[Question #1393] Test Results - Herpes

46 months ago
Hello. I asked a risk assessment question a few months back and during that time,  in the state of my panic and aniexty, I ordered the 10-Test Panel from the website, stdcheck.com. I only did gon/char, trict, and HIV-RNA at the time which came out negative. Since it has been 3 months since post exposure, I figured I might as well get tested for the other tests as well (HSV 1-2, HIV 4th generation, Syphillis, Hep A-C). I thought it might be nice to know my status since I never did get tested for those before. So my test results came back and I have a few questions related to it.
HSV - 1 Igg Type Specfic - 61.2
HSV - 2 Igg Type Specfic - <0.91
HIV 4th generation - Non reactive
Hep C Virus Ab - <0.1
RPR (I'm assuming this is a syphilis test) - Non Reactive
Hep A ab Igm - negative
Hep B core ab Igm - negative

1) Why is my HSV -1 so high? Does that mean I have oral herpes? I don't remember ever getting cold sores or an outbreak. I do get canker sores under my tongue or inside my mouth. Or am I mistaking those as canker sores when I should take them as cold sores or herpes? Does that mean I shouldn't kiss or share food with my wife and kids when I have those "canker sores" or I guess now I should take them as herpes. 

2) Does non reactive means negative?

3) Did my encounter with an escort three months ago be the exposure for this? I didn't do any kissing or anything with her. All I got was oral sex from her with a condom on.

I know now that I can finally move past the HIV fear but now I'm worried about herpes and passing them on to my wife and kids
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
46 months ago
1) Your HSV 1 is so high because you have well established HSV 1 infection.  About 70% of those infected with HSV 1 don't recall a history of cold sores so you are certainly not alone in your situation.  The sores you describe in your mouth sound very much like canker sores to me, not herpes, but in order to be more certain, you would need to have them swab tested, preferably with PCR.  It is also possible that you could have it genitally, though that is less common.  I would certainly not change your behavior with your wife or your children.  Has your wife been tested for HSV 1, do you know?  It would probably relieve your worry if she also tested positive.  Try to remember that more than half the US population is infected with HSV 1 so to be NOT Infected would be the exception - you are the rule.  Try not to be alarmed by this very very common result.

2) Yes, non-reactive means negative

3) I do not think your HSV 1 is related to the escort contact since you did not do any kissing and used a condom for oral sex

Terri


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46 months ago
Thank you! I feel very relieved to hear that. A couple of quick questions. Can I transmit the hsv-1 if I'm not having any visible cold sores? Can I still share my food/drinks with my wife and kids without fear of transmission? Is there a test to show what type of hsv-1 I have even though I haven't had an outbreak of any kind? I do have PPP I think since I shown them to two drs in the past 10 years and they told me not to worry about them. It is tiny white and flesh colored bumps along the rim of my penis head. I had them since I was 16. Could these be genital herpes and I didn't know? If they were, wouldn't the doctors that I shown them too would of taken some sort of culture? Thanks for taking the time to answer my questions
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
46 months ago
You can certainly share drinks with your family members without fear of transmission.  There is a low possibility of you transmitting the HSV 1 to your wife either through deep kissing  or giving her oral sex if you have the HSV 1 infection orally.  We don't know where you have it - it could also be genital and you don't know it and that would have been transmitted to you most easily by receiving oral sex.  Without a specific lesion that tests positive by swab test, we honestly can't say where your HSV 1 infection is.  There is not test to know which strain of HSV 1 you have and I can't imagine that it would make any difference if you did know.  The things on your penis most definitely sound like penile pearly papules to me.

Terri
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45 months ago
Thank you Terri. I am very relieved to hear your answers. I guess I have one more follow up questions. Should I believe my tests results and finally move on from this mistake or do I need to retest down the road?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
45 months ago
Can you please tell me more about your sexual encounter that worries you?  That way, I can get a better idea about how safe it is to believe your test results and move on.  Thanks! 

Terri
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45 months ago
Sure thing. My exposure was 3 months ago with an escort. It was protected oral and vaginal. There was no kissing or touching. The whole thing lasted like 5 mins. I think I tested for all kinds of STDs that were available to me through online testing site and they were all negative except for the HSV 1.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
45 months ago
So in that case, yes, you should believe your HSV 2 test result in terms of this encounter.  Absolutely.  You did a great job using a condom for both intercourse and oral sex - you're a rare bird that way! 
As far as I can see from your description of this encounter, you were not at any real risk at all.  Congratulations on your very careful behavior during this sexual encounter!

Terri
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