[Question #1514] Conflicting results need second opinion please
81 months ago
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Hi all, I have been helped out by Terri Warren already on her website and just hoping to get a second opinion here from the Docs. Thank you so much for your help thus far Terri. I will more than likely pursue the WB but just for piece of mind wanted to hear some other opinions as well!
My testing results:
Partner A 3 protected encounters Feb-April 2015
Feb 6 2015 HSV1:equivocal HSV2: neg
July 8 2015 HSV1: pos; HSV2: neg
No sex May, June, or July
Partner B 8 encounters (4 protected 4 unprotected) Aug-Nov 2015
June 22, 2016 HSV1: pos; HSV2: neg
No sex Dec, Jan, Feb, March, April
Partner C Several encounters ALL with protection from May 2016-present
July 15, 2016 rash/ulcers on right buttocks
July 22, 2016 positive culture (not typed) but MD told me shingles
August 24, 2016 HSV1: pos; HSV2: equivocal
Dec 8, 2016 HSV1: 1.13; HSV2: 4.28
Dec 9, 2016 Biokit was NEGATIVE
Dec 15, 2016 HSV1: 1.13; HSV2: 3.65
Since July OB, I have not had a recurrence of obvious ulcers or bumps in that same area. I have had pretty consistently every few weeks with little break in between: occasional thigh tingling, painless pimple like bumps (that leave dark scars) scattered on different parts of my buttocks (1-6 at a time), low back (1), torso near rib cage (2), anterior thigh/hips (2) but I do have a history of back and butt acne so it's confusing . I don't know the status of any of my partners. I do know that partner C (current bf) gets cold sores. We still have protected sex. Been trying to figure out the likelihood of getting this from Partner B vs Partner C. Also the likelihood of a false positive at 4.28, then 3.65 is low but would you suggest more testing? I guess the negative Biokit threw me off. The MD who gave me the results said I likely have HSV1 (which is what Terri thought until I got the equivocal HSV2 result) Please let me know your thoughts on my conflicting results. Thanks!
81 months ago
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H. Hunter Handsfield, MD
81 months ago
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81 months ago
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First of all thank you and Terri for collaborating and being so compassionate and kind in your responses. This is a very difficult time for me as I have been very cautious with my sexual encounters (aside from the few times with partner B) and have finally found someone that I want to be with and hopefully marry. But oh boy the luck of catching this at my age 33, not married and not children is just a huge disappoint, especially since I used protection. I do have a few more questions.
1. How common are false negatives on the Bikoit test? So I should just throw that result out of my mind?2. I get tingling, but do you think the pimple like bumps I described could be HSV? Could they be considered an outbreak? If so how contagious are they? Like if they were on my buttocks and I had sex could Partner C (assuming he is not the source) have gotten it from me?
3. So essentially Terri has explained that at 7.5 months the HSV IGG is 93-95% accurate. So 5-7% scares a bit into the WHAT IFS, which I know you don't like to deal with often. But you mentioning that my July OB seemed more like a reoccurrence scares me. If Partner C turns out to be positive is it possible to have gotten this from Partner B (esp since there were 4 times we didn't use protection) and had delayed seroconversion with no noticeable symptoms and then passed it on to partner C? What is the likelihood of this? Or do you feel it is more likely I missed the genital symptoms from May-July and then had the buttocks OB? And why am I not having true ulcers like the first OB, just pimple like bumps? could that be unrelated to HSV? Have you seen that before, an OB with ulcers then subsequent ones look like pimples? At the time of the OB in July I had muscle soreness/twitching and night sweats.
4. Also when I first had the OB Partner C said he tested in April clean, but he knows that they will on test for HSV if you don't show symptoms. He stated he did not have any symptoms of it. Recently I've noticed him scratching his genital area and thighs quite often, I don't know if I'm just paying attention too much or if this possibly a sign he may have it. I noticed a bit in July but seems to be progressively more scratching in the last few months (Nov-Dec). Also he had one single bump not on his penis but on the area we call the mons pubis for women (looked like a pimple with yellow pus inside). And a single bump on his buttocks that I did not see. But he did not seem concerned. Assuming I got this from him, Is it possible that he could have caught HSV near the time we were first having sex and then did not show symptoms until after my OB in July?
5. How does a woman contract HSV with condom use? Would the man most certainty have to have it on the base of his shaft (where the condom may not reach)? Could he be asymptomatic when passing it to me, then have symptoms months after?
Thanks just trying to cover a lot of questions he may have when I have to tell him this sad news! 2016 has been the worst year ever! Thanks again!
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H. Hunter Handsfield, MD
81 months ago
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81 months ago
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Thank you for your prompt responses and patience. I have a few more questions as this is still devastating to me and I just want clarity. I promise to be out of your hair after that unless some odd scenario arises with his results.
1. Regarding the sensitivity I was just referring to the 93-95% sensitivity at 7.5 months after Partner B..... meaning that the chances of getting it from him could be deducted to be 5-7% correct? It's just this small percentage change leaves me a bit uneasy. In your experience how many people that were healthy and not taking antivirals took longer than 6 months to seroconvert. Teri stated that she has not had this happen with ANY of her patients.
2. I'm feeling some type of anxiety now and I know that my partner will likely deny he has it or had it first and I just want to be able to answer his questions. Since we haven't discussed the issue much since my equivocal result I feel very guilty and sad that there is still a slight chance I may had this first and passed it on to him. At this point now that I have it there is nothing I can change, but I would feel much better if I got it from him unknowingly, than if I had it all this time and was confused with all this testing and misinformation from my MD, passing it on to him when I could have prevented him from getting it! I know there is no 100% guarantee but I guess overall since you say I'm definitely positive for HSV2 would you be more inclined to think I got it from Partner B (condoms 50%) and seroconverted later than normal or Partner C despite condom use 100% of the time? Obviously had sex more frequently and more times with Partner C. Partner B was like 2 times each month (aug, sep, oct, nov). Teri still seems to think I got it from Partner C? Do you feel the same?
3. If I had already gotten this from Partner B (7.5 months prior to neg IGG, 8.5 prior to equivocal, and 13 months prior to confirmed positive) would you expect the IGG levels to go from Neg to equiovocal to positive as they did over this time period? Or would delayed seroconversion typically go from negative straight to positive? Would my index number be higher if I had gotten it 13 months ago? Or does the testing and time frames almost surely leading you to think I got it from Partner C?
4. Any suggestions on how to bring this up since we haven't talked much about it since the equivocal result? Or any resources you have for having this type of talk with a partner? I'm really nervous especially with the Holidays season approaching I feel depressed that this is something I have to bring up during such a happy time!
Please excuse any reduancy but I think mainly for me now is trying to sort out which partner gave this to me. I know it can't be 100% sure but if your feelings are similar to Teri's I will feel more relieved. Thanks!
Thank you for all of your help!!!!!!
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H. Hunter Handsfield, MD
81 months ago
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