[Question #5057] STD Exposure

26 months ago
In November of 2018 I was tested for STDs and they came back negative on both HSV1 (.13) and HSV2.  At the end of November I had unprotected vaginal intercourse with a low risk male who had not had sexual partners for a number of years.  In January of 2019 I began a monogamous relationship with a male partner. Either the second or third week of February he preformed oral sex on me.  At the end of February (12 weeks from the November encounter) I began to have serious vaginal irritation (redness) and went to the Dr for testing. I did not have lesions or blisters that I could see and the Dr said I had a bacterial infection after swabbing my vagina. Seven days from that testing I am still mildly red on my labia and I noticed a small spot that is raw and slightly open but not blistered it appears to be about the size of a pencil tip on my labia and close to my vaginal opening. I have been on an antibiotic for 7 days. My IgG results came back as negative for HSV1 but the number is now .25 and the HSV2 number is the same at .09. My IgM was 1.44 and he said he would like for me to come back in 3 months to retest because of the elevated IgM. After reading your answers I see that IgM is not a valid way to gauge HSV transmission but I found it odd that my HSV1 levels were doubled and believed it may be possible that my second partner passed HSV1 to me. My question is what is the likelihood that the first partner gave me anything since my HSV1 numbers were so low at the time of testing at the end of February? If this came from him would my numbers be more elevated. Also if my partner gave me wither HSV1 or 2 should my symptoms be more severe if this is my first "outbreak"? Is it possible that it was not a bacterial infection but a different type of nonviral infection? And lastly if this is a lesion can anything else cause it? I feel like by the seventh day of an antibiotic the redness should be cleared up uI do not want to pass HSV1 genitally to my partner if his is just oral. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
26 months ago
The difference in the two numbers is not in any way significant.  it is completely normal to have variation in these number.  But the other issue is that the IgG test misses 30% of HSV 1 infections, compared to the gold standard western blot.  So you could have HSV 1 and not know it. 
When you went to be seen was any swab testing done of the area at all for herpes?  And if swabbing for a bacterial infection was done, do you know the result?
The person with whom you are having a monogamous relationship  - are you having unprotected intercourse and has he been tested for HSV ?
If your partner does have oral HSV 1, he is EXTREMELY unlike to acquire the same infection genitally

Terri
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26 months ago
Terri thank you for the fast response. At the time of my appointment he did not swab my labia because I did not have any lesions only redness. He did swab inside my vagina and told me under the microscope he saw bacteria hence the prescription for antibiotics. But I was not told any numbers.  If I had HSV 2 from the prior partner would it have shown by now via IgG testing? The reason I ask again is because I read that HSV 1 is more receptive to antiviral medicines.  I am trying to get another appointment to have the area swabbed. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
26 months ago
Actually, HSV 2 is a bit more receptive to antiviral medicine. 
If you acquired HSV 2 from the person in November, yes, I would expect it to pick that up by now. 

Terri
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26 months ago
He tested negative for both HSV1 and HSV2 in December.  Since my post the raw "spot" is almost gone. I am still red but not as bad. I am guessing it could be a yeast infection from the antibiotic. For peace of mind I may go back and ask them to swab the spot but I don't want to be an alarmist. During the first visit they saw no signs of a sore or blister. And I was checking myself so much I think I may have irritated myself more.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
26 months ago
I agree that a yeast infection from taking the antibiotic is a more likely explanation.  If this happens again, with the raw spot, I would suggest that you be seen right away and ask for a herpes swab test.  For now, I think you should feel reassured.

Terri
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