[Question #5791] hsv & hiv testing

20 months ago
Hello Doctors,

To clear my mind of any doubt I'd like to get tested for both hsv 1 & 2 and HIV.

1. What is the best to take for HIV?
- When will I get 90% certainty ?
-When will i get 100% certainty ? 

2. What is the best to take for HSV?
- When will I get 90% certainty ?
-When will i get 100% certainty ? 
- no lesions

Edward W. Hook M.D.
Edward W. Hook M.D.
20 months ago
Welcome to the Forum and thanks for your questions.  

For evaluating HIV status results of 4th generation, combination HIV antigen/antibody tests, results are 99% conclusive at 4 weeks following exposure and 100% conclusive at 6 weeks.  At 3 weeks these tests may detect around 90% of recent infections.

If you are asymptomatic and have not been tested before, we strongly recommend AGAINST  blood tests for HSV.  If you test and are positive you will not know if the positive test is falsely positive or not, or if you actually have HSV, how long you have had it.  Further, blood tests for HSV-1 miss about 25% of recent infections and about 5% of HSV-1.  For persons with proven HSV, about 90% of infections are detectable around the 3 month time after exposure.  Again however, unless you have a good reason to do so, we recommend against blood tests for HSV.

Hope this comment is helpful. EWH
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20 months ago
Hi Doctor,

You mentioned HSV-1 here twice...can you clarify ?
-Further, blood tests for HSV-1 miss about 25% of recent infections and about 5% of HSV-1.

also, what is the timeline with no lesions that you would feel comfortable someone didnt acquire hsv 1 and 2 ?

20 months ago
referring to both oral and genital lesions 
20 months ago
i’m at 21 days past a possible lip to lip kissing exposure. she didn’t have any visible soars. left part of lip tingles a little bit after waking up this am
20 months ago
would lymph nodes be inflamed with lesion ?
Edward W. Hook M.D.
Edward W. Hook M.D.
20 months ago
The site of the infection makes no difference- HSV-1 can infect both the genitals and oral cavity.  Most people with HSV-1 (about 60% of American adults) have acquired HSV-1 during childhood, do not experience cold sores, and do not know that they were infected.  HSV-2 almost exclusively causes ano-genital infection.  Almost 1 in 5 Americans has this infection- most people who do have the infection (90%) do not know they have it.

I made a typographical error in typing HSV-1 twice, the latter figure referred to HSV-2.  Thus the sentence should have read "Further, blood tests for HSV-1 miss about 25% of recent infections and about 5% of HSV-2."

If you were going to acquire symptomatic HSV-1 through kissing, you would have developed sores on your lips by day 11-12.  EWH
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Edward W. Hook M.D.
Edward W. Hook M.D.
20 months ago
I cannot keep up with your rapid fire questions.  When persons acquire HSV-1 orally, they may have swollen lymph nodes below the jaw or in the neck with their first episode but not with recurrences.  I really think you may be worrying too much.  Even if the person you kissed had HSV-1 (remember, most people do), most exposures do NOT lead to infection.  EWH---