[Question #12951] Risk and research

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3 months ago
Thanks for the service.  I am hsv 1 positive for yrs.  Negative all other sti through both no symptoms and testing.  Recently started a relationship with a person that hasn't had sex in 5 yrs.  She tested negative for syphilis, hiv, gonna, chymidia, trich (urine vs swab)   and hsv 2, igg.   She does have lupus. We had brief sex both viginia and anal, condom protected 11 days ago. On day 7 I got flu like symptoms, including a lot of congestion.  My questions

1.  I assume I can trust her urine tests, even though we did urine, did not swab anal.

2.  I assume her lupus did not impact her hsv2, hiv or syphilis blood test

3.  I have been sick for 4 days.  I assume I am 11 days out with no hsv symptoms on penis and my flu, congestion like symptoms are not part of hsv prodrom that will crop blisters in a few days?   

4. I recent read a published study from China that said hsv2 igg test picked up only 30% plus. Done in 2024.  No specific test was mentioned.  Hers was labcorp roche.  I assume this picks up 90 plus infections, despite recent study from outside the USA?

Thank you
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Edward W. Hook M.D.
3 months ago
Welcome back to the Forum.  Thanks for your questions and your confidence in our service.  I’ll be glad to comment.  There is close to no risk of any STI in the relationship you describe given both of your test results and the fact that your partner has been abstinent for 5 years.  Further specific replies below:

1.  Correct.  Urine tests provide accurate results and it is most unlikely that an anal infection, if present, would persist for 5 years.  Over a period of years, if an infection were present, it would have resolved.

2.  The presence of lupus would not make her blood tests less reliable.  If anything, lupus is occasionally associated with falsely positive blood tests.

3.  Your symptoms sound nothing like a herpes prodrome.  Herpes prodromes last a day or less.  Further, if you were going to develop herpes lesions, that would have occurred within 10 days of your encounter.

4.  Herpes blood tests certainly have problems, both with giving false positive results and with sensitivity, particularly for recent infections which would not be the case in your situation.

Personally, I think you need not worry.  I would encourage you to move forward without concern.  I see no need for additional testing.  EWH
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