[Question #2579] Two Fold Question about HIV and Herpes 1

43 months ago

6 months ago (February) I had unprotected sex with a new guy just once. 16 days after that night I found a scab near my vagina. About 7 hours later, by the end of the day two more scabs appeared. so 3 total. underneath the scabs looked like a cankersore ulcer thing. no liquid or wet blisters. Whatever it was it had appeared & scabbed by the end of the day. I went to the doctor that same day & she swabbed & did bloodwork. She said she wasn’t sure what it was. The IGG & IGM blood tests both negative & cultures all negative. the scabs went away & healed in a week. I then got tested at both 2, 3 & 4 months post encounter, herpes 1 & 2 IGG both negative. I also got tested for HIV which was negative. I am confused if I should consider that it was not STD related? I haven't had any symptoms since. My doctor tells me to move on, but I've heard of false negative HSV1 tests I’m concerned i'll transmit something to someone. If i use condoms going forward should I be worried about infecting someone? 

Also I had an HIV test last week, i went to a free clinic to get a rapid finger prick test. Negative result. But the counselor seemed super rushed & I'm afraid now there is a chance she reused something that I saw laying on the counter. I know lancets are one use only, but i am concerned about the plastic capillary tubes that suck the blood if she used one from the person before me (who i know was HIV +) could have infected me. is that possible?  I'm considering getting tested in a month.

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
43 months ago
The scabs and ulcers beneath them are quite worrisome for a herpes infection.  Your clinician was likely concerned as well as they did the antibody tests for this infection.  It's good that the IgG tests are negative but not definitive.  The IgG test for HSV 1 misses 30% of HSV 1 infections and about 8% of HSV 2 infections, compared to the gold standard western blot.  And you have heard about that as well, as you mentioned.  The herpes western blot would give you the most definitive answer.  You can obtain a kit from the University of Washington and work with your own clinician to have this drawn, spun and sent back to UW.  If you do this, I would advise using condoms until you get the results back. 

You don't need to worry about the HIV testing procedures.  Even if the clinician was rushed, no clinician would ever reuse a capillary tube to do an HIV test.  No one!  We are all very aware of the precautions that must be taken when doing STD and HIV testing.  If you still have worries, please call the clinic and express your concerns and they will reassure you, I believe.  Be specific about your concerns and ask about the procedures used.  I don't think repeat testing is necessary because of this situation. 

Please let me know what other questions you might have

Terri
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43 months ago
Right. But with the western blot since it cannot tell me where the infection is I feel as though if it comes back positive it doesn't actually give me any answer. Because i guess it could be positive from when I was 5 years old (although I've never gotten a cold sore). So then I probably would be right back where I am, unsure if what to do and won't really help me. So my question is more about transmission here. If on the off chance I contracted herpes 1 and all tests are wrong, is that easy to transmit to someone genitally?  Is it even something to really worry about?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
43 months ago
It is true that if you are HSV 1 positive you cannot know the location of the infection.  But if you are negative for HSV 1, then you can believe that the symptoms that you had genitally were not due to herpes.  Would it be worth knowing that you are negative if you are?  If you are positive for HSV 1, you can then take the step of having any lesions swab tested that should appear either orally or genitally to determine if they are herpes. 

We can assume for purposes of discussion that you have HSV 1 genitally.  This infection is rarely transmitted via intercourse.  So it is not easy to transmit, but we do know that it happens.  If you are having sex with someone who is also HSV 1 positive (if you are), then you are not a risk to that person, regardless of the location of their infection.  It is extremely unlikely that you or they would get HSV 1 in a new location. 

I think you also can't forget that the IgG test also misses some small amount of HSV 2 infections.

Terri
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43 months ago
True. I am going to think about the Western Blot, but for now I'm not going to obsess over it. And my last question- for the HIV test, if I do get a test, if I get a 4th generation DUO test at 28 days can I feel good about that result?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
43 months ago
You can definitely feel good about the results.  The guidance now is that a final HIV test is most reliable at 6 weeks post contact.

Terri
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