[Question #4739] Living in hell

27 months ago
Thanks doctor hands field
Had protected sex condom was offered by csw but I don't know quality and expire date with csw high risk group in India am from India only vaginal sex for five minutes..
Two days after swollen metus burning and discharge for two months doctor diagnosed ngu with out test and offer 1g azitro and 7days doxy symptoms went away..
At 11thday HIV 1 pcr RNA negative at 4,8,12 weeks HIV 4thgen,hbsag,hcv,,tpha ,vdrl negative
At4months hsv1 and hsv2 negative and at 6months HIV,hbsag,hcv negative
At 12months a lot itching scrotum with 6 itch lesion  no pus or water in it they are hard doctor diagnosed with scabies it went away  in three days.
And 24 months blood in urine horrible pain in pennis urine culture negative and urine analysis wbc 8-10 and also shooting pain In anus..
And hsv2 igg was 5.9  had 1gm azitro 10days twice doxy,2g flag symptoms went away but swollen metus and discharge and at 36months I tested hsv1 igg 2.65 and hsv2 igg was 1.85 .urine pcr gonorrhea and Chlamydia and positive for Chlamydia had taken 2g azitro and twice doxy for 20days and levofloxacin 1g daily for 7days and am on currently taking minocycline 100mg twice daily but discharge and swollen metus are present
My question 
1 Is my HIV test conclusive and do I have herpes?Do am infected hsv1 and hsv2 single explore genitally..
2Why my treatment not working for Chlamydia?Is Chlamydia resistant to antibiotics
And if I were your patient what treatment and test further you recommend for me..
3 India is third world country doctor says igg test wrong and Igm is correct I know they are wrong
4 finally what is your further advise for me..In India there is no good doctor and medical field In STDs..My further treatment and test and relationship is depend on your advise...
Edward W. Hook M.D.
Edward W. Hook M.D.
27 months ago

Welcome to the Forum and thanks for your question.  Clients on this site are not permitted to request who responds to their questions.  All questions regarding herpes go to Ms. Warren and Dr. Handsfield and I split all other questions.  As it happened, today I happened to pick up your question.  As an FYI, having worked closely for more than 35 years, Dr. Handsfield and I never disagree on the content of our replies although our verbal styles vary.  I will be addressing this question.

Thanks as well for the detailed information on your past test results.  Several portions of what you provide are a bit unclear to me.  As I understand it, you has a single condom-protected exposure to a CSW more than two years ago, is this correct?  If so, have there been other exposures to any other partners since that time?  

I also note that you report using a condom for your exposure to the CSW over two years ago and that you did not state that it broke.  If the condom did not break, then it did its job and would have provided highly effective protection against HIV, gonorrhea, and chlamydia and would have dramatically reduced your risk for herpes.   for you to have had symptoms and repeated positive tests for chlamydia despite treatment with azithromycin, doxycycline, and levofloxacin is most unusual and may suggest that something other than a persistent infection is going on.  could you have a regular partner who became infected and keeps re-infection you?  Alternatively, could there be some other problem- kidney stones, a urinary tract infection or prostatitis?  Finally are you confident that the medications you have been taking are real and not counterfeit?  Any of these things may be occurring and it may be appropriate to seek a second opinion if all of your treatments so far have been from the same person.

In answer to your specific questions:
1 Is my HIV test conclusive and do I have herpes?Do am infected hsv1 and hsv2 single explore genitally..
Your tests prove that you did not acquire HIV.  there is no need for further testing for HIV.  Your herpes test results suggest that you may have had a falsely positive test for HSV-2 if you have not had herpes outbreaks or genital sores.  

2Why my treatment not working for Chlamydia?Is Chlamydia resistant to antibiotics
See my comments above.  Antibiotic resistant chlamydia is most unusual.  In addition, rarely some people have falsely positive tests for chlamydia.  When he test results are falsely positive, switching to a different brand of test may give different results.

