[Question #4644] Testing

26 months ago

Dr. Handsfield,

 

I have bloodwork from 11/23/18. My last perceived exposure was 10/6/2018.

 

Are these tests reliable and conclusive? Do my tests indicate that I am infection free permanently at this point?

 

·         Last unprotected sex (all 3 kinds) was with a woman in a relationship (status uncertain)– over 3 years ago (One woman I met after that however did slip the head of my penis real quick in her vagina – over 15 weeks ago)

·         Last exposure was a hand-job at a massage parlor on 10/6/2018. I’ve been to countless massage parlors. I’ve done a table shower at a couple. One woman may have kissed or licked my testicles quickly at another parlor on 6/7/2018 (I didn’t feel anything though – I believe I stopped her in time). A couple of women fingered my anus at a massage parlor.

 

Do I need to concern myself with different strands of bacteria, virus’, etc with this testing? Do I need to be concerned with HPV or other STIs that are not common and tested? If I get the HPV vaccine, that only prevents future infections of HPV, correct?

 

Can I put my mind at ease finally?

 

HIV

HIV -1/2 AG + ABS, 5th GEN W/ REFLEX

HIV-1 Antibody                                                            Non-Reactive

HIV-2 Antibody                                                            Non-Reactive

HIV-1 P24 Antigen                                                       Non-Reactive

HIV Antigen-Antibody                                                 Non-Reactive

 

Hepatitis

Hepatitis A (TOTAL ABS)

ABS                                                                                    Negative

 

Hepatitis B (HEPATITIS B SURF. AG /W REFLEX CONFIRMATION)

SURF. AG. QUAL                                                          Negative

 

Hepatitis B (SURFACE ABS)

SURFACE ABS                                                                  54.70 HI

 

Hepatitis B (CORE TOTAL ABS)

CORE ABS                                                                       Negative

 

Hepatitis C (HEPATITIS C IGG ABS)

ABS                                                                                Negative

 

HSV (Herpes Simplex 1 and 2)

HSV TYPE 1 IGG                                                            .10       

HSV TYPE 2 IGG                                                           .08

HSV 1/2 IGM ABS                                                         2.24 (Abnormal)

 

Syphilis

SYPHILIS SEROLOGY

ANTI-TREPONEMAL ABS (IGG/IGM)                          Non-Reactive

 

Chlamydia

CHLAMYDIA TRACH, RRNA URINE

CHLAMYDIA TRACHOMATIS rRNA URINE                Negative

 

Gonorrhea

N. GONORRHOEAE RRNA URINE

NEISSERIA GONORRHOEAE rRNA URINE                Negative

 

Trichomonas

TRICHOMONAS VAGINALIS URINE

TRICHOMONAS VAGINALIS URINE                            Negative

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
26 months ago
Welcome to the forum. Thanks for your question.

Hand-genital contact is risk free, and so is oral contact with scrotal skin. (The only oral sex with STD/HIV risk requires exposure of the head of the penis and urethral opening.) So the timing for interpreting your tests is 15 weeks, when apparently you had brief unprotected vaginal sex. 

All the negative and non-reactive results are normal and conclusive at 15 weeks. (They also are reliable if somehow you had been exposed 10/6, 7 weeks before testing.) Your hepatitis B results indicate you have been vaccinated and are immune.

So the only result not ocmpletely normal is the positive HSV IgM antibody test. However, HSV IgM antibody is very unreliable, with frequent false positive results. For this reason, STD and herpes experts never do the test -- and if dealing with a lab that does the IgM test routinely, we ask that it not be done. The results never is helpful and often misleading. Your HSV IgG results are conclusively negative for both HSV1 and HSV2.

There are no "strands" (strains or types) of any of these bacteria and viruses not detected by the tests you had. There are no tests at all that can reliably tell whether or not someone is infected with HPV. Since you're not a virgin, you can safely assume you have had genital area HPV and could be carrying an active infection. Somewhere around 90% of all people get HPV and at any point in time, up to half of all adults are carrying it. But this is simply a normal aspect of human sexuality and nothing to be ocncerned about.

Finally, you correctly understand the HPV vaccine:  The version used in the US reliably protects against 9 types (2 types or 4 types in some countries) but has no effect on existing or prior HPV infection.

