[Question #5712] Western Blot Results

20 months ago
Hey Terri-

I know we spoke about a month ago when I was about to take the Blot. Just received my results. HSV2 Negative, HSV1 Indeterminate. I'm a little confused as what steps to take next. I know that can happen if you test too soon. I waited around 16  weeks from the time of the original symptom/red spot around my lip before I tested. The only thing is like I said the last time we spoke, I had gotten those similar symptoms 3 times, 1 month apart from one another, starting back to that original 16 week date. Although the red bump/spot around my lip on the last occurrence, lasted the longest (This was around two months ago) Is it possible that this was actually the primary infection and i tested too soon? I just felt they were all the same each time thats why I tested instead of waiting for 12 weeks after the very last partner/exposure. (I tested around a month after that partner) Also, a few weeks ago (around 30 days after receiving oral sex from that same/3rd partner) I noticed a pimple type bump at the base of my penis, I popped it just because I thought it was a pimple. The next day it was a little red so I went to an urgent care and they said they we're concerned about it. I squeezed at it a bit because I was still seeing if there was more pus/liquid, and there was like two super tiny scabs that formed from the me irritating it. I don't exactly remember what color the fluid was inside but it was completely resolved in 4 days. No pain or anything. Does that sound like it could have also been HSV1 related? I feel like a month is uncommon for a primary genital infection to appear but since I noticed something orally first, I wasn't sure if that would effect getting the timing of getting it genitally as well. Should I be doing a comparative test next? I'm just a bit confused and unsure. Thanks. 

20 months ago
To clarify as well, each of these bumps/red marks near my lips were each around the time of a different partner (3 partners total). The last exposure with these individual partners occurred 16 weeks before taking the blot, 12 weeks before taking the blot. and then 4 weeks before the taking the blot. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
20 months ago
An indeterminate is so difficult, I know.  Very frustrating not to have a clear answer on the blot. 
I have two things to suggest here:
1) if you get any of these things again, I want you to go in right away and have a swab test done of the area.  Ask for a PCR or NAAT swab instead of a culture if possible - far more sensitive
2) the UW recommends retesting three months from the first test. 
You did wait long enough but HSV 1 can be tricky.  Do these things sound like a reasonable plan to you?

Terri
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20 months ago
Hey Terri-

Yes I think these are totally reasonable. I guess I'm just most bummed/unsure of what to do as far as dating and sexual intimacy. I was preparing myself to be ready for the worst and now I just feel weird about it all. I already disclose my HPV status with partners prior which is stressful, but really isn't that big of a deal amongst most that I have dated, but now I'm unsure if I should just not say anything about possibly having HSV1. I use protection when I have sex regardless and I know you've stated on here many of times that genital to genital hsv1 transmission is very rare. So should I carry on as if I don't have it genitally until I see some sort of symptom again? I also realize that there's a chance that if I actually somehow have GHSV1, I may never have another symptom for the rest of my life. The retest is definitely an option I want to look into but I know it's not going to tell me if I have this genitally. I also know it's pretty expensive to do the comparative exam. Thanks for your help on this. I really appreciate it.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
20 months ago
I do think you should carry on as though you are not infected with HSV 1 until or if you have symptoms.  That's not a 100% perfect recommendation, I know.  But I'm at an STD meeting now where we learned from a research project that IF people have HSV 1 genitally, the shedding rate is less than 2% after the first year of infection, which is just terrific news.  I wish we had more firm news for you Tyler - I guess we can only go with the best we have.  Again, I can't tell you that you are definitely NOT infected with HSV 1 but you've had no symptoms and lack a positive western blot.  BTW, why are you telling people that you had previous HPV  - or is that a current infection?

Terri
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20 months ago
That is good news for sure! Yea I don't think this would be bothering me as much had I not had that small bump near the base of my genitals that I popped that caused alarm. But because the whole thing only lasted 3-4 days total, I just wasn't sure. I've had pimples in similar areas before, but I just didn't really know what to think it was because I couldn't tell if the liquid was white, cloudy or clear that came out. I took a photo at the time but it's out of focus and doesn't really look like that was actually there. I also don't remember if the photo was before or after it was popped so it just sort of looks like a shiny skin bump or lump/bubble. I also dont want to get a wrong diagnosis based on a low resolution phone photo.  As far as my HPV, I had a wart reoccurrence around 3 months ago and am going for a 3 month follow up this week because I had a bump which I wanted looked at which is why I've been open about it with recent potential partners. I really appreciate you walking me through this. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
20 months ago
I understand your concern about both things, yes.  But not much to do unless you get another lesion.

Terri
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