HSV-1 positive culture neg blood tests.

[Myshell216]

I recently made a mistake and had unprotected sex oral and vaginal. A week or so later I had one very small red bump near the opening of my vagina.  It did not hurt or itch. I did have a fever, but I was also very sick with a respitory infection. I was due to go in for a pap smear and STD screening the next day(A Friday).  My doctor looked at it, said it resembled a small blood blister but that she would swab it to be safe.  The next day I had two more new bumps but these were different and the original one had changed.  A three where not near each other, only one had mild discomfort and all were very small.  They looking like I had a layer of dead skin on them.  The next day there were red and very hard to see, by Monday when I got back in they were almost gone, they never scabbed over.  They were so small my doctor couldnt even see them.  She swabbed the areas I was talking about.

A few days later my first swab came back positive for HSV-1.The person who I had unprotected sex with is the ONLY person I have been with in 9 months.  Prior to this new partner I was in a LTR and had never had any signs or symptoms.  I told my new partner about this and he said he has not had signs or symptoms but that he had had unprotected sex about two months prior to me.  We both decided to go in and get blood tests.
All his tests came back negative.The next day my blood tests came back..NEGATIVE.  The second swabs came back negative.

1. I know that cultures are usually right but could have something gone wrong
2. I am going back in two months to get retested and so is he.  Could we both be newly infected and thats why we both are still negative
3.  Should I still be worried this could be my ex from 9 months ago?  We were together 10 months.
4. What if he/we are still negative in 2 months? What if only one of us comes back positve. He is now convinced its not him but since I have no antibodies who else could it be? How would my body not make antibodies after 9 months???

[Terri Warren, RN, Adult Nurse Practitioner]

I think that's a good plan, but be sure you wait long enough to test with western blot.  It isn't a great screening test, I would wait at least 4 months before getting a western blot drawn.

Terri

[Myshell216]

Too much confusing information.  I thought the test just missed 1 out of 10 people, not that 1 out of 10 people didnt have enough detectable antibodies.......I am thinking that if I come back negative again I may try the Western Blot test i have been reading about.  Thanks again, I would like to keep you updated not only for me but for other people that may come into my situation which seems a bit out of the norm!

[Terri Warren, RN, Adult Nurse Practitioner]

Remember that if your antibody test does not become positive, then you aren't one of very few who don't develop antibodies detectable by this test - the number is really one out of 10 people don't.  
Do let me know how this goes, if you like, with further testing.

Terri

[Myshell216]

It's weird to say but I hope it is positive the next time I go in for some peace of mind. Until then I am going to keep educating myself (and friends).  I would be surprised if I am one of those very few that don't develope antibodies!

I am just glad my symptoms seem to be very mild and hopefully will continue to be.

Thanks for your help, I will update this posting after my next set of blood work.

[Terri Warren, RN, Adult Nurse Practitioner]

I think if you seroconvert in 4 months (and are negative now), then you can be clear where and when you got this.  If you remain negative on your antibody test 4 months from now, you will not be able to be clear about where you got your HSV 1 infection.
'
Terri  

[Myshell216]

Thank you.  I do believe the swab.
My Clinician was actually suprised by the negative results of my blood test and even though she can't say for sure believes I was newly infected as she feels I should have enough antibodies by now to be detected. (9 months or more)
For me the whole thing is just to much of a coincidence.  From what I have read people get some signs 2-18 days after infection. That falls in perfect with this new person.
Unfortunatly I think he is going to be difficult about being tested from this point on since his blood test was negative he is "convinced" he doesnt have it and is actually angry with me that I want him to test again a few months from now.  Honestly in my head this has to be him because everything just fits to well.

Lets say I do test positive in a (3-4) months...wouldn't it be also be weird that after being with this person I get symptoms, then down the road test positive if it were a long standing and not new infection? (my reasoning being that everything fits from symptoms to the time it shows in my blood etc)  I just really would like to know when this happened for sure.  My clinician thinks recent but I guess I will never be sure?? I just need to know who to inform that I could have possibly infected too (my ex).  It's just so mentally draining.

[Terri Warren, RN, Adult Nurse Practitioner]

Hmmm.  I can see why you are confused.  First, I would believe the culture.
The antibody test for HSV 1 is only 90% sensitive - that is, it misses 1 out of every 10 infections, so this could be true for either of you.  HSV 1 is very often transmitted to the genital area through receiving oral sex from someone who is infected orally.  A cold sore doesn't need to be present for this to occur.  
It is possible that he was newly infected a few months ago and has not yet become antibody positive and recently infected you.  Or it could be that the test is just missing his HSV 1 long standing infection.  It is also possible that you have long standing infection and the test missed yours or that you have new infection and you had no antibody present because you had new infection.  If you do have longer standing infection, it could certainly be from your ex partner, yes. It could also be from any sexual partner prior to that.
The problem is that you are dealing with a test that misses a significant amount of infection, so trying to sort all this out is going to be a challenge for sure.  Still, if I were your clinician, I would tell you to believe the results of a swab test that was taken from a suspicious area of skin.  
You can certainly retest in a few months (I would wait four) and see what shows up in a repeat antibody test for both of you, but for now, I would believe that you are infected with HSV 1 and that he may or may not be, still an unknown.
Terri