The index value has nothing to do with whether you have a lesion when the blood is drawn. The index value tells you that this is certainly not a new infection; it is a long-standing infection, whether you recall symptoms of a cold sore in the past or not. This represents a history of cold sores, in your case. I don’t think for a moment that your genital symptoms are related to HSV 1.
First, once you have an oral infection, it is highly unlikely that you would subsequently acquire it in a new location. Second, HSV 1 would definitely not cause symptoms for so long. It is normally a quiet infection with short infrequent recurrences. So, I don’t know what is going on here.
Terri