Dear XXXXXXXXXX,
There's much confusion about the diagnosis of HSV1 and HSV2. At one time HSV1 was associated primarily with "cold sores" and HSV2 was associated primarily with genital herpes but those distinctions have become blurred. 60-80% of the population will test positive to HSV1, but that does not mean they have or will ever have genital herpes. The EIA tests which are reported as type2/type1 ratios are not really type-specific. A person with oral herpes simplex type 1 may show a false positive for type 2, and vice versa. That can give a person a false sense of security about a falsely negative result, or unnecessary anxiety about a falsely positive result. A more accurate, sensitive and type-specific test is the Western Blot blood test. It can distinguish between type 1 and type 2 herpes with an accuracy of about 99%. Typing is important.... especially as regards future outbreaks and transmission to others. A person with an outbreak of HSV type 1 genital herpes is less likely to have recurrent outbreaks than a person with HSV type 2. I hope this guidance has been helpful. If so, please click accept. Best regards, XXXXXXXXXXX
Physician Assistant
25 + years of experience in family practice, internal medicine and family planning