[Question #5767] Follow Up From Previous

22 months ago
Hi
To summarize , I awaiting response from Terri but I’m hoping other docs may answer due to western blot question.   I’m a male who received oral and some kissing from woman 30 days ago.  I was tested for all STDs a year ago and was negative.   After this episode I was worried so I got tested again Elisa HSV 1-2 at 21 days and received a 1.36 positive result.  Further questions led to me being told recent infection was unlikely , could possibly be false positive , or my test last year was false negative.  As a result , I got another igg test at day 25 with the exact same result 1.36 for HSV 1.  Can this still be a false positive after 2 tests , and should I confirm with Western Blot , or was I just unlucky and had this happen from recent event.  Also, if I do in fact have the HSV1, how do in ensure that I don’t pass it on to my 4 years old child.  Very anxious and worried.   Can’t believe this has happened.  
22 months ago
Just received a response from Terri.  It sounds like it could still a false positive due to a protein weight my body may have.  Final question before I get a WB test;  if it was protein related , would the protein weight not have been there last year with negative test?  And would still appreciate precautionary items regarding being around my child.  
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
22 months ago
Welcome back to the forum, but sorry you found it necessary. I reviewed your previous three discussions with Ms. Warren and Dr. Hook and agree with all they said.

But since you're here, I will add a few thoughts of my own. First, genital HSV1 really isn't something to worry much about. Unlike HSV2, genital HSV1 recurs infrequently: most persons have no recurrent outbreaks at all, or only 1-2 episodes over a couple of years and then no more. And the virus rarely is present without symptoms (asymptomatic shedding). As a result, it is rarely transmitted to sex partners. In my 40+ years in the STD business, I believe I have never had a patient with genital HSV1 acquired by vaginal sex:  every case was acquired from oral exposure. And as already advised by the others, the chance of catching genital HSV1 after any single oral sex exposure is very low -- I would guess under 1 chance in many thousand.

Second, as for your child, there is little risk. In the event you ever have an oral herpes outbreak, don't kiss your child (or anyone else) until it heals. Otherewise don't worry about it and no special precautions necessary. And accept the fact that your kid is very likely to catch HSV1 anyway, since half of all adults have positive HSV1 blood tests, mostly due to infections acquired in childhood (probably your situation, if confirmed by WB). Most infected kids catch HSV1 not from infected adults, but from other kids with oral herpes. (From just having a toddler with typica;l toddler's hygiene, you undoubtedly understand the potential for HSV1 transmission in day care, among playmates, etc.) And look at it this way:  since half of all adults have positive HSV1 blood tests, in a two-parent household there is nearly a 75% chance one parent has HSV1, and yet kids infrequently catch HSV1 from a parent.

The problem now is that because of your unnecessary anxiety, you had a blood test you did not need and should not have had. If you had asked after the exposure and beforre testing, all three of us would have advised against testing:  the risk of infection was too low after such an exposure. But now you have to deal with the uncertainties until and unless you have the HSV Western blot. If positive, it probably will reflect a distant past oral infection, but it will not be possible to know the source with certainty.

I don't understand "protein weight". I have never heard that term, either in connection with WB or anything else. But I hope my other comments are helpful.

HHH, MD
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22 months ago
They are.  Not sure if you are familiar with the information regarding last year negative test and now 2 test  with exact same results of 1.36.  Terri stated it could still possibly be false due to a protein  in my blood weighing same as  the hsv 1.  That’s what I was referring to refusing my question about whether or not my blood or any protein weight would’ve been the same for the negative test result last year. Sorry for confusion.  And yes my anxiety is really bad right now.  All of the doctors and nurse on here provide such a valuable service for those of us with such anxiety.  Thank you 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
22 months ago
I clarified with Terri. This protein business is a possible but not proved explanation for some false positive HSV antibody tests. No particular protein has been identified.

You'll just have to wait for the WB results. Threads are closed after two follow-up comments and replies, so you have one follow-up comment to come. I'll leave this thread open so you can let me know your WB results, but won't have any further comment until then. Or you could post a new question for Terri.

In the meantime, please re-read my comments above very carefully. They explain why your axieties about this are unwarranted. If you understand and absorb those commetns and remain anxious, consider professional counseling to address probable underlying psychological issues going on.

Thanks for the thanks about our services!
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22 months ago
Coincidentally I had a physical with my GP today , and he will order the WB. We discussed the  other items as well.  I know I’m anxious person when it comes to this stuff , and I’m working on it.  How long past exposure is a good time frame for WB.  Thanks to all of you for the service you provide.  Very valuable service for people with questions.  Thank you 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
22 months ago
I was editing my reply above when you were sending this. The WB is valid any time the ELISA test is positive; it can be done now, no need to wait. I'll still leave this thread open, but no further comments or advice until you have the WB result to report. Thanks.---
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
21 months ago
This thread will be closed at 28 days after your initial question. If you have a test result to report, please do so within the next two days.---
21 months ago
Hi Dr Handsfield
I’m actually going for the WB this weekend , which will be 2 months post incident.   As time had passed,  I’ve come to accept either result , but still would like to know.  And I know that HSV1  isn’t a big deal , but I was someone who was “clean “ for a long time , married , and didn’t think it was something I’d need to worry about.  But life is ever changing  I guess.  I would like to state again that you and your colleagues provide such a valuable service for individuals,  and it’s much appreciated.   Additionally, something that I don’t see mentioned here much is the role of drugs and alcohol.  99 % of my mistakes and worries in life have been a result of too many drinks , and it’s been on and off for years.  When the inhibitors are off , bad choices can and will be made.  Safe sex can also be practiced by avoiding situations that shut the inhibitors off. When I get my results , I’ll pay $25 to let you know  how it came out.  Thanks again for all that you do.  You have most likely saved lives from  these forums.   Be well. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
21 months ago
It's been a few more days and this thread is being closed. Whatever follow-up test you have, it won't be a Western blot. That older technology is no longer used for HIV testing. But whetever it is, there is definitely no need to start a new thread to report a negative result. All we will do is agree "Yup, you'r negative, move on." Of course should it be positive, let us know -- but that isn't going to happen.

Thanks for the thanks about our services. I'm glad to have helped.
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