[Question #6111] Oral PCR Accuracy

19 months ago
Hi Terri

I was recently corresponding with Dr. HHH relevant to a recent (brief) deep kissing incident with a TS CSW on Sept 12.

I had mentioned that, after 7 days exactly, I started feeling strange tingling, irritation, mild burning on the tip of my tongue. There appeared by Day 10, a small while inflamed papillae/taste bud on the corner of the tip of my tongue. It went away, then another one appeared exactly on the tip, went away, then came back again! They were not painful per se, but my whole tongue felt like it was irritated. 

I was concerned about potential HSV1 infection, however I never had any blisters, not sore throat, nor malaise nor any other signs (Dr. HHH said this didn't sound like HSV) - and I am sure he is right on this, but I decided to be on the safe side, so see a Dr in person for a visual examination.

I went to see the Dr on Oct 2 (20 days post). By this time, the white inflamed papillae on the tip of my tongue had returned for the second time, so it was visible again. She said that she did not see anything unusual and was also sure this was not HSV. Anyway, she proceeded to swab my tongue (in particular the tip and the papillae) and conducted a PCR for HSV1, HSV2 and Traponema Pallidum (Syphilis) - test is done as a package deal. These came back negative the following day.

My question is, can I rely on this PCR that, 3 weeks after the deep kissing incident, is it NOT HSV that is/was causing my tongue discomfort and the inflamed papillae? Can I use this result to move on with my life from this incident?

Many thanks for your time.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
19 months ago
I would agree with Dr. Handsfield that this sounds nothing like HSV 1 to me.  And a PCR of a symptomatic "something" that is negative is important.
Now I have no idea if you might have had HSV 1 prior to this - about half the population has this - so I am addressing only the situation and symptoms that you are currently describing.  If you know for a fact that you were negative for HSV 1 prior to this, and your only worry are these tongue papules, then yes, I think you can safely move on.

Terri
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19 months ago
Many thanks Terri, you hit the nail right on the head and surely calmed my nerves with your response, which was exactly what I was hoping for! I guess whatever I am feeling on my tongue could just have either been a coincidence (they do happen I guess!) or another more common virus that people catch from one another perhaps that my body will fight off in its own way, and not HSV1 or any concerning STD. 

I am 35, and I have had shingles all along my neck once as a teenager, I know it is from the Herpes family, but it is perhaps not precisely HSV1 - I do not recall if I have ever had cold sores, I may have done (quite likely I have had) - but I don't think I have ever had any blood work done to confirm Herpes before. 2 years ago, as part of Urine tests, they tested for HSV1/2 which came back negative but I read that those are never accurate because HSV is not commonly found in urine.

I have a short follow-up, now my regular partner, with whom I am now in a monogamous relationship, has vaginal HSV2, this was diagnosed before we met years ago.

(1) As though I read in certain previous threads that, by her having HSV2, she will be immune to catching any oral HSV1 from me (assuming I already have it from before) - is this correct? However I also understood that this doesn't work the other way though (ie. If you have HSV1 orally you can still catch HSV2 genitally);

(2) I have never ever had an outbreak of genital HSV2 in my life, even though we have had unprotected intercourse in the past (but never during an outbreak of hers), and she has had outbreaks but the last being some years ago. 

Do you suggest that I get a blood test (IgG) to test and check my status, just for info? Or it doesn't really matter and it would just be a waste of time and money, considering that we are now going to be monogamous and exclusive. At what point after an "exposure" would an IgG blood test give a good indication of ones HSV status, would 6 weeks suffice?

Thank you again Terri
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
19 months ago
(1) As though I read in certain previous threads that, by her having HSV2, she will be immune to catching any oral HSV1 from me (assuming I already have it from before) - is this correct? However I also understood that this doesn't work the other way though (ie. If you have HSV1 orally you can still catch HSV2 genitally);

You are correct.

(2) I have never ever had an outbreak of genital HSV2 in my life, even though we have had unprotected intercourse in the past (but never during an outbreak of hers), and she has had outbreaks but the last being some years ago. 

Do you suggest that I get a blood test (IgG) to test and check my status, just for info? Or it doesn't really matter and it would just be a waste of time and money, considering that we are now going to be monogamous and exclusive. At what point after an "exposure" would an IgG blood test give a good indication of ones HSV status, would 6 weeks suffice?

If you do decide to test for HSV, it would be most accurate if you waited 12 weeks after your last contact with her.  But if you are going to be continuing to have intercourse with her, it will always be a moving target.  If she takes daily antiviral medicine, this will reduce the risk of you becoming infected by about half.  And if you decide to use condoms, that will also reduce the risk considerably of you becoming infected.

terri
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