[Question #12015] Ghsv1 questions

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10 months ago
Hello and thank you.   I have a question about a possible exposure to genital herpes. Terri has already answered some of my questions and I know she normally answers these questions but if Dr Hook or Dr Handsfield could help I'd appreciate it. 

Back in February I received a handjob from a csw.   She used saliva as lubricant and possibly kissed and licked my penis.  I have tested negative for all STIs and was negative igg for hsv1 at 3 6 8 and 14 weeks.  In June I had pain on my scrotum.  The dr said it looked like infected hair follicles.  They popped it took a sample and had a negative viral hsv sample.   Recently I had a red dry circular patch around the same area on my scrotum.  This was not painful and there was a hair in the center.   The dermatologist i saw said it looked nothing like herpes and did not swab it.

1) igg tests miss 30% but do we know if they always miss if they miss once or is it by brand or company?  I used 2 different testing services and both negative. 


4)Does my event carry any real exposure for transmission.  I know you can never say never but realistically would you be shocked if this exposure gave me herpes?
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H. Hunter Handsfield, MD
10 months ago
Welcome. I can't find any discussion with Terri -- maybe not on this forum? Or did you change account or username?

You could not have acquired HSV from the exposure described. Hand-genital contact rarely if ever transmits HSV, even if lubricated by saliva or genital fluids. Your symptoms certainly don't suggest you have genital herpes, which is easily distinguished from foliculitis, especially by a dermatologist. Herpes does not cause testicular pain or a "red dry circular patch". (Maybe lichen planus?) Herpes should not have even been on your mind.

1. Even if your HSV1 blood test had been positive, I would conclude it had nothing to with the exposure event or your symptoms. There was no point in being tested for it, given he exposure and your symptoms.

2. "Does my event carry any real exposure for transmission?" Nope. Would I be "shocked"? Yes.

Most likely these comments are consistent with the advice you have had from Terri. I hope this helps resolve your concerns. Let me know if anything isn't clear.

HHH, MD
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10 months ago
Thank you so much for your reply.   My question with Terri was on her personal website but I appreciate you taking time and responding  

Would that fact that she kissed or possibly licked the tip of my penis change your opinion on the matter or not?

Are symptoms associated with herpes such as neuralgia, constipation, burning skin possible without obvious herpes lesions?
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H. Hunter Handsfield, MD
10 months ago
It sounds like the oral-genital contacts were brief and fleeting; the chance is near zero. And as I said, you describe no symptoms at all that fit with herpes -- and that includes the ones you describe this time. Neurologic symptoms (typically tingling prodrome) only precedes overt herpes outbreaks; on rare occasions, there may be such symptoms of an incipient outbreaks that don't progress. But ongoing or recurrent neurological symptoms or skin burning are rarely if ever herpetic. And also, the sores or blisters of initial herpes occur only at the precise sites where the virus was inoculated. ---
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10 months ago
Again thank you so much.   Just to finish up. 
I know viral culture for hsv can miss infections but is that true when they are able to obtain liquid from the site?

About 5 days after the event i had sex with a woman who about 6 days after described symptoms of a yeast infection.   She wasn't diagnosed but it cleared up about 2 weeks later after using anti fungal cream.  She did describe small tears in her vagina. This is basically what convinced me that I had gotten ghsv1.  With this knowledge you would still say that it is remarkably unlikely that I could have gotten ghsv1?

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H. Hunter Handsfield, MD
10 months ago
The main test is PCR, not culture; but for either one they can be negative even if fluid is obtained, especially if lesions are more than several days in duration and starting to heal. But please do not focus on that test result; it is only one of several reasons to be confident you do not have genital herpes.

Unlike oral HSV1, genital HSV1 is rarely if ever transmitted sexually. Terri has said that in her decades of experience with thousands of herpes patients, she has rarely if ever seen anyone with genital HSV1 acquired by genital contact:  every case was from oral contact only. That also is my experience. (This is one important reason you shouldn't care very much if you acquire genital HSV1 someday.) And although some genital herpes outbreaks can cause yeast-like symptoms, a diagnosed yeast infection almost never is herpes. That your partner's symptoms included vaginal area "tears" doesn't change anything; that's common with yeast.

Clearly you are obsessed with these issues. I genuinely hope Terri's previous advice, and now mine, enable you to move forward without concern. However, we understand that it is the very nature of obsessions that this might not be possible for you. Obsessed persons so often re-think and over-think everything and repeatedly invent "yes but" or "could I be the exception" sorts of thoughts. I hope you do not. But if your fears continue, professional counseling should be your next step. I suggest it from compassion, not criticism. Best wishes to you; good luck.

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