, I was freshly brazilian waxed and received oral sex from him, which I've read can be a recipe for disaster if he is hsv-1 positive, so it really makes me wonder. Anyway, he will be going in for a blood test -- as will I -- but can a swab test not tell the type unless they look for it? (The gyn I've seen since told me "it doesn't matter" which type I have, but I disagree.)

[gracefromHHP]

indeed type does matter very much!  Your provider needs to improve their knowledge of herpes as well as how they educate their patients!  You and your partner can't make educated decisions as to what precautions to take until you both know who has what as well as knowing what type you have is important for deciding how to treat your herpes long term too.

at this point it's probably too late to ask the lab to type your culture. they do keep them frozen for a certain amount of time after the test is done but if it's been a couple of weeks, odds are they no longer have it. Your provider should familiarize themselves with the CDC herpes guidelines which recommend typing of herpes so that they start ordering typing of infections automatically when they do cultures. they are doing their patients a great disservice and delaying proper diagnosis as to type by not doing so.

You'll have more information once you and your partner both get type specific herpes igg blood tests this week to see who has what and go from there. I can help you with test results once you have them too.

grace

[Katka126]

I'm going to call the lab Monday when they are open to find out if they tested for type -- perhaps they did test for both and just didn't specify on the phone? It seems that the viral culture can definitely distinguish, and I wonder if its something they check automatically and is obviously apparent when they grow the culture. I've never read of someone getting a positive swab and then needing a blood test later to confirm the type.

I've just read about these antigen tests, but it sounds like doctor's offices don't do those, am I right?

Its just driving me crazy that they said it came up "positive for herpes" because that's really not helpful. Or maybe the default assumption is hsv-2?

[Katka126]

Wow, apparently there are a few different types of swab tests and not all test for type. I wish I knew which one the lab used!

[gracefromHHP]

correct - they don't automatically type it unless it's ordered to do so.  It's typically only a few extra dollars to order the culture typed compared with having to have a patient come back months later for type specific herpes igg blood testing and charging them another $100-$200.  

if you weren't told type, odds are your culture wasn't typed which is why the 2 of you getting type specific herpes igg blood tests is the next step for you both.