[Question #3976] Herpes 1&2

33 months ago
I'm a male & 22 days post a single unprotected vaginal (10min) & oral (10min) encounter w/ a female of unknown status. In the following days I experienced itching & tingling of the genital region, w/ a mild burning sensation on the inner thighs for roughly 12 days. Around day 8 I began to apply Lotrimin AF to the affected areas & by day 15 there was much improvement. I have no genital lesions or sores so far. Initially I had 0 oral symptoms. However at day 14, I developed a mild itchy upper lip w/ very slight redness & no pain. So mild that you wouldn't notice it if you were speaking w/ me. It is now day 22 & it still remains, but unchanged. At day 20 I developed a slight mostly itchy/sore throat. It's a 2 tops on a scale of 1-10 for soreness. It doesn't affect eating or drinking. My neck lymph nodes feel swollen, but groin ones do not. I have also experienced a mild headache the entire 3 weeks. I've experienced fatigue, but no nausea & no fever at all. Appetite has remained normal. The back of my tongue is white & scaley. Thrush? Additionally at day 14 I experienced some aches in my back, buttocks, and left hamstring. They seemed more muscular than nerve related since messaging felt good & the skin is not sensitive. The feelings have remained since & are mostly located in left hamstring & buttocks. At 16 days post exposure I took a 10 panel STD test with the HIV RNA early detection from Labcorp. ALL negative. This was my first encounter since my last round of testing back in March which were also all negative. I know with good confidence that I'm not a carrier of either HSV 1/2 antibodies, & this would be a new infection if I am. What are chances I'm infected knowing my situation? Thoughts on my symptoms? If this is an initial infection, would I be more likely to develop lesions or sores not having either antibody? Would IgG testing results be positive earlier? Accuracy of IgG at 16 days? Explain the hamstring & buttocks pain? THX
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
32 months ago
If you are truly antibody negative for both (and I assume you are basing that on IgG testing rather than an opinion), I think it is likely that you would have noticed something more specific, like sores, than you have.  And yes, IgG tests become positive slightly earlier if you are totally antibody negative than if you have a prior HSV 1 infection.  The accuracy of the test at 16 days post exposure is less than 50%.  Research shows that by 3 weeks from infection, 50% of people will have made antibody (that are going to do so).  It has been my experience that people who experience the muscle aches that you are describing, without any sores, rarely end up having herpes. 

Terri
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32 months ago
Hello Terri,
I'm now 27 days (2 days shy of 4 weeks) post exposure. I continue to have the odd minor aches in my left buttocks and hip. My upper lip still itches from time to time with the faintest of what I consider a very small spot of "something" on it. It's still unchanged for a full two weeks now.  On Thursday I went to see a doctor at an urgent care but because its such a small spot, he could only speculate as to what it was or is. However, he reassured me that it was most definitely NOT herpes. I'm trying to believe him the best I can. I still get a burning sensation from time to time on the shaft of my penis, but Lotrimin seems to calm it down. Still notice NO sores of any kind, and trust me, I'm searching.

Latest testing update: First of all, yes, I'm basing my HSV 1&2 status on many past testing results, not just speculation. 
I just received back my results of the HSV 1&2 Ab testing that were taken at the 26 day mark. (3 days shy of a month.) They are once again NEGATIVE for both.
Timeline:
June 24th, 2018 UnProtected Encounter (Stupid I know)
July 10th, 2018 (2 weeks post encounter) (Labcorp) all NEGATIVE
July 19th, 2018 Doctor reassured me that my lip was NOT HSV.
July 20th, 2018 (4weeks post encounter) (Quest) all NEGATIVE.

Questions: 
1: Percentage of people who test positive (if they are going to) after 4 weeks. (...and 6, 8, 10) so I don't have to keep asking you when the time comes.
2: Your honest to goodness evaluation of my situation.
3: Burning sensation on shaft of penis 4 weeks post exposure, but no sores or redness what so ever? What could it be?
4: Once again, since I'm truly negative for both with zero antibody built up; things seem to be in my favor no?
THX!




Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
32 months ago
We only have data on 3 weeks  and 6 weeks and 4 months. 
At 6 weeks, about 70% of those who are going to be positive for HSV 2 will be positive. 
Things are definitely in your favor!  You have no lesions consistent with herpes AND your antibody test is negative for HSV 2 so far.  That's all great news
I don't know about the burning sensation on your penis at this point - but without redness or lesions, I really think it is unrelated to HSV

Terri
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32 months ago
Update:
Saw a dermatologist today who said that both my lip and penis (which is feeling better after 3 days of hydrocortisone) looked completely normal. I feel very good about that. 
So: 
Negative at 2 weeks for all STD’s including HSV 1&2.
Negative at 4 weeks for all STD’s including HSV 1&2.
General Practitioner after 25 days examined me and said I look fine. 
Dermatologist after 31 days examined me and said I look fine. 

BUT: I still have this constant “numbness” feeling in my left buttocks and a dull ache in my left hamstring and calf going on for over 2 weeks now.
Not really painful, just concerning. This is driving me crazy. Information on this is all over the board. Is it a symptom; is it not a symptom, etc. 
Dr. Handsfield says that it is highly unlikely associated with herpes in what I can find. Some people say it’s almost certainly a symptom. What gives? What are your true feelings about neuropathy regarding initial outbreaks of herpes?
Have you seen it before? Ugh! 
I’d be feeling fortunate but for this! 

Thanks!

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
32 months ago
I think new infection with herpes is highly unlikely in your situation.  Pain and numbness in the calf and buttocks from herpes would not last 2 weeks, in almost all cases.  The fact that you are negative at a month is good news and the fact that the clinicians you have seen do not  think that this is herpes is most helpful indeed.

Terri
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32 months ago
Thanks for your time Terri, 
One last question:
What could cause a slight burning/raw sensation on the shaft of the penis that didnt start until a month after exposure and has now lasted for a week without any sores or redness? Does that sound like the M/O of a herpes infection?
Thx. 

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
32 months ago
I'm not clear on what might be causing that sensation but without blisters and this far out from exposure, it is extremely unlikely to be related to a herpes infection, no.

Terri
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32 months ago
Ok, well thanks Terri!
I don’t think I have any further questions beside this...
If I tested back in March and my HSV2 IgG level was negative with a numeric figure of 0.15, and my test at 4 weeks past this recent exposure was negative; theoretically if I tested again now, 5 weeks post a recent exposure; and was able to get a result showing a specific number and that number hasn’t risen significantly from the 0.15 result back in March, then that would be a good indicator of not having a newly acquired infection correct? 
Other than that, thank you for your help and advice. Thanks! 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
32 months ago
Yes.

Terri
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