[Question #1719] HSV-2 and HPV Questions
91 months ago
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Edward W. Hook M.D.
91 months ago
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Welcome to the Forum. Although Ms. Warren usually answers questions on herpes, given the more general theme of your question, I will do so today. Taking your questions in order:
1. herpes testing. Given your history (i.e. no suspicious outbreaks) I would recommend against blood tests for herpes. I would add that my recommendation against testing in your case is in agreement with the recommendations of the U.S. Preventative Services Task Force and the CDC. The reasons for this recommendation are multiple and revolve around problems with the test. In persons such as yourself, false problems are rather common (some would estimate up to 50%) and about 5% of persons who get herpes will not have positive blood tests at all. Thus the information you might get from a blood test would not be particularly helpful and very well could be wrong. The herpes blood test is useful for persons who may be infected or have suspicious lesions but not in your case.
2. Warts. I'm afraid that he information your doctor gave you long ago did not reflect current thinking about warts and HPV infections. There are more than 100 different types of HPV and interestingly while related, different types of warts tend to infect different types of tissue. Thus it is most unlikely (in medicine one can never say never) that you transmitted warts from your hand to your scrotum or penis. Far more likely that this was acquired sexually. Now that the wart is gone, it is behind you and I would not worry further. Our experience and that of others is that once warts have resolved, either with treatment or by themselves if they do not recur in 3-6 months, they will not and the person should not consider themselves infected or feel a need to disclose to sexual partners. Warts and HPV are widely mis-understood and while in a well-informed, trusting relationship disclose is always a good thing, the fact is that there are frequent misunderstandings and for those reason we do not recommend routine disclosure of past, resolved warts or HPV infections.
I hope you find my comments helpful. EWH
91 months ago
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Edward W. Hook M.D.
91 months ago
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91 months ago
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Edward W. Hook M.D.
91 months ago
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I'll comment your question about shaving and follow up a little bit regarding your question on herpes testing as well, having seen that you raised the question of testing with Dr. Handsfield and Ms. Warren as well.
Regarding shaving, in scientific studies in which experimental animals are infected with herpes viruses, to facilitate infection, the skin which is about to be infected is often slightly abraded/scraped to make the likelihood of infection more likely. Thus, at lest from a theoretical perspective a close shave or nicks could increase your risk of acquiring herpes is you were directly exposed. If you then caught herpes, we would expect that infection to be a typical herpes infection.
Regarding testing, I think Dr. Handsfield has laid out the issues pretty well. None of the lesions you have described are suggestive of herpes to me although admitted, I have not examined you and HSV lesions can be variable in appearance. On the other hand the locations of your lesions, that they have not recurred, and the description of the ones you have described are not typical of HSV. As a man in North America with more than 10 sex partners, your average risk of having had HSV is about 1 in 3 or 4. Your risk of having a falsely positive test is about 1 in 25-30. Given your concerns, perhaps testing will be helpful but, before you test, I would urge you to consider whether the results of the test, whether positive of negative will give you peace. If testing will help you in this way, then test. As Terri and Dr. Handsfield have indicated, this is a difficult area and decisions about testing need to be made from an informed perspective. I hope my comments, along with those of my colleagues will help you.
As you know, this is my third response to your question and therefore this thread will be closed later this morning I hope this information will be helpful. EWH