[Question #3979] Confused/HSV & HPV

85 months ago

Hello, I'm male, early thirties, and unfortunately I had a lapse in judgement and was the recipient (I think this makes me the "insertive" partner) of unprotected fellatio from an exotic dancer. She was eastern European (but said event took place in the US), probably in her mid-twenties and no visible cold sores (though I didn’t give her a mouth exam in a poorly lit strip club). The encounter lasted 15-20 minutes and has been the source of much anxiety.

The day following the incident, I noticed two purple spots on my penis shaft. One looks like a small broken blood vessel, and the other looked like a cut, perhaps a tooth mark. I panicked and went to my primary care physician two days later, who looked at the marks and said he was not worried about herpes, but agreed to give me a full STD panel.

The results came back negative for HIV/chlamydia/syphilis and the herpes IGG test came back negative HSV-1 but positive HSV-2. Aside of the above mentioned marks, I have never had a noticeable lesion, pimple, mark, etc. on my genitals. I visited MedHelp and after doing some research, I asked my physician for the values of my HSV-2 positive IGG test, to which he replied no values were given to him.

At my insistence, my physician ordered a western blot test. My blood sample was 2 weeks after the event, and after a lengthy (3 week) wait, the western blot test came back negative for HSV-1 and HSV-2. At 6.5 weeks, I went back to do another full round of testing. All results have come back negative, except for the herpes IGG test which is still pending. Based on my above experience, I have a few questions...

#1. On the Western Blot test results, something was written to the effect of "the western blot test is not FDA approved" -- is this true? If so, why?

#2. It is apparent my doctor knows very little about HSV-2, he explained to me that my body developed anti-bodies because I was exposed to the virus, but never contracted it and therefore do not have it. Yet, from all that I have read his explanation is not possible. Can you please clarify?

#3. Given the nature of the incident, it seems to me that it’s near impossible I contracted HSV-2, rather, the greatest risk would be HSV-1 and the likelihood of contracting after a single event is slim. Considering I have not had signs of an initial outbreak, do you think it is unlikely I have HS-1 ?

#4. Yesterday, I noticed what appears to be a skin tag in my groin area. Could this be HPV? I don’t recall the dance ever coming into contact with this part of my body. Do genital warts only affect the genitals or can they affect the entire boxer region like herpes?

Edward W. Hook M.D.

85 months ago

Welcome to our Forum. Before I get to your specific questions, let me make a few general comments. the exposure your describe was low risk for all STIs (with your low risk confirmed by your negative tests) and virtually no risk for HSV-2 which almost never infects the oral cavity and likewise, is almost never a source of HSV transmission to sex partners. I would also comment that the abnormalities you describe on you penis occurred o early to be HSV which would never lead to lesions just 2-3 days after contact. I would not be at all worried about HSV-2 occurring from the encounter you have described. Now, on to your specific questions:

#1. On the Western Blot test results, something was written to the effect of "the western blot test is not FDA approved" -- is this true? If so, why?

Yes, it is true.. Getting FDA approval for a test takes years and millions of dollars. OTOH, the FDA does accept the Western Blot as the gold standard for serologic diagnosis of HSV.

Your doctor is wrong, you are correct. Antibodies to HSV develop when you are infected. Not all persons know they are infected without a blood test. In your case this is irrelevant since your HSV Western blot was negative.

I agree entirely with your assessment. In my opinion, there is o evidence that you acquired HSV from the exposure you describe and, conversely, excellent evidence that you did not acquire HSV-1 or -2.

Skin tags are common, HPV without direct contact is not. I would be quite surprised if the lesion you have noted is HPV. If you are concerned, I would have a dermatologist take a look.

I hope these comments are helpful to you. At this point, I would not be concerned about having acquired ANY STI from the exposure you describe above. EWH

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