[Question #6632] Possible exposure STI-Herpes (follow up)

66 months ago

This is my second question after Dr Hunter answered to my concerns. I really appreciated that as I was able to put my mind at rest. Still however I get worried from time to time.

I did tests on the 7th week (49 days after exposure) and all came negative including HIV, gonorrhea, chlamydia, Hep b and Herpes (IgG blood).

How accurate is the urine RT-PCR test?

My worry now is the Herpes. Although it came negative, the index alarmed me.

HSV 1 is less than 0.01

HSV 2 is less than 0.5

There is a huge deference between the two and also I read that at 7 weeks the accuracy is 70%. Given the exposure I had (no penetration but there was light genitals rubbing with no protection), can I consider this result conclusive? Isn’t 0.5 at 7 weeks high? I didn’t notice symptoms so far (10 weeks)

Sorry my questions might be naive but I am still getting the “hyper worry” moments

Thanks

H. Hunter Handsfield, MD

66 months ago

Welcome back, and glad to hear our previous discussion was helpful. I'm sorry you found it necessary to return.

You continue to overreact -- you've apparently been thrown for a loop (psychologically) by your first sexual experience. Arguably, it wasn't even real sex (no penetration). Even if there had been anal or oral penetration, the risk of STD is always low for any single encounter. Even among the highest risk population groups -- and I would include many transgender women (i.e. anatomic males) as very high risk -- at any point in time, most have no transmissible STD. And even when a partner is infected, most exposures don't result in transmission. STDs aren't all that easy to transmit. I'll also point out that you can't go through life expecting to have comprehensive STD testing every time you have a new sexual experience! Nobody does that and nobody should.

Your worry about your HSV test results is unwarranted. All numerical values below the cut-off are equally negative, no matter what the actual number. For HSV, that cut-off almost always is 0.9. Your values of 0.01 and 0.5 for HSV1 and HSV2 both are entirely negative, showing no infection. The very same blood specimen tested ten times (using different test kits supplied to the lab) would give 10 different numbers, which might vary from 0.1 to 0.5 to 0.85. All are equally negative.

Are you sure "RT-PCR test" was on urine? That terminology sounds like an HIV blood test. If so, the negative result is conclusive.

Based on your exposure and absence of symptoms, you sholuld not have had any of those tests, and certainly not the HSV test. But it's negative, so you can move on.

Does that help?

HHH, MD

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