[Question #6449] Hepres

15 months ago
Dear there,
I’m 31 year old male. 10 years ago I had sex with sex worker and I used condom at the time. However, few days later I developed red raised lesion on thr side of my penis just below the glans. It wasn’t painful nor itchy. Since then I started to panic. The lesion took a while until its gone. However since then every now and then I started to suffer from abnormal discolouration and lesions in my penis (redness, dryness, annilar lesions) I once had cut underside my penis... although I didn’t have typical herpes lesions no blisters no vesicles no ulcers, yet I have what I think symptoms very similar of prodromal symptoms ... I have abonrmal neurological sensation, random burning/itching/tingling sensations mostly in my penis and buttocks and underwear areas and sometimes same sensation in random areas of my body. 

I was totally convinced that what I have was herpes because I know condom do not offer 100% protection and because many herpes patients have similar neurological sensations. However, I did herpes igg tests 5 times since 2015 everytime it came back negative.... last time I did it in the USA in 2019,beacuse I still have prodrmal symptoms whenever I have a flu or when stressed... I uploaded my test here and it is still negative 
Hsv1 = 0.49
Hav1= 0.10

My question is, could it be false negative? Because I read that 0.2% of igg test can be false negative as some viruses would ve G deficient 

If it is not false negative, then how can you explain my symptoms because I will lose my mind.. I still cannot get married out of fear of transmitting something to my wife...please help me
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
15 months ago
sorry, I was offline for the holiday.
The lesion that you describe does not sound herpetic to me.  It wasn't itching, it wasn't a blister, and just a raised red area may well be something different.  A single encounter with a condom is very low risk for you.  A single encounter without a condom is low risk as well.  And your lab values support the assumption that this is very unlikely to be herpes. 
I think you would be a good candidate for doing the herpes western blot test for greater clarification

Terri
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15 months ago
Thank you for your answer 

So when you say I need to do western blot, do you think there is a possibility that I have it even with negative herpes igg test after 10 years from the encounter???  Do hepres patients have similar numerological sumptoms to mine? Did you have many patients with negative igg test and positive western blot? Im not from the USA so it’s difficult for me to do the test
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
15 months ago
I don't really think you need to do the blot IF you can let this go.  The blot would be useful if you continue to be concerned about herpes and cannot let this go.  But if you are postponing marriage due to this concern, you are still worried.  Do you see what I mean here?  Your index value for HSV 2 does not concern me at all.  And if you only had intercourse but did not receive oral sex, that's the thing we need to be looking at most closely.  Let me know what you think

Terri
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15 months ago
I didn’t have oral sex
Only in the beginning with condom
Do you know any other place where I can do western blot ? I’m in Kuwait it’s very place from the US, I wish if there is an opportunity to do it in Europe at least.  Do you think If I get married I will be ok ?  And ethically ok ?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
15 months ago
I cannot be certain about your HSV 1 index value.  it is negative but not a low negative.  It is not alarming but I cannot be certain that it is correctly negative.  Anyone can ship blood from anywhere to the University of Washington.  You would need to get a lab requisition which I can help you with if you want to do that.  But you would need someone to draw and spin your blood and then it would need to be shipped to the UW. 

Terri
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15 months ago
But what If I have positive hsv1 how would I know that my symptoms down are related to it? Maybe I got hsv1 since childhood!! Please just tell me... if do you think its ok for me to get married with tesing ? 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
15 months ago
The only way to know if a particular symptom is related to herpes or not is to have it swab tested.  And it is also possible that you've had oral HSV 1 since childhood.  But for now, you are testing negative for HSV 1, even though the number is a little higher than usual, it is negative and without a western blot there is no way to know any more than that.  I think you can get married with the negative results that you have, yes?

Terri
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