I have had 8-10 timely (within 24-48 hrs) cultures for genital HSV over the last 18 years. All negative except one when I was pregnant (18 years ago)--3 days before I gave birth. I was in the hospital in labor, but it stopped. That's why they cultured me, not because I had a lesion--there was nothing there. I did however, feel a cold sore coming on that day and have had them since childhood. A week later they called as said the culture was positive, but after many years I eventually stopped worrying about it because so many other cultures with symptoms were negative. I do not recall an "initial episode" and my symptoms are always very mild. And multiple (4-5) significant others over the last 17 years have never shown symptoms, although they could be asymptomatic.
I'm well read now on the percent of population affected for HSV1&2, asymptomatic shedding, risk of transmission, etc. I'm in a new relationship and had a mild OB over Labor Day weekend and could not get a culture because of the long weekend. I decided to get the blood test for the first time on Sept. 2. Doc scripted for the IgM test so I went back and had her scrip for HSV Type 2 spec, as well.
Results from LabCorp:
HSV, IgM I/II Combination <0.91 Ratio
HSV 2 IgG, Type Spec 2.56H Index (I do not know if this was HerpeSelect or the test they are switching to)
Unfortunately, we did not do a type specific test for HSV 1 even though I am sure I have it orally.
Partner was tested on 9/11 and sent brief email on 9/17 saying his results were "fine" (I don't have the specific test types or numbers yet). We've had unprotected sex twice. Once 3 weeks before his testing and once 5 weeks before his testing. I realize the risk of transmission to him from those two times is extremely low; I had no lesion either time, but that he might want to retest in a couple of months to be sure.
My core questions are regarding the posts here about how being positive for HSV 1 can sometimes elevate the risk for a false positive HSV 2 if that result is under 3.5. I believe I'm in the 50/50 category as far as chances for a false positive?
1. Should we both get the HSV 1 IgG Type Spec? (He says he's never had a cold sore, I get a couple a year)
2. Why would my IgM, as unreliable as it it, be definitively negative, esp. when I know I have oral herpes AND the HSV 2 test was positive?
3. Should I get the WB or BioKitUSA test for HSV 1 & 2 for a definitive answer?
4. I am seeing an ID specialist next week, and he knows my results and will do additional blood work--I'm assuming either the BioKit or WB.
5. In addition to the WB or BioKit test, should I have future oral and genital outbreaks cultured for type specific HSV 1 & 2?
My partner is relaxed and understanding, thank goodness, but I would like to know for certain if either of us has HSV 1 and/or 2 so we can better plan our sex life and understand his risk, as well as informing potential future partners accurately.
I sincerely appreciate your response.