[Question #2685] [Question #2684] Herpes infection scare: follow-up

43 months ago
Terri,

Sorry I could not find a way to re-open the original question so started a new thread. Yes, I plan to go for antibody testing. What is my best option- in terms of the time to wait after the exposure (been 9 days now), and the accuracy?

Thanks.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
43 months ago
You have a couple of options:  you could test now for a baseline value.  This would tell you what, if anything, you had in the way of herpes, prior to this encounter.  I do not worry that you would have seroconverted from negative to positive at 9 days.  Then you can repeat at 12 weeks and you would be looking for differences in the two test results to indicate new infection.  The one thing that could come up is that you could be HSV 1 positive and you cannot know if that infection is oral or genital, since you've never had a cold sore.  Also, the IgG test misses 30% of infections compared to the gold standard western blot.  So you can see that testing is not a perfect science.

Terri
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43 months ago
Thank you Terri.
I have observed that most lesions are now almost completely healed. It's just dark skin which I see now. Is it possible for Herpes lesions to never get filled with fluid, or burst and crust over? Especially in case of an uncircumcised penis? 
Btw, one of the swab tests came negative, it was a culture test. I am waiting for the next culture result, which should come within a week. I already did two STD tests in the last 6 days. But one of the doctors did not order a Herpes blood test, saying that it isn't reliable and she just went with the culture test. I will confirm today if the second doctor ordered a Herpes blood test. If not, I will go for a special Herpes blood test- I assume it should be IGg? After how much time are Western Blot tests reliable?
What are the chances of genital-to-genital spreading of HSV1? I know an exact number is impossible, but as per your experience, what will your best guess be? I am really concerned since I was planning to start a long term relationship soon.  Sorry for the barrage of questions, but can Herpes cause testicular pain?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
43 months ago
the western blot will be reliable at 12 weeks post exposure.  If doing it routinely, it would be IgG, correct.  And do get a baseline test so you will know later, if something that is negative now is positive then, that this was the acquisition time.  Otherwise, if you only test later, and it is positive, you will never know but always believe that you contracted it at this encounter.  If the doc won't order it, you can order it yourself online from a number of different testing services
We don't have specific percentages about genital to genital HSV 1 but it is very low.  I don't recall that I've ever seen this but it has been documented in the literature.  Herpes does not cause testicular pain,no

Terri
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43 months ago
Hi Terri,
I got the other test results today. There were 2 swabs taken from the lesions, both are negative. The test name used is BioReference Solana(R) HSV1+2 Assay, which is NAAT test. I guess this test has better reliability compared to viral cultures? Also, got baseline IgG results. Herpes I Ab. came as positive with 47.20 HI. Reference is <0.90. Herpes II Ab. came back as 0.71 and negative.  have planned with the doctor to do IgG tests 3 months later once more. I had a real scare last night since I had bad headache and pain in the abdominal area, after the lesions are healed. But I think results make me feel better now. Would you agree? Also, is it possible to have Herpes prodome like symptoms - headache and abdominal pain after lesions are healed? The doctor just suggested me to take Tylenol for now. Can herpes cause pain the the lower lymph nodes- along the crease between abdomen and the legs? I have been feeling it once in a while.  Also, can herpes cause penile discharge ?I am afraid if what I saw today morning was anti-fungal cream or some discharge. I am getting too paranoid now I think. Sorry for being like this and thanks a ton for your help.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
43 months ago
So here's the deal - you already have HSV 1 infection, you didn't just get it, your antibody test is strongly positive indicating previous infection.  Because you have never had a cold sore, we cannot know if your infection is oral or genital but you didn't just get it from this encounter so you don't need to be concerned about this particular encounter.  Pain in the abdominal area is not a sign of herpes.  With new herpes lymph nodes can enlarge but your risk here was the oral sex and the risk from herpes with oral sex is HSV 1 and you already have that so no, I don't think the lymph node enlargement has anything to do with new herpes.  And great news on the swabs, too

Terri
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