Does genital herpes show up in a PCR blood test when the virus is inactive?

I should have clarified, but a pcr test looks specifically for viral dna, hence why a pcr blood test is useless for testing routine genital herpes in healthy, immunocompetent individuals. Antibodies to the virus are present in blood, however, hence the IgG antibody test (not IgM - unreliable for herpes).

Hello, i recently had a swab taken from a sore on my lip which looked as if it was herpes which appeared 3 days after giving oral sex and was confused to find that it came back negative for both type 1 & 2 , i was wondering if i should go to my gp and get a blood test taken looking for antibodies as i have been with this person for 9 months now and its not the first time i had this sore appear when giving oral sex to him the last one happened 7 months ago.

If the sore was new when swabbed, then the swab test should be reliable. However, you can do an IgG test (not IgM) for herpes if you're still concerned.

Thank you for your help, i went to get it swabbed the day it appeared but will get the igG test done just incase

In your initial reply to titus79916, you said that a PCR blood test is unreliable for genital herpes, regardless if the person is having symptoms or not. Is this true of a PCR blood test for an HSV-1 infection as well? Will a PRC blood test detect HSV-1 only when symptoms are present or will it not be useful at all?

Oral Type 1 does not always cause symptoms, not even following new infection. You could well have acquired it orally, too, just asymptomatically. I guess the genitals are more sensitive to outbreaks.

But possible it's only genital as well, for whatever reason. Sometimes herpes is rather random!

Thanks for your reply. It really is very random, if you don't get it from someone you can be the carrier and we never know who has it and who just doesn't know! All very mysterious and is enough to put me off sexual contact altogether. Although it's too late now but I don't think I'll ever relax now knowing that I can pass this on in the future.

If you have genital Type 1, the odds of sexual transmission are actually quite low, especially once you have produced sufficient antibodies (usually 4-6 months), plus many people already have oral Type 1 (whether with or without symptoms), which in theory should protect them from acquiring it again elsewhere. Type 2 is different.

Thanks, they did a swab on the lesions and took secondary blood tests to test specifically for herpes 1+2 both came back negative as I said in another chat. I went within 48 hours of them developing, so they had just formed really I suppose, I don't know what to do now as I could possibly still have herpes 1 which is what they think it might be visually, my sores are all healing up now just redish areas remain is there a way to post photos?

Types 1 and 2 look identical, I'm afraid, so unless you only had oral sex recently, it's hard to say which by just looking. You can redo the IgG at 3 months to find out which it is, as you should have antibodies by then, assuming your first diagnosis was correct (that it's herpes). These days, especially amongst younger posters on this forum, Type 1 seems to be more common, though. Did your swab test negative as well, despite having new lesions?

Yes the swab tested negative too. The health advisor that gave me the results said that if a swab is taken too late it can be negative even though you have it but mine was taken within 48 hours of symptoms and the sores were new. I think I'll wait the 3 months and go back to my GP for another blood test, just to be sure. I thought hearing negative to both tests would be a relief but I dont feel that way.Thanks for the advice.

Once you have herpes, it is for life. The types can be distinguished by swab if lesions are present (pcr swab is more sensitive and accurate than a viral culture swab). Without lesions to swab, you can do the herpes IgG antibody test (not IgM - unreliable for herpes), ideally after 3 months from exposure/infection.

Okey will try to find a hospital that does that test. Thank you very much for all the information and advice FelisCatus, much appriciated .

How are HSV-1 and HSV-2 different in practice? Do they differ in anything in practice - especially during child birth? I  tried googling but none of the links I found told me how they differ in practice, if in any way.

If genital herpes is shedding with no symptoms during child birth can it still contract to the baby? Or there has to be sores for the child to be able to get it?

Lesions/sores increase the risk, as they are associated with increased shedding, but shedding without symptoms can also be risky during natural childbirth (and sex with an unaffected partner). It is more of a risk to the baby if the mother contracts herpes in the final trimester, as no immunity may have been passed to the baby in utero and shedding is worse for new infections. The risk can be reduced with daily suppressive antiviral meds or C-section.

There are notable differences between the two herpes types. While they look and progress the same way during an outbreak, Type 2 is known to asymptomatically shed and recur as outbreaks more often, is more infectious as a result, and increases the risk of HIV acquisition (if exposed), even without lesions/sores. Type 2 strongly prefers the genitals. Type 1, though milder and less infectious when contracted genitally, is less choosy as to where else it can infect in those with new, non-established infections or no prior Type 1.

Thank you, very informative. I've had oral herpes outbreaks since I was a child, so that probably means I have at least hsv-1 then? Is it possible to have both hsv-1 and hsv-2 viruses in your body, one in the face area and one in the genitals? I'll go get tested next week for which type(s) I have via the iGg antibody test and wanted to prepare for how to handle the results.

If you have had cold sores as a child, you should test positive for HSV-1 by IgG. It is possible to have both HSV types, yes. In some people, existing HSV-1 can cause an equivocal or low false positive result for HSV-2 by HerpeSelect, which is the main IgG test used in the US. If that happens, don't be alarmed. For definitive results, there's always the western blot via the University of Washington, but that is rather costly. Hopefully you will get a clear negative, so no need to seek further testing.

