[Question #3726] Very worried about transmission

37 months ago
Good afternoon doctor. Well I had unprotected sex with a female I’ve been dating on and off.  After two days I had symptoms of pain when I’ll urinate and a very small white spot that looked like a pimple. I got a swab of my urethra and tested positive for hsv2. The white spot was gone two days later. Then i had a small white spot inside the urethra but it was gone a few days later. All symptoms were gone within a week. I got a blood  test done 9 days after the exposure which I was negative for everything except hsv1. The woman I had sex got tested on February  and was negative for hsv2. Then she got tested again at the 5th week mark after her last exposure that she had with another man before we had unprotected sex and the test was a igg blood test with negative results. 

So can this swab actually be a wrong diagnosed because if this was a outbreak, this outbreak was very mild without any sores,blisters or lesions. Also the symptoms went away within a week?
How accurate is a 5 week negative igg blood test? Also what are the chances of that negative becoming positive within 3 months? 
Could this be hsv1 because I’ve never had a cold sore in my life and this outbreak wasn’t really a outbreak? 
So if I decide to have sex with this situation going on I should be fine with using a condom when there’s no outbreak? 
Can I transmit hsv2 to someone else if I touch my gentile area but I forget to wash my hands?
Can I get a outbreak in the anus area or you only get a outbreak on the penis area? 
Is it  hsv2 outbreaks very painful with blisters or lesions or sores?
I really don’t want to give this virus to anyone, so would you recommend suppressive therapy? 
I’m just having faith and praying to god that everything goes well which it has been with the negative igg blood test and hope it stays negative. I’m so worried and confused. I’ma get tested again at the 3 month mark and so is she. 

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
37 months ago
Generally speaking, one can rely upon a positive swab test that has also been typed. 

How accurate is a 5 week negative igg blood test? Also what are the chances of that negative becoming positive within 3 months?

5 weeks is probably about 60% accurate - did you take antiviral medicine after you were diagnosed?  That can interfere with the antibody test.

Could this be hsv1 because I’ve never had a cold sore in my life and this outbreak wasn’t really a outbreak?

You don't have to have an actual outbreak to be swab test positive.  I think you are suggesting that they typing was incorrect?  I don't have more reason to believe that this was HSV 1 vs. HSV 2.

So if I decide to have sex with this situation going on I should be fine with using a condom when there’s no outbreak?

Not really, condoms do reduce the risk of transmission by 96% but condoms do break.  I would advise, after you get an accurate diagnosis here, that you be on daily antiviral therapy to reduce the risk of transmission but not yet, not until a bit more testing is done to try to sort this out.

Can I transmit hsv2 to someone else if I touch my gentile area but I forget to wash my hands?

No

Can I get a outbreak in the anus area or you only get a outbreak on the penis area?

You can get an outbreak anywhere between your waist and the middle of your thighs

Is it  hsv2 outbreaks very painful with blisters or lesions or sores?

Not always,no. but often there are sores present with herpes yes

I really don’t want to give this virus to anyone, so would you recommend suppressive therapy?

Yes, see above for that recommendation

I’m just having faith and praying to god that everything goes well which it has been with the negative igg blood test and hope it stays negative. I’m so worried and confused. I’ma get tested again at the 3 month mark and so is she.

Again, I would rely more upon the swab test than the antibody test.  The antibody test you had done was too soon and the Igg test overall misses 8% of HSV 2 infections.

Terri
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37 months ago
I’m not taking any anti-viral medication. The women I slept with tested after 5 weeks of her last exposure and was negative for hsv2. 

So you think this is hsv1 and not hsv2 from my past history of having hsv1 and never having a cold sore or a outbreak below the waist? 

How often do you get outbreaks? 

Do my symptoms sound like it was a outbreak of  hsv1 or hsv2? Or does it sound like it was a bacterial infection? 

Ima still get rested 12 weeks from the exposure to make sure I’m hsv2 negative and so is he women I slept with. 

Thanks for your answer 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
37 months ago
There is some confusion here.  I believe that you do have HSV 2, based on the swab test.  You might want to actually look at the results and be certain that it says HSV 2 rather than someone assuming that since it was genital, it is HSV 2 - sometimes that happens.  You want to go by the written test results that you can see.  As I mentioned the antibody IgG test misses 8% of HSV 2 infections.   Have you taken antiviral medicine, if yes, how much and for how long?  That can certainly impact the antibody test results.

Terri
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37 months ago
I have not taken any antiviral medicine. 
37 months ago
Well it was a herpes culture (vcm) 
Hsv culture isolated 
Hsv type 2 isolated 
Hsv type 1 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
37 months ago
did you leave something off there - HSV 1?
doesn't really matter, I have only once seen both types isolated in the same swab.
I would believe that you have HSV 2.

Terri
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