[Question #11152] Hsv
 |
16 months ago
|
I asked some questions last year about sti risks and wanted some clarification on HSV. I have been reading about accuracy for various tests and have had a concerning event.
In August 2023 I received unprotected oral sex from a female. I tested at 1,4, and 9 weeks with rpr, hiv 4th gen, and hsv igg tests. The woman I was with was tested at 3 and 5 weeks after our encounter and then again in December, 4 months afterwards with the same tests. Each time everything came back negative. In March 2024, 7 months after the encounter she was tested again but this time the lab ran NAAT for hsv. She showed me all her results. Yesterday I noticed a bump on my scrotum that looks like a pimple. It had a hair in it and looked similar only a bit larger to the bumps I have always had down there. I pulled the hair out and there is very minor irritation but only if I directly touch the bump. I have had no suspicions of an outbreak of hsv and she says she has never either. Not even a cold sore. She had no sores at the time of our encounter and it was brief. Her most recent NAAT was negative for hsv1 and 2 but I am so confused about hsv tests. My main questions are,
1.
How long after an encounter do outbreaks usually occur?
2. Does my bump sound suspicious?
3. With me having a total of 3 negative igg tests from 1,4 and 9 weeks and her having negative igg tests at 5 and 15 weeks and her reports of no symptoms can I conclusively rule out hsv concerns or should I do a western blot?
I am very anxious but have tried to ask this in a way that is edifying rather than pacifying. Thank you for your help.
 |
Terri Warren, RN, Nurse Practitioner
16 months ago
|
1.
How long after an encounter do outbreaks usually occur?
2-10 days
2. Does my bump sound suspicious?
Not really, I don't recall seeing a new infection on the scrotum only, ever.
3. With me having a total of 3 negative igg tests from 1,4 and 9 weeks and her having negative igg tests at 5 and 15 weeks and her reports of no symptoms can I conclusively rule out hsv concerns or should I do a western blot?
The IgG tests are not perfect - they miss 8% of HSV 2 and 30% of HSV 1 compared to the western blot.
Only you can know how comfortable you are with these statistics, I'm afraid.
Terri Warren
--- |
16 months ago
|
The bump in question went away overnight, no pain or irritation. I looked up folliculitis and think that is more likely. I feel kind of ashamed for letting it worry me so badly.
Last year in one of my exchanges with Dr. Hook regarding my encounter he advised, “we don’t usually recommend blood tests for your type of encounter but your test results and absence of an outbreak also prove you did not get hsv” that may not be verbatim but it is definitely what was said. He also advised I was “in the clear” and saw no reason to abstain from unprotected sex with a regular partner. I took that advice and my partner has had no concerning events. Excluding the bump that prompted my initial question to you I have had no cause for concern and it has been 8 months since the questionable encounter which was again one brief receipt of oral sex from a female.
Do you agree with Dr. Hook that I can move on or would you advise further testing?
|
Terri Warren, RN, Nurse Practitioner
16 months ago
|
I think if your bump went way overnight with no pain or irritation, it is not HSV. If you've had no other symptoms in 8 months and the contact was only brief oral sex, it sound to me like it is time to move on and not do further testing. This has been a challenging time for you. I so hope you can put this worry away and go back to normal living with your partner.
Terri
--- |
16 months ago
|
Thank you ma’am. I really appreciate your work. People make mistakes and you all have been a blessing. I want to clarify I wasn’t doubting Dr. Hooks reply, he was very kind and exceedingly knowledgeable. I just wanted some clarification. God Bless
|
16 months ago
|
One final question, in your expert opinion, considering all my tests and lack of symptoms along with the lady’s tests and absence of symptoms who I had the encounter with do you feel like there is any real possibility I was infected with hsv 1 or 2?
|
Terri Warren, RN, Nurse Practitioner
16 months ago
|
I don't worry at all about HSV 2 for you. Because half the population of the US has HSV 1, between the ages of 14 and 49, higher after that, and the IgG misses 30%, I really can't be as certain about that but if you were positive for HSV 1, we couldn't know if it was oral or genital, new or old. So I think you should just take that worry off of your list. There is really not point in worrying about that one. And if you went ahead and did the western blot for confirmation and it was positive, it still wouldn't give you the information you seek. So I say move on now.
Terri
---