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Different Types of Swab Tests?


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I recently realized that there are many types of swab tests (viral culture, PCR, etc.) and that not all distinguish type. Viral cultures, even, don't necessarily test for type unless certain steps are taken by the lab to do so, and it takes several more days to yield type (as opposed to just 1-2). PCR is the gold-standard and gives type, but is supposedly expensive, and rare for that reason. And there are other ones, too, and those don't test for type either. Its sounds like its a matter of how the doctor orders it and how much money and time the particular facility feels is worth spending, from what I read.

This all occurred to me later, since the lab only said I was positive for herpes. Maybe "herpes" is default language for hsv-2 but I can't assume (I did at first, because of where the infection shows up, but HSV-1 is so common, and the guy who gave me the virus has a regular cold sore problem). Plus the NP who did my exam thought I was crazy to think I needed a swab (minor symptoms) so I wonder if she didn't demand something more rigorous. But I have no idea how doctor's offices or labs work. Anyway, I feel like in everyone's story I read the person was given their type, so it seems odd to me that I wasn't told specifically. Right?

...(Of course, I will call the lab on Monday, but I can't help but obsess until then. If they don't know the type, I am running off to get a blood test.)

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I am having issues with typing. I am super frustrated by unreliable tests at the moment and how dismissive the Drs are.

I got genital herpes from somebody with visible cold sore on there lips too. I have had 2 tests recently. The western blot (blood test) that says HSv-1 only...which makes sense given how I got it. And a PCR of a lesion which says HSV 2. I know that given the number of outbreaks I've had it would be impossible to have no HSV 2 anti-bodies. So one of those tests is wrong. I am PO'ed with the Dr and the nurse I'm currently dealing they both say--no big deal you have herpes, why do you want to know. But I am involved with a man who is HSV-1 positive...so I want to know I am not going to give him a whole new herpes in a whole new region--hardly unreasonable.

The long and short...I have had it 9 years and I have dealt with 2 nurses, 4 GPs, 2 midwives and an OB/GYN...and I am only getting typed now because the medical profession just don't care!

I'm planning on getting another PCR as soon as I get an OB but this time round I'm demanding that it not be identified as a genital swab--can't get out of my head that a lazy lab technician will just go with the obvious. Genital must be HSV 2!

BTW are you in the UK? I have read that they are very disinclined to type there.

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Wow, that's very frustrating. You hear that both those tests are very reliable so that's puzzling they give different results. I'd be interested to hear the final verdict.

I'm in the US, actually. I learned from the lab that they have me down as hsv-2, but I felt a little rushed, and the first person I talked to at the lab didn't know what I meant by "typing" so I want to get a blood test some months down the line to know for sure. I agree that knowing type is important and you would hate for them to assume based on locale.

You know, I met someone who's had herpes 10 years. He had a blood test all these years later and it came up negative for hsv-2. He shrugged it off and found it funny, but I think thats extraordinary. I didn't want to pry too much, but I wondered if he's has hsv-1 this whole time...

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It is all so confusing...only made worse when the Drs and labs are not on the ball! I remember having an HIV test once and calling in for the results and the person on the phone getting all flustered and rustling papers...in those 5 seconds seriously I felt like the bottom of my world had fallen out...They really don't understand emotions very well do they?

With my confusion at the moment I keep thinking if I do have HSV-2 what a nightmare it would have been if I had only had the blood test thought I had HSV 1 and then my boyfriend had got HSV 2--he would have thought I'd been cheating on him!

I read somewhere that rarely (like 5%) of people don't make antibodies--but I think it would be doubtful that a person can have antibodies for type 1 and not for type 2.

Yeah, you can't help being curious when you hear things like your friends results. I think it is becoming more common now days for people to get 1 on they genitals--the positive in that is that people are obviously having more oral sex ;-)

Good luck...I hope you stay outbreak free.

