This is an interesting case. I would personally trust the PCR swab test as well. A PCR taken from a lesion (as opposed to just blindly swabbing the genital area for some reason) is virtually certain to be accurate. And the tests used to do the typing both confirm that it is herpes and, with great accuracy, sort out the type.
The antibody test for HSV 2 picks up 96-100% of the cases, depending on the study, in a STD clinic and/or OB population. That means there are a few cases where HSV 2 antibody is not detected in a swab test positive person. We have certainly seen these folks in our clinic as well. Also, you may just need a bit longer to become positive on the antibody test. You could also try being tested with the western blot antibody test through Quest labs. However, regardless of the antibody test results, I'm with your doc - the PCR swab test from a lesion is very accurate and should be relied upon as the accurate diagnosis.
Terri
Both the PCR and the western blot should be covered by insurance. I think there might be something wrong with the billing if it wasn't covered, or, perhaps it went into your deductible. I would check on that carefully. High numbers would more likely be present with old infection than new infection. But we certainly can see people who have long established infection with low numbers. In general, the numbers are not very useful by themselves.
If you've not had symptoms and are truly infected, then you are asymptomatic
Terri
Thanks for your response and advice. I have some additional questions -
1. Is the western blot test covered by insurance? I had to pay $300 that insurance didn't cover for the PCR. Everything I have read about it on the net states that it is expensive.
2. Do "high numbers" on positive antibody tests indicate a new or old infection?
3. Since I have not had any breakout since Sept and none before that that I am aware of, could I be assymtomatic?
Thanks again.