[Question #1628] Follow up to q#1613

44 months ago
Hi, i previously enquired about a one time encounter in which i had unprotected sex and then experienced a lone pimple at the base of my penis. Doctors said this was an unlikely place to get herpes but i had shaved peior to sex. I got my igg test results back today. I had them done at 4.5 weeks exactly. Results where: HSV1: negative 0.196 and HSV2: negative 0.5. Could you tell me why the hsv2 score is slightly higher ? And what percentage of people will have seroconverted by this time?  If a negative result is closer to 0.9 does that mean i am more likely to test positive at 3 months ? As a precaution i did take acyclovir for 5 days. I also have a new tiny spot on my penis, about 3 inches further down the shaft, although again it is painless and has no fluid, i have historically had many similar ones.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
44 months ago
We don't have statistics about 4.5 weeks.  However, I am slightly concerned about your value of 0.5 and the fact that it is going up a little bit.  Not very concerned honestly, just a little concerned.  When we look at our study of people with HSV 2 results on the IgG, we don't see many people above 0.3.  If you were my patient in the clinic, I would recommend that if you have sex with anyone right now, that you use condoms every time until we have a chance to see what you results are farther down the line - say 6 weeks.  It's probably just fine, but with a "pimple" and a rising HSV 2 level to 0.5, I think reasonable caution is appropriate.  I don't want to send you into a panic, I want you to carefully and thoughtfully proceed with further diagnostic testing when the timing is appropriate.  We will likely learn more from the 6 weeks or 12 weeks test.  And please -don't take any more acyclovir as it could throw off the testing.  to be clear, I don't think this means you have herpes but it does mean we need to follow this now a bit more closely.  Are you with me on this?  In a non-panicked state? 

Terri
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44 months ago
Hi terry,

Ive just had the results sent through to me and my hsv2 reading is actually <0.5. The lady on the phone simply read it out as 0.5. So i'm back to square one in terms of a baseline result. When do you think i should retest? My partner who the exposure was with is testing next week. I have noticed a new tiny red blemish in the middle of my shaft about 3 inches down which again doesnt hurt/itch but hasnt changed since i noticed it 3 days ago. Should i test at 6 weeks do you know roughly the accuracy? Also how long do you have to wait until you take a western blot?

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
44 months ago
well, that's different!  That result doesn't tell you anything specifically.  What you do know is that you are negative at baseline.  Interesting that they report out HSV 1 at levels so low and specifically but not HSV 2.  If your partner tests negative for HSV 2, that's a very useful and good sign and I think that should help you relax a whole lot more
Usually, herpes doesn't present as a tiny red blemish, that just doesn't sound herpetic to me and also, normally, herpes lesions do change over time, even over 3 days. 
At 6 weeks, the accuracy is about 70% - that is, if you are negative at 6 weeks, there is a 70% chance it will stay that way.  We don't recommend western blots until 16 weeks have passed since exposure. 
I would say things are looking up for you!
Why don't you save your final post with me until you have your partners results back, what do you think?

Terri
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