Me, I'm wishing santa brings me an outbreak so I can get a conclusive answer ;-)

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    • sgt98
      Hey @WilsoInAus ok thank you, I will do my best to move on and stop trawling forums haha. 
    • WilsoInAus
      Hey @sgt98 but there is no feasible infection or outbreak to suppress and antivirals do not suppress an initial outbreak in any event 
    • sgt98
      Thanks @WilsoInAus I understand apologies for this but the only other thing I am worried about is that I did take a course of Famvir on day 1 as I felt like I was having an outbreak of cold sores and am worried that has suppressed the initial outbreak genitally 
    • WilsoInAus
      Hi @sgt98 it is not feasible to obtain a HSV-2 infection from receiving oral sex - only HSV-1 is feasible but you've already got that and immunity from any further infection with HSV-1. You do not need any further tests for HSV. You're feeling regret, try to forgive yourself and calm down, let the rational take over. You know the answer here and it won't be long until you believe it too.
    • WilsoInAus
      Hi @NerdP423 and welcome to the website. You raise a lot of points and I think the best way to address your concerns is add some comments at each key point. I've copied your note again below and added these comments in square brackets. I appreciate any insight (even speculation) as to what has been going on with me. I'm a 37y/o M. I last was intimate with a new partner on 2/11/2022, and a few days later started having a huge amount of discomfort in my face. [The first thing that happens though is that herpes causes lesions or at least some skin based disruption. Other symptoms are then related to the actions of the immune system responding to the virus. Without lesions, it is highly questionable that the ailment is related to herpes, yet testing is useful if you have concerns as you have done so.] About a month after that [herpes causes issues within days, if the first 'symptoms' are a month later - its extremely unlikely they are related to herpes], significant discomfort downstairs, however every test I have ever taken for HSV 1 and 2 has been negative. Here are the details: Face: Previously, some significant tingling and itching on the right side of my mouth, lips and chin (still there, but milder) [herpes does not cause general tingling and itching, it can cause a reasonably concentrated feeling of itch/throb from which a herpes lesion appears within hours]. Occasional hot flashes near my right eye, cheek and ear [herpes does not do this, it may be a immune response to something, or stress]. Sometimes it will feel like the skin is crawling on the right side of my face [herpes does not cause a general crawling sensation]. Never seen anything that looked like a traditional cold sore [that's extremely telling, even people with associated atypical symptoms will have experienced herpes lesions]. Occasionally, the left side of my face will have a momentary feeling of skin crawling, but it's so mild that I am not really worried about it. Downstairs: Thankfully, most of these are now milder than they were before. Occasional momentary pinch of pain at the base of my genitals. [herpes does not cause a general pinch feeling.] Aching pain in my boxer area (groin, leg folds) [nor this] Occasional feeling of cold in my boxer area, butt, or lower back. ( also in my shins and occasionally even my arms) [nor this] On 4/30/2022, I had been in discomfort for almost two months. I scratched an itch, noticed it hurt, and then checked - I did have an open ulcer down there. Took myself to the ER to get swabbed, came back negative. [If this was a PCR then this will be very conclusive.] Practitioner said it may come back negative because it was already open. However the lab report noted that it definitely didn't look like what you'd expect a typical first herpes outbreak to look like [how would the lab know??]. All blood tests negative so far. I had two western blots, the second one was nine months after exposure. [Two negative Westernblots!!! Many that's real convincing]. All other swabs also negative. I went to urgent care, because I know the timeliness of when the Swab is taken matters. One time, a swab was not done, because practitioner said it was folliculitis and wouldn't swab it (It was at my belt line). [Belt line is highly unlikely to relate to herpes.]   A blood test revealed I had low-ish B12 (technically in range, but at the very low end, especially for a man of my size). I had a series of B12 injections, and I am taking a B12 supplement. I am not taking any lysine or arginine at the moment. I was taking the Arganine to see if I could induce an outbreak. [This is irrelevant, there is no known linkage between herpes outbreaks and arginine/lysine intake - its a myth - and B12 infers nothing.] I think what I am asking is - has anyone here ever repeatedly tested negative over and over again over long period of time, before getting a definitive answer, be a positive test, or something else? [The answer to this is: Extremely few people with a HSV-1 infection and even more rarely HSV-2 test repeatedly negative on Westernblot and actually carry the virus. Of the cases that I know of that had delayed detection by a swab and negative blood tests in the meantime (and that's only 3-4 cases), they had some form of lesions within days of infection but did not obtain a swab for various reasons and then obtained a positive swab of a subsequent lesion with the record being 11 months later. A couple of the cases did have some 'background' symptoms they thought might be related to herpes but that isn't ascertained and some did not have any unusual symptoms at all apart from the lesions. Hence as you did not have lesions around your mouth or lips within days of the last sexual encounter as is exceptionally common for a primary oral HSV-1 infection, that pretty much rules out herpes orally as it is. The fact that you had no genital symptoms for a month also rules out genital herpes. I am not aware of anyone at all who has genuinely gone on to test positive by swab or blood in your specific circumstances. There are hundreds if not more than a thousand experiences on this website alone that are similar to yours that are truly negative for herpes I'm one of them!]  
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