Your closing statement suggests you've been unnecessarily concerned, perhaps for a long term ("Can I put myself at ease finally?") As described, you really haven't been at risk in any significant way. Keep it up -- and keep those condoms handy, in case further contacts like this end up including insertive sex.

I hope these commetns are helpful and reassuring. Let me know if anything isn't clear.

HHH, MD
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26 months ago

Hi Dr., 

 

So just to make sure that I understand, the information that I provided illustrates that I have been tested for all of the common STIs except HPV, that includes, HIV - Hepatitis - HSV - Syphillis - Gonorrhea - Chlamydia - Trichomonas. The tests are completely reliable (excluding the IGM test for HSV which is irrelevant with the IGG) and they are all conclusive at 15 weeks. Or is it sooner, and you were just referring to the time passage of the vaginal exposure? (I think the vaginal exposure might have only been insertion between labia not actually the vagina. Nonetheless, I will assume vaginal. Exposure date: 8/13) 

 

So, if I am negative, non-reactive, or in normal range for all of these infection types at 15 weeks, I am clear from these infections, meaning that I have no infections and if I was infected in the past from exposures over 15 weeks prior to testing, my immune system got rid of the infection and I wont become infected again after that unless I have new exposures?

 

Just to clarify, if I may, you had mentioned if I was exposed on 10/6 somehow, that the test results would be reliable and conclusive. Is that relevant only for the type of exposure I had because there was no form of oral, vaginal, or anal sex? It was just about 7 weeks not 15 weeks for what I interpreted was the testing window for the complete set of infections unless of course again you were only referring to the vaginal exposure and the testing window that covers all of the common STIs is less than 15 weeks.

 

Lastly, are bacteria and viruses associated with uncommon STIs weak pathogens with no viability to cause infection; nothing the immune system could not get rid of? If someone is negative for the common STIs, is it safe to assume that they are negative for the uncommon ones.

 

Thank you. 

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
26 months ago
First paragraph:  You correctly understand my opinions and advice above.

Second paragraph:  Also correct.

Third:  The tests are reliable regardless of the type of exposure. Even if you had been at risk (you were not), the tests prove you did not catch any of the infections for which you were tested.

Finally, I'm not sure what you mean by "uncommon STIs". My advice above, and the accuracy of your test results, are valid for all STDs for which you were tested, including both the common and uncommon ones.
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Don't overthink it! And don't search the web for further information: most persons with anxieties like yours tend to be drawn to inaccurate information that inflames their fears. Don't have any more tests of any kind.---
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26 months ago

Hi Doctor,

 

I am on the same page for paragraph one and two. I am conflicted with the testing window that covers all STIs including HSV. Is it 15 weeks or 7 weeks? Fortunately, you had explained that my test results for the date I had taken it was sufficient to cover exposure if there was any on October 6, but that was just under 7 weeks.

 

Also, could an exposure on October 6 accumulate bacteria, virus, etc. collectively with exposure in August to develop infections, or are these exposures too distant from each other? So, if I am clear for August exposure, October would be isolated. However, I do understand that conclusive test results would cover both exposures with sufficient time passage.

Lastly, I think I misunderstood another thread where it was explained that there were over 30 different bacteria and viruses that are sexually transmitted. I was assuming those were the uncommon STIs that are untested. Then, are the above 30+, types of the ones that I was tested for (including HPV types) or are they general bacteria and viruses that just happen to be a part of sex among anything else and aren’t exactly STIs?


I really hope that my test results are completely reliable and conclusive for exposure on 10/6  assuming there was any for all STIs (excluding HPV), and of course the exposures before that.

 

Thanks. 

H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
26 months ago
6 weeks is fine for all STDs except HSV. For that, 90% of new infections show up by 6-7 weeks, but it taked ~15 weeks for conclusive negative results for HSV2. There is never a conclusive result for HSV1, since 20-30% of infected persons do not develop positive antibody tests.

There indeed are 30+ organisms that can be transmitted sexually, but many of those are garden variety things like common intestinal infections, and genital bacteria that are harmless. It's probably best to look at these as sexually transmiSSIBLE but not usually sexually transMITTED. And most of these would cause obvious symptoms, which you don't have, which itself is reassuring.

Your tests are as conclusive as possible. It's time to move on without worry and to have normal sexual relationships without fear you are putting your partner(s) at risk.

That concludes the two follow-up comments and replies included with each thread and so ends this thread. I hope the discussion has been helpful.
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