Reply To: Conflicting Test Results & Unsure Symptoms

[Carmen]

Hi Terri,

Thank you for answering my questions. I have a few more in follow up.

If I have oral HSV1, I guess it’s a possibility that I gave genital herpes to the guy from Jan 2014, or any of my previous partners. That is an eye opener for sure, for which I feel bad about. How likely is it that I could have given someone HSV1 genitally when I didn’t have an outbreak at the time, especially if I hadn’t had one for years? I understand the possibility of shedding, but how often does someone with oral HSV1 shed?

Is it possible to have HSV1 and HSV2 orally at the same time, or does having HSV1 orally stop one from acquiring HSV2 orally? And if I have HSV1 orally, does this prevent me from getting HSV1 genitally?

Regarding the accuracy of the type-specific test, you mentioned that it misses 1-2 out of 10 HSV1 infections. I interpret this to be 10-20% of missed infections, or that it catches 80-90% of infections; am I interpreting that correctly? With the type-specific test I had having a sensitivity of 99-100% for HSV-1 and 97-100% for HSV-2, and a specificity for HSV-1 reported to be 93-95% and 94-98% for HSV-2, wouldn’t this mean that it catches 99-100% of HSV1 infections, or that it would miss an HSV1 infection 0.01 out of 10 times? And the likelihood of it missing an HSV2 infection would be greater since the sensitivity is lower? Is the 1-2 out of 10 of missed HSV1 infections that you mentioned linked to the sensitivity or specificity, or both combined? What impact does the specificity have on a negative test result? I’m just looking to better understand how to interpret the accuracy test of the test I had.

When a person has an outbreak, does the outbreak always appear the same every time, or is it possible or common for it to appear differently from outbreak to outbreak? For example, the rash on my upper lip versus the small sore inside my lower lip.

I would be interested in having the Western Blot test done. I understand that my options for doing this, since I live in Canada, are to go to a nearby clinic in the US, or to order a kit (through your clinic or the University of Washington) and have the blood drawn through my doctor. Should I arrange a phone consultation to determine the best option and process?

If I’ve asked too many questions here to qualify for the initial cost of posting, and I need to purchase additional questions, please let me know.

Thanks again for helping me sort this out.