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Negative HSV test due to a "local" infection?

I've had Herpes-like symptoms recurring in my genital area for over 1,5 years after an sexual encounter. So i have had 3 blood tests done during this time: first after 8 weeks from possible exposure, second after 11 months from possible exposure, and last of them was done last month, 1,5 years ater possible exposure. The type on the test performed to my understading was ELISA that didn't differentiate between HSV1 and HSV2. And that didn't really matter because the result was negative everytime, meaning - due to the general guidance, that i am HSV-negative altogether. Right?

But: the infectious disease specialist i saw, said that if the infection is local, the body doesn't produce antibodies to be detected in a blood test. That is somewhat confusing, because i thought that most of the herpes infections are "local" and not systemic? If my doctor is right, that would mean that all the general info about herpes blood tests and their accuracy in diagnosing herpes, oral or genital, was wrong or at least very misleading.

So, is it really so? Of course i asked my doctor this : Isn't herpes almost always local and not systemic, meaning it presents itself as a sore or a blister on lips or genitals? And why are antibody tests then used and recommended fo diagnosing that type of HSV-infections if the body isn't really likely to produce antibodies to be detected?

Answer was that the body produces antibodies to be detected in blood mostly if there is, for example, mouth full of blisters - but not if there is, for example, one blister on a lip?

This goes against pretty much everything i've read about diagnosing herpes via blood tests and the reliability of them in doing so.

I understand that false positives and false negatives do happen but do they really happen that way? And if they do, wouldn't that mean that most of the negative blood tests for HSV (when there is a reason to believe in a possibility of being infected) were actually false negatives, if it really is that Unusual for the antibodies to be produced in a way that could be detected in a blood test if the infection (like most of the HSV-infections?) is local?
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Avatar universal
how long do u have a nerve test ?
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No i haven't had one yet. But i will when i present clear symptoms on skin.
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They said not herpes from blood test. Did you have swab test before ?
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Well i think it is possible to keep multiple possibilities open at the same time? No reason to settle down to herpes speculation only. Of course herpes is one of the possibilities. But what can be done? If the blood tests are not accurate enough to rule out herpes, then a PCR swab should be taken from a suspected herpes lesion. And if it turns out to be negative, then it can be repeated - and at some point, if everything has continuously turned out to be negative for herpes, it must be accepted that it isn't likely to be herpes. And then, if not earlier, it would be reasonable to concentrate on other alternatives and consult different doctors from the fields of dermatology, urology and neurology - and, although i'm not a flag-bearer for psychosomatic explanations at all, some kind of psychological consultation could be beneficial for some people at least in trying to tolerate those symptoms without a known cause.

What has your own doctor said about your set of symptoms - does he think it is likely you have herpes? (I assume you have discussed this with your doctor since you've had blood tests done)
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Yes sorry the nerve pain. The problem is the blood test not accurate to let us move away from herpes problem.
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I don't understand what you mean by "nerve test"? In case that was just a freudian slip and you in fact meant "nerve pain", then yes - i think that herpes isn't the only thing that can cause nerve sensations. But herpes is one of those conditions.
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