[Question #4320] Possible Herpes
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82 months ago
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Hello experts,
I’m a mid 30’s straight male. I saw a csw 20 days ago (sept 6) and received unprotected oral sex and had protected vaginal sex. The condom did not break and seemed to have stayed on properly. However at the end when I was withdrawing I noticed the condom looked like it slipped up a bit.
8-9 days later I noticed a small bump about half way up my shaft. It was small and raised up just a little bit. It wasn’t very red and the area around the base was not red at all. I freaked out and went to planned parenthood to have it looked at. The provider was confident it wasn’t herpes and thought it may have been folliculitis. She even noted that it looked like it had a center to it; the center appeared dark almost like a scab color. It never came to a head and nothing came out of it. It stayed like that for a couple days then almost overnight it turned into a very light scab. The scab stayed on for a few more days then came off naturally in the shower. So it took about one week from the original bump forming until the scab fell off. After the scab came off I was left with a red spot the same size as the scab. The red spot was not an open sore and there was no fluid or blood at all. It is perfectly flat and painless with no itching. In the right light it will almost appear shinny. The red spot has been there for five days now and gets progressively better everyday. I saw another provider yesterday 9/25. She felt that it wasn’t herpes but her knowledge seemed very limited. She said herpes does not scab and that I could take a blood test whenever I wanted. I knew right there she was uninformed. I never had any other classic symptoms of herpes. No fever, swollen glands, blisters, etc. Also I didn’t the So my questions are....
1. Does my description seem like this bump could have been herpes?
2. I know the recommended test is the IGG blood test at 12-16 weeks post exposure. What is a accuracy of the test earlier at maybe 6, 8, 10 weeks? The waiting is killing me.
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Terri Warren, RN, Nurse Practitioner
82 months ago
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The bump does not sound like herpes but I cannot be certain. I'm glad that you saw a professional that was in a better position to make the evaluation.
And correct, the second person you saw is uninformed about herpes.
The accuracy of the IgG test at 6 weeks is about 70% for HSV 2- that is, if someone is going to seroconvert, 70% will have done so.
The IgG misses 30% of HSV 1 infections at 12 weeks compared to the westernblot.
Terri
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82 months ago
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Thanks for your reply. So I took an IGG test at exactly 3 weeks to try to establish a baseline, I tested negative for both 1 & 2. Is this result any good for my recent potential exposure? Also when you say that the igg misses 30% of type one at 12 weeks do you mean the test misses 30% or that 30% of people have not converted at that point? Hope that makes sense. Trying to determine the accuracy of the test. Based on my exposure what do think the chances of me getting herpes is? Also do you recommend that I continue blood testing?
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Terri Warren, RN, Nurse Practitioner
82 months ago
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Yes, it is possibly good news. 50% of those who are going to be positive from a recent infection will do so by 3 weeks out.
The IgG test misses 30% of those infected with HSV 1, when they wait about 12 weeks to be tested.
Since the test at 3 weeks only picks up 50% of those infected with HSV 2, it certainly is not definitive, wouldn't you agree? It is helpful to have this as a baseline value, however.
Terri
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82 months ago
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Ok so the blood test for hsv1 always misses 30% of infections? Say a person has had hsv1 for years, is the test still only 70% accurate? Also let’s say I did contract herpes from this event but did not have symptoms in the first 2-20 days. When could I expect to see symptoms appear? Asking for both oral and genital. Reading the other posts it seems like primary outbreaks would occur within the first 3 weeks. Since I made it thru the 3 weeks when could I expect to see symptoms from the possible infection?
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Terri Warren, RN, Nurse Practitioner
82 months ago
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The 70% sensitivity for the IgG test for HSV one is all people who have been screened for HSV one and two. It was not broken down by whether they had cold sores are not in their history. Yes, people who have symptoms with the first infection we'll normally have them within 2 to 10 days after up concerning a encounter but not everyone who gets herpes gets symptoms right away so it's difficult to say whether or not you might have outbreaks in the future. If you want the most accurate test for HSV one it is the herpes Western blot from the university of Washington . I can help you obtain that through a study that we are conducting comparing the sensitivity of IgG versus Western blot. You can find out more about that on my website, www.WestoverHeights.com
Terri
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