[Question #11468] Regarding hiv and other std testing

15 months ago

Exposure on nov 25th 2023 unprotected sex and she did oral to me

Symptoms : Three weeks after exposure I got fever and my lips got swollen with red pimple kind structure and one white color fluid pimple on my lip it’s hard to eat for one week and went away

2) started observing flat red spots kind of flat red rashes immediately after mastrubating or if glans gets dry I can see a red inflammation kind of rash

Testing :

Feb7 2024: std 10 panel test from quest : all came back neagtive except hsv1 (abnormal >58 IgG)

Feb28 2024 : std 10 panel test from Labcorp : all came back negative except hsv1 (abnormal >62 IgG)

March28 2024: std 10 panel test from Labcorp : All came back negative except hsv1(abnormal>62 igG)

Doctor visit : I visited urologist and showed him my glans he said it might be blantatis and after I produced my reports he prescribed valacyclovir .And I started applying anti fungal ointment to my glans .

April4th 2024 : qualitative hiv1/hiv2 RNA from Labcorp non reactive

April24th 2024 : hiv ag/ab p24 from Labcorp non reactive

May9th 2024 : std 10 panel test from Labcorp all came negative except hsv1(>60 igG)

May 28th 2024 : hiv ag/ab p24 from Labcorp non reactive

June 11th 2024 : hiv ag/ab p24 from Labcorp non reactive

15 months ago

So 6 months testing completed

Please clarify my following questions :

1) I am not getting any lip swelling with sores or nothing only I got white fluid kind of pimple on lip after 3 weeks of exposure and never got it back

2 )why my rashes on glans kept coming after mastrubation . If I didn’t touch it it was normal or if the glans become dry my foreskin got sticked to my glans and hard to push skin back

3) after visiting urologist on 118 days after exposure I started using both valacyclovir and antifungal cream both every day from last two months rashes on my glans are not noticeable. But recently I stopped using anti fungal cream but I continued using valacyclovir never missed a day . I am observing slight red rashes again on glans why ?

4) I have sawn many of you posts saying don’t use antivirals before std testing coz it will manipulate antibody levels

5 ) I started using valacyclovir from 98 days after exposure and have given many fourth generation tests for hiv and qualitative hiv rna tests while using valacyclovir . My question is will valacyclovir affects my other std testing especially hiv antibody testing

6) do I need more hiv testing or any other std testing

7) after listening all this do you think do I have hsv1 on glans or genital herpes (I don’t think coz every panel showed me hsv2 negative ) or those are blantatis rashes which I never got them in my life only started observing them after exposure .

H. Hunter Handsfield, MD

15 months ago

I'm sorry to learn you are having such trouble understanding (or believing?) the information you received in your two discussions with Terri Warren. I've read those and your introductory comments above and I agree entirely with Terri's replies. It is clear you have NO infection of ANY KIND from the sexual exposure you are concerned about. All your symptoms are due to things other than herpes, HIV, or other STIs. Also, your questions seem to assume we can diagnose a problem and advise treatment. That is not what our forum does. For direct medical care, continue to work with your own doctor or clinic.

1) I don't see a question in this statement.

2) I cannot explain this. Sorry.

3) I also cannot judge the reason for your continuing penile rash.

4) This is not entirely correct. Anti-herpetic drugs can delay have an effect on HSV blood test results, but usually do not. It is not only the blood tests that show you did not have herpes. All your symptoms etc are atypical for herpes and something else caused those symptoms, probably not from your sex partner.

5,6) Answered in your two previous threads. There are NO drugs or medical conditions that alter the reliability of the HIV blood tests. For sure you do not have HIV and should have no more tests for it. (And your symptoms do not fit with HIV anyway.)

7) No. You have none of these conditions.

All your questions above were addressed before. No more like that please. If you don't understand something, re-read all the replies so far. But please do not ask the same questions again using different words.

HHH, MD

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15 months ago

Hi Hunter ,

Thanks for responding . I have a quick question today I visited my urologist . Regarding follow up check up for my hsv1 . I told him rashes on my glans kept repeating if I stop antifungal cream regardless of using valacyclovir . He again said rashes on my glans are not hsv1 lesions . But still prescribed me valacyclovir for another six months

I asked him why he said there might be chance of virus converting into hsv2 is it true ? And he also said if I kept using valacyclovir my antibodies reading which test show will go down . It’s been six and half months completed since my exposure from last three months I was using valacyclovir every day and tested for almost 7 fourth gen hiv tests. And one qualitative hiv rna tests and for other std which everything came back negative . Yesterday also I did std 10 panel test all came back negative except hsv1 and hsv2 is negative

What I need to do is it safe to use valacyclovir ? All the tests which I have done by using valacyclovir for hiv and other stds are waste of time and money ?will this Usage of valacyclovir make all my tests for std’s false negative ?