Got my results from IgG test. Tested positive for both HSV-1 and HSV-2 antobodies. Should I get a second test just to be sure? They didnt specify what sort of test it was (outside of the US so not as scientific). 

I have a partner Im sexually active with who has had genital herpes symptoms once, a year ago, went to hospital and was then diagnosed with genital herpes. Treated it and has not had symptoms since. Ive never had any genital herpes symptoms. I assume I should take my partner to get the test as well just to be sure?

Is there a difference in having both HSV-1 and HSV-2 instead of just having HSV-2? If she tests positive for HSV-2 as well what sort of steps can we take to prepare for a safe as possible child birth (not pregnant yet, but planning some time in the future)? 

I live in an Asian country where healthcare is not as effecient and a doctor might have roundabout answers just to "save the patients face". Extremely annoying concept when all you want is pure concrete information and advice on what to do :p

You should be able to ask for a copy of your lab report and the brand name of the test they did. That would be useful and can determine whether further testing is warranted. I am confused, however, because in your original post you said you did have genital symptoms, and now you're saying you didn't, only your partner.

If you are planning on a baby at some point, yes, your partner should get tested to see which type(s) she has. She already has at least one type genitally, probably Type 2 if you definitely have that, in which case she should consider a C-section delivery, otherwise antiviral meds in the last trimester. This needs to be be disclosed and discussed with her obstetrician when she's pregnant, even if it turns out to only be Type 1.

If she luckily only has Type 1 and you have Type 2, then you must ensure she doesn't get it while trying for a baby, especially once she becomes pregnant. Find out your lab results and test brand. If a clear positive for both, and she's negative for Type 2, then you should go on daily suppressive meds.

Thank you for response. Sorry, I was unclear on the original post, Ive had oral herpes symptoms in the past but have never had any for genital herpes. My gf had genital herpes symptoms in the past one year ago (and was diagnosed as positive at the hospital) but never since. I just assumed Ive had it too but without symptoms and wanted to check with a test finally, sorry I should have been more clear on that.

The name of the test was IgG antibody test. The brand of the test was "National Healthcare System" or "NHealth" - according to the doctor. I have a copy of my lab report, it says SV (IgG) Ratio is 2.55. In this test below 0.8 is negative, 0.8 to 1.1 is borderline and above 1.1 is positive. According to the doctor I tested positive for both HSV-1 and HSV-2. I can ask for more information if required. 

Is there need for further testing? I was thinking of maybe going to a different hospital and get the IgG antibody test together with my gf. Would be good to know which type(s) we both have reliably.

That brings me to ask, how reliable are these blood tests in general? I read that the only absolutely reliable way is to get it from a swab, and that blood tests might easily give false positives and are not recommended for normal testing, but I have no way to confirm how true that is. Seems like it might be a while until getting a swap test is possible given that Ive never had noticeable symptoms and my gf had them only once, and never since in a one year period. Seems like its re-occuring at a very slow rate, which is obviously pretty nice :p. I read the median rate for genital herpes outbreaks is four times at a year, with a decreasing rate over the years as time passes, but given that during the first year since an outbreak it has only happened once Id assume its not a very often re-occuring happening.

Seems like for us its a slight irritation and inconvenience at most, and honestly most of the harm is done on the mental side, but the more I read about it the better and more normal I feel. I never knew chicken pox is a type of herpes! :p Seems like information is the best weapon we have against this virus. But for childbirth seems like we should gather more information than we currently have as it will affect the procedures during and before labour. Thanks for all the information again, duly appriciated.

Seems like the previous brand of test was the name of the company who provided the lab test. From this companys website I found the following information regarding HSV IgG antibody tests:

Test name: HSV IgG Code: P745 Method: ELISA Sample: Serum 2 mL Temperature: 2-8 ºC TAT: 5 days  

 

Test name: HSV IgG IFA titer (CSF) Code: P789 Method: IFA Sample: CSF 1 mL Temperature: 2-8 ºC TAT: 5 days   

Test name: HSV IgG IFA titer (serum) Code: P697 Method: IFA Sample: Serum 1 mL Temperature: 2-8 ºC TAT: 5 days

The one I used was the first one. 

Hmmm, I've not heard of that test brand, so don't know how good or reliable it is, but at least it's an IgG test. IgG is the best test available without symptoms, unless you are willing to splash out and are able to arrange a western blot test from where you are with the University of Washington specifically (the US-based clinic Westover Heights can assist with international testing arrangements).

I would probably get tested again with a known IgG test brand, if you're able to. HerpeSelect is the main one used in the US, while EuroImmun is possibly used more in Europe (German brand). Either or both may be available where you are, if you ask around.

EuroImmun claims not to cross-react as its Type 1/2 tests look for completely different type-specific IgG proteins (c1 & g2). The two HerpeSelect tests, however, look for the same albeit type-specific IgG protein (g1 & g2), hence why I believe it may occasionally cross-react. I've also read that some people may have unrelated proteins in their blood that resemble the ones being tested for.

But such cross-reactions do not cause significant false positives, only relatively low false positives or equivocal results. Most people in that situation who are desperate to know their status usually go for the $$$$ UoW western blot. Where that's not possible, I guess when it comes to new partners or pregnancy and childbirth, it's safer to assume such a positive as being true, until if and when proven otherwise.