[Question #4292] HSV2 Concerns

83 months ago

29 year old male, one-time unprotected exposure. The female says she has never had hsv2 symptoms.

Tested through Quest IGG at 6, 8, 12 weeks – all are negative for hsv2.

Have had hsv1 for 20+ years, test numbers have ranged from 27-30.

I have not had any blisters, sores or rash. A pimple or two – which isn’t uncommon for me, but they never showed any signs of water blisters, as they were hard and when popped had a white thick pus (one was on my testicle and the other was on in my lower pubic hair region – neither on my penis).

My only symptom has been nerve related. Around week 9 I started to noticed a tingle in my feet. That has made it way up to my calves, hands and some other upper body parts. It comes and goes daily, sometimes feels like shocks or muscle twitching, but it has been noticeable for the last month. Also, seems most noticeable at night or early morning – mostly in feet. I also sometimes have a pain in my armpit but no swollen nodes.

Questions:

1. 1. Should I retest at a later point?

2. 2. Would hsv1 delay hsv2 seroconversion?

3. 3. I spoke with a NP at UW Virology Research Clinic and she said test were conclusive at 8+ weeks as long as I didn’t have a compromised immune system or was on any antivirals?

4. 4. If I somehow missed a mild sore early on, or around week 9, would the IGG test have picked it up by now?

5. 5. Would an initial sore mostly show on penis or elsewhere?

6. 6. Could you see anything else delaying a seroconversion?

Thanks so much

Terri Warren, RN, Nurse Practitioner

83 months ago

1. I don't feel that you need to test again, no. The test is as good as it is going to get at 12 weeks out.

2. A little, yes, perhaps a week or two, but you are good at 12 weeks, even though you are HSV 1 positive

3. I would mostly agree with that though I have seen a few people develop antibody between 8 and 12 weeks out.

4. the IgG, compared to the western blot, picks up 92% of HSV 2 infections.

5. Yes, on the shaft of the penis is the most common site of infection in males

6. I don't see anything else delaying serconversion, nope. And a single encounter is really low risk, statistically.

Terri

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83 months ago

Thanks, Terry.

A few follow up questions.

1. Is there a correlation between hsv1 and hsv2, antibodies and testing — meaning that since I show for hsv1, should show for hsv2 if I was infected?

2. Should I be concerned about the tingling sensations I have been experiencing? Again, they have been on and off for a few weeks now. Started around week 9.

3. Do mild cases still typically show as blisters or ulcers — as opposed to a pimple look?

4. How often have you seen people show positive for hsv2 after 12 weeks that weren’t on antivirals?

5. At week 12, if infected, would most people at least have a low IGG result?

6. Do you still offer video conferencing?

Thanks

Terri Warren, RN, Nurse Practitioner

82 months ago

1. Is there a correlation between hsv1 and hsv2, antibodies and testing — meaning that since I show for hsv1, should show for hsv2 if I was infected?

Yes, if you were infected with HSV 2 it should show up on the antibody test, regardless of whether or not you have HSV one.

2. Should I be concerned about the tingling sensations I have been experiencing? Again, they have been on and off for a few weeks now. Started around week 9.

Many people who have a concerning sexual encounter describe tingling and the vast majority of those people who end up testing for herpes test negative. On and off tingling, in my opinion, has no particular meaning if that is the only symptoms that one experiences.

3. Do mild cases still typically show as blisters or ulcers — as opposed to a pimple look?

Even in mild cases of herpes infection, people will most often, at some point, demonstrate a herpes lesion and it does not really look like a pimple. It looks more like a blister.

4. How often have you seen people show positive for hsv2 after 12 weeks that weren’t on antivirals?

If you are asking about becoming positive for HSV-2 on the IgG test after 12 weeks, I have not seen that happen if they are not on antiviral medicine. I have seen people who are negative on the IgG test at 12 weeks be positive on the Western blot.

5. At week 12, if infected, would most people at least have a low IGG result?

Yes.

6. Do you still offer video conferencing?

Yes, I do offer videoconferencing for the purpose of obtaining a herpes Western blot which is part of a study that we are doing looking at the accuracy of the IgG test as compared to the herpes Western blot. This can be done at WestoverHeights.com.

Terri oh Hello

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82 months ago

Thanks, Terri - I apologize for spelling you name incorrectly on the last reply.

A few quick follow ups.

1. How many people, in your experience, have tested negative on the IGG at 12 weeks but positive on the WB?

2. The tingling in my feet has now turned into more of a heat sensation. Is this common?

3. How often do you find patients that have psychosomatic symptoms?

4. I was diagnosed with prostatitis, is there ever a mix up between that and HSV2?

5. Do you have confidence in the IGG tests?

Thanks

Terri Warren, RN, Nurse Practitioner

82 months ago

in my experience, and that date from 7 years of data collection at our clinic,8 out of 100

Oh, so often!

No, the symptoms of prostatitis and herpes do not overlap

I have some confidence in the IgG particularly the HSV 2, with the limits that I have described above.

Terri

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