H. Hunter Handsfield, MD

15 months ago

This is weird. There is no way your penile skin problem is herpes of either type. "HSV1" and "HSV2" are the names of two viruses; neither can change to the other. (The terms do NOT mean oral versus genital herpes.) I cannot believe your urologist doesn't know these things, or that he advised that HSV1 can change to HSV2. I also cannot understand why he would advise or condone continuing treatment with valacyclovir. For both these "decisions" or advice, I have to suspect you asked pressing and leading questions, and your own mistaken belief herpes and/or HIV are somehow responsible for your symptoms, and he found it easier to go along with you than advise otherwise.

As I write this, the bookshelf on my left includes "Genital Dermatology Atlas". As the name suggests, it is filled with photos and brief descriptions of genital skin conditions. Of its 300 pages, all STDs are covered in 15 pages. It seems 100% clear that whatever the cause of your penile problems, it is not herpes or any other STD.

I have no idea why all the HIV tests. These are among the most accurate diagnostic tests ever developed, for any medical condition. A single AgAb (4th generation) test was sufficient to know with certainty you do not have HIV.

No, valacyclovir is not making your HSV tests negative. But there's no reason to be taking it, so why not just stop? That said, at least it is entirely harmless. And yes, all the tests plus the valacyclovir are wastes of time and money.

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15 months ago

Hi Hunter ,

These are the questions I have asked my urologist

As I visited yesterday almost 7 months completed after my exposure with no exposures in middle

1) what’s my red rash on glans comes right after mastrubation or if I stop applying cream . It won’t come if I mastrubate with applying cream on glans . It never happened in my life I started observing only after exposure

2)And I asked him actually reminded him it’s been 3 months I am using valacyclovir antibodies count not reduced as he said while prescribing it will be reduced .

3) And I asked him as it’s been six months since my exposure he prescribed me valacyclovir from last three months does usage of these anti viral making my fourth gen hiv and other stds in panel tests making false negative .coz in these 3 months only I have given seven std 10 panel tests . Starting 3 months I only did just three std 10 days panel tests from Labcorp with out using any anti virals

All stds came back negative including hiv except hsv1.

Hsv1 Ab IgG >58

HSV2 Ab IgG > normal

4) And I asked him is viral load test for herpes required for me coz I had a lot of confusion in me that I only got lips swollen one time with white color fluid and fever came three weeks after exposure after that never saw anything on my lips in first three month with out using antivirals (valacyclovir). And next three months after using valacyclovir

His responses :

1)He said it might be irritation while mastrubating or might be blantatis or it might be erosive sti blantatis which will quite common when a person has antibodies for hsv1

15 months ago

2)he said readings in my herpes tests will got zero or normal after using next course of valacyclovir he is going to prescribe for next 6 months . And also it will not convert into hsv2 which came normal every time I do antibody test.

3) for this he said same answer you suggested . Valacyclovir does not affect fourth gen hiv tests or any other std antibody tests ? Is it true

15 months ago

4) for this he said viral load test is not required for me to check what kind of herpes I have .

Please suggest on this conversation after I saw antibodies for my hsv1 in reports . I reached out to girl who i had unprotected encounter with she said she had oral sores from childhood and she said she don’t have genital . But she gave me oral while we met . I am thinking that’s what the reason for my flat rashes is it true

15 months ago

Lastly yesterday you asked why I did so many tests in last three months while using valacyclovir . I have no trust in her who I had sex with coz when I saw rashes after exposure I asked her did she had any stds she said no . After I got my results I asked her angrily she replied oral sores or herpes are common in USA many people have it

H. Hunter Handsfield, MD

15 months ago

You need to just accept the reality that you have asymptomatic HSV1, like half of all adults in the US (and up to 90% in some countries). It is not the cause of your penile rash. That you have never noticed oral outbreaks is typical and says nothing about whether or not your initial HSV1 infection was oral. Even if it was genital, the large majority of persons with genital HSV1 have NO recurrent outbreaks and never transmit HSV1 to sex partners by intercourse.

Beyond that, you are seeking much more detailed information than this forum is able to provide. As I've said before, we do not provide direct medical care, which in effect you are requesting.

"Valacyclovir does not affect fourth gen hiv tests or any other std antibody tests ?" Correct.

There is no point in a "viral load" test for HSV.

My final judgment and advice is that you are being misled by one or more doctors who do not well understand genital herpes. Most urologists are not especially up to speed on the more sophisticated aspects of herpes. You might consider seeking care at an academic medical center, e.g. through an infectious diseases clinic.

That concludes this thread. Please note the forum does not permit repeated questions on the same topic or exposure. This being your third about your genital rash and your concerns about HSV and HIV, it will have to be your last one; future questions on these topics are subject to being deleted without reply and without refund of the posting fee. This policy is based on compassion, not criticism, and is intended to reduce temptations to keep paying for questions with obvious answers. In addition, experience shows that continued answers tend to prolong users' anxieties rather than reducing them. Finally, such questions have little educational value for other users, one of the forum's main purposes. Thanks for your understanding.

I do hope the three discussions have been helpful. Best wishes and stay safe.

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