And if I were your patient what treatment and test further you recommend for me..
I would perform bacterial culture tests on your urine and examine you for other problems such as I mentioned above.

3 India is third world country doctor says igg test wrong and Igm is correct I know they are wrong.
HSV IgM tests are frequently incorrect.  Here in the U.S. we specifically recommend against their use, preferring the IgG test.  Please see my comment above regarding falsely positive HSV blood tests.

4 finally what is your further advise for me..In India there is no good doctor and medical field In STDs..My further treatment and test and relationship is depend on your advise.
I look forward to your further responses to my questions.  It sounds like you have another regular relationship.  If so, it may be important for her to be tested for chlamydia.  EWH

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27 months ago
The explore was Nov 2015 and I also tested HIV 20,30,36 months and it was negative
Condom was intact only penis head was entered in vagina but after that I did not removed the condom and weared underwear and travelled for 15 min and removed condom from pennis and weared same underwear and it was wet I think due to my semen from condom does std transmission occur this way
I never and any partner in my life except the explore
My doctor offered semen culture for any bacteria the report will be in three days
My metus is swollen and always there is some discharge when you squeeze it
One year back I had one lesion on shaft of penis it had a hair in middle of it and with white pus went away in three days and also some time I get itching alot only on scrotum 
Why my treatment does not working
What is next step should I take tests , treatment 
Is my herpes test false positive
And what about Chlamydia

Edward W. Hook M.D.
Edward W. Hook M.D.
27 months ago
thanks for the additional information.  It leads me to the following conclusions and advice:
1.  It sounds as though you may have falsely positive tests for chlamydia.  I suspect there are sexual health experts in India, you will just need to find one and work with him or here.  
2.  I think the semen culture is a good idea.
3.  A certain amount of discharge is normal.  Further, repeated self examination and squeezing the penis can be irritating and increase the otherwise normal amount of discharge present.
4.  I do not have a good explanation for your repeated positive tests or that your treatment is not working and have little to add other than to suggest testing with a different test for chlamydia, looking for other causes such as a bladder or urinary tract infection, or kidney stones or other non-STI problems.
5.  The penile lesion you describe does not sound like herpes.  My sense is that you do not have genital HSV from the exposure you have described and suspect the lab tests you've had were falsely positive.

Please be aware that our guidelines allow us to provide just three responses to each question.  I strongly advise you to wait to respond with your 3rd question until you have your semen cultures.  EWH
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26 months ago
Thanks dr hook
My semen culture came back negatieve...My doctor says not to worry and says forget the incident and move on with my life
But I have some questions
1 is my hiv tests conclusive do i need further testing ?
2 why my herpes test are positive ..Can a person get infected with hsv1 and hsv2 gential in single encounter without oral or kissing?
3 can i procedure to further relationship with out telling her about my herpes tests?
4 why my Chlamydia treatment not working...Why antibiotics not working?
5 what tests and treatment do you recommend if I were your patient?
Edward W. Hook M.D.
Edward W. Hook M.D.
26 months ago
Thanks for the follow-up information.  I agree with your doctor.  It is far past time for you to stop worrying and put these concerns behind you.  I have provided final responses to your follow-up questions below, many of which have already been addressed.  As per Forum Guidelines, this thread will be closed following this response:

1 is my hiv tests conclusive do i need further testing ?
Yes, your HIV tests were conclusive long ago.  No need for further testing related to the encounter you described.

2 why my herpes test are positive ..Can a person get infected with hsv1 and hsv2 gential in single encounter without oral or kissing?
Repetitive and answered previously- please see my responses above.  The encounter you described is most unlikely to have resulted in herpes infection.

3 can i procedure to further relationship with out telling her about my herpes tests?
Yes

4 why my Chlamydia treatment not working...Why antibiotics not working?
Repetitive-please see my earlier responses.  

5 what tests and treatment do you recommend if I were your patient?
I would follow your doctor's advice and move forward from here.

This ends this thread.  EWH

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26 months ago
Thanks for your response...