#1. I understand you said that many of those infected with HSV1 are asymptomatic and so do not get a primary outbreak but I have also read that it is more common that not that a new genital HSV1 infection results in a primary outbreak. What is your expert opinion on this information?
I would agree that more primaries with HSV 1 are symptomatic than first episode infections with HSV 2 in a person with prior HSV 1
#2. And, just to clarify, you’re saying it’s possible that I contracted HSV1 orally as a child (my parents both have it) and only get a recurrence as an adolescent/young adult? Do you see this often? Is it common to have an antibody count of 20plus and only been infected several years prior?
yes, that is possible and I certainly have seen it. and yes, that number could easily represent an old infection
#3. Is it common for someone to have contracted both HSV1 orally and genitally at the same time, or autoinnoculated, shown initial symptoms for only one location, and then had a HSv1 reoccurence later in a different location?
That is possible and pretty common.
#4. Is it more common to be a symptomatic HSV1 oral carrier than an asymptomatic one?
More common to be asymptomatic
#5. I have read that ELISA testing has a 97% sensitivity and a 98% specificity for HSV2. How does this relate to the 92% accuracy of the HSV2 negative result you mentioned? I think I am missing something.
Those number are comparing apples and oranges. In the sensitivity reported by lab kit makers, they are comparing the sensitivity of their test to people who are know to have positive swab tests for herpes. Our study, with the other numbers, is in a screening population – very different.