Can an HSV-2 Carrier Test Negative?

[JonQDoe]

Hello Terri,

Approximately 12 weeks ago my former partner and I went our separate ways. We were together for approximately 2 years. In July 2013, she was diagnosed via lesion swab with HSV-2 during what she stated was her first (and only) herpes outbreak.

My former partner was adamant that she did not have HSV-2 prior to engaging sexual contact with me and that she had not had sexual contact with anyone else since our first time. Her infection must have come from me. Therefore, I must be a carrier of HSV-2 since I had never suffered an outbreak or experienced any noticeable symptoms. However, I was tested at that time (July 2013) and the blood test came back negative for HSV-2.

This week, I had another full panel screening done. Again, the results came back negative for HSV-2. Here is the information provided in results:
HSV 2 IgG – result: negative, Index <.91

Here is my question: Is it possible that I am a carrier of HSV-2, and infected my former partner, yet have tested negative on two separate occasions for antibodies?

I have not had sexual contact with my former partner since January 10, 2015. I want to confirm that I can trust the test results, especially given that my former partner and I often had unprotected sexual contact. I have researched online and found that false negative results can occur in cases where the initial infection happened recently because the body hasn’t yet developed antibodies. However, I haven’t been able to find anything definitive regarding my specific situation.

Thanks for your help,

JQD

[Terri Warren]

I’m curious about why your former partner was so absolutely certain that she did not have HSV 2 prior to her relationship with you? Did she have a negative antibody test prior to having sex with you? Did she possibly have a negative antibody test at the time she had the positive swab test? I’m thinking, if neither of those are true, that she had HSV 2 before she met you. The screening test that you had done picks up about 97 out of 100 cases of HSV 2.

There’s really no such thing as being a carrier of HSV 2 without being infected.

The most certain test is the herpes western blot if you feel the need to be more certain than 97 out of 100 cases. What are your thoughts?

Terri

[JonQDoe]

Thanks Terri for the quick reply.

According to my former partner, her medical history included annual full panel screenings which included HSV1/2 tests. This was a standard part of checkups with her OB/GYN. These tests had always come back negative in the past. This was the basis of her certainty that I am the one who infected her. I had never had a screening or test of any sort prior to learning of her positive swab test. She also got a blood test to confirm the swab test which came back positive for HSV-2.

I’m definitely not saying that I trust my ex more than the science, I’m just wondering if there is any margin of error in the science of the testing. I think that western blot sounds like a possible alternative for me so that I can know for sure. Can you give any information on approximate cost and availability of this test? Is it a different type of blood test? The most important thing to me now is to know whether or not I could potentially put future partners at risk.

[Terri Warren]

So she may be confused about what was included in her testing. Was her HSV 2 serology positive at the time the swab was taken? If yes, then it was NOT her first infection/outbreak. When you have your first infection, you have no antibody because there is virus on the skin but not enough time has gone by to have made antibody. Does that make sense?

I think I provided the statistics on the sensitivity of the screening test that you had done – it picks up 97 out of 100 cases. The western blot is better.

We can order the test for you to be drawn at Quest near your home. The cost for the consultation and test is $250. It is a different kind of blood test, yes, it looks for the whole range of proteins associated with the HSV 2 antibody vs. the screening test that only looks for one protein that is different between HSV 1 and 2.

You are clearly trying to do the best you can and I can understand how you would be confused by this situation.

Terri

[JonQDoe]

Thanks again Terri. I don’t remember the exact timing of my former partner’s blood test. I’m sorry, those details are not clear enough I’m my memory to answer with certainty. I would, however, like to go ahead with the western blot.

Thanks for your help!

[Terri Warren]

No worries about the timing, just curious.
Anyway, we can help you set up the western blot. I believe we can do the consultation on Tuesday of this coming week and you can have the bloods drawn on the following Monday.

Terri

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