Herpes Blood Tests Accuracy

[JHCC]

How accurate are blood tests for herpes? I have taken two blood tests four months apart, and they both came back negative. What are the chances of that happening and still having herpes?
I will explain. In September I began dating a girl and we had unprotected sex. Shortly afterward, I came down with a fever, aches, swollen lymph nodes, and my penis swelled up. But I had no visible lesions, rashes or marks. My doctor initially thought it was a herpes outbreak. We did a blood test about 10 days after the exposure and it came back negative. We then repeated the blood test four months later and it came back negative again.
I have been in a monogamous relationship with the same girl since September. She has also tested negative and has no symptoms.
In the last few weeks I have broken out with 4 or 5 lesions  at the base of my penis. They are not painful, but they are red with white in the middle and scab over. I went to see a dermatologist who took swabs and now I have to wait 3 weeks for the results.
What are the chances that my two blood tests taken 4 months apart didn't catch the herpes? Is this common?

[JHCC]

I think they are doing a culture actually. Why is this less accurate? I went to get the swab about a week after the symptoms occured. I just couldn't get an appointment sooner.
But I'm just so frustrated and confused when I have all these persistent negative IGG tests, yet have physical symptoms of herpes. Is this common?

[Terri Warren, RN, Adult Nurse Practitioner]

If a dermatologist said he thought it was herpes, that's a bit concerning.  However, research says that 1 out of every 5 times a clinician looks at something and calls it herpes by exam only, they are wrong.  That's why we have lab tests.  
I would await the swab test results.  I can't believe it would take three weeks, that makes me think they are doing culture and not the much better PCR test.  Might check on that.  And if it is positive, be certain that they request typing of the virus.  how soon after the symptoms came up did you go in for swab testing?
Unless the swab test is positive, I would go with the antibody results.

Terri

[JHCC]

Thanks for your response. I'm trying to garner as many opinions as possible. Judging by the pics of molluscum contagiosum, it's difficult for me to tell -- but I would say that my lesions are larger and not so raised.
I'm very stressed and frustrated. Since my initial post, I've seen a urologist and a dermatologist. The urologist thinks I do not have herpes (based on my consistent negative IGG tests) but the dermatologist thinks I definitely do have herpes (based on his inspection of my lesions). From someone with your expertise, how rare is it for someone to have consistent negative IGG tests and yet still have HSV?

I have been tested three times in the past 12 months. In the past 6 months I have been in a monogamous relationship with a woman who has no symptoms and negative IGG tests. Here are my results:

Jan. 2011:

HSV 1 IGG Herpeselect AB       0.08        0.00 -- 0.89
HSV 2 IGG Herpeselect AB       0.10        0.00 -- 0.89

Sept. 2010: 

HSV 1 IGG Herpeselect AB      0.21          0.00 -- 0.89
HSV 2 IGG Herpeselect AB      0.27          0.00 -- 0.89  

April 2010:

HSV 1 IGG Herpeselect AB     0.27           0.00 -- 0.89
HSV 2 IGG Herpeselect AB     0.10           0.00 -- 0.89

  




Thanks for your response. I'm trying to garner as many opinions as possible. Judging by the pics of molluscum contagiosum, it's difficult for me to tell -- but I would say that my lesions are larger and not so raised.
I'm very stressed and frustrated. Since my initial post, I've seen a urologist and a dermatologist. The urologist thinks I do not have herpes (based on my consistent negative IGG tests) but the dermatologist thinks I definitely do have herpes (based on his inspection of my lesions). From someone with your expertise, how rare is it for someone to have consistent negative IGG tests and yet still have HSV?

I have been tested three times in the past 12 months. In the past 6 months I have been in a monogamous relationship with a woman who has no symptoms and negative IGG tests. Here are my results:

Jan. 2011:

HSV 1 IGG Herpeselect AB       0.08        0.00 -- 0.89
HSV 2 IGG Herpeselect AB       0.10        0.00 -- 0.89

Sept. 2010: 

HSV 1 IGG Herpeselect AB      0.21          0.00 -- 0.89
HSV 2 IGG Herpeselect AB      0.27          0.00 -- 0.89  

April 2010:

HSV 1 IGG Herpeselect AB     0.27           0.00 -- 0.89
HSV 2 IGG Herpeselect AB     0.10           0.00 -- 0.89

  







 


 

[Terri Warren, RN, Adult Nurse Practitioner]

I think the chances are high that you are truly negative.  When you say they are red with white, have you looked at any pictures of molluscum contagiosum?  Check that out online, and see if it might look similar.  The other issue here is that the antibody test for HSV 1 picks up 9 out of 10 cases (HSV 2 much higher), so its possible for the test to miss the infection if it is HSV 1.  If you ever get another lesion, it is best to have that swab tested immediately for the most accurate answer.

Terri