[Question #6844] HSV1

11 months ago
I recently found out I have HSV1.  My index was 45.  Did a test a few weeks later and my index was 48.  Can you explain how the indexes work?  I keep on seeing people with a 9 for instance, does a high number like mine mean recent breakout/infection or one that I've had for a while?  Will this number go up and down, for instance in 6 months could it be 15 or will it always be high like this?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
11 months ago
Different test BRANDS have different result ranges - some report a range, for example, that tops out at 16.  Other brands top out at 70!  It's just a difference in how the test brand establishes their cut-offs, it says absolutely nothing about you.  And the index value itself means nothing in terms of transmission or frequency of outbreaks or frequency of viral shedding.  And if you took the test again, it would not be 45 or 48, it could be 55 or 33.  It is going to vary over time and those changes mean nothing.  Your index value only means that you have a well-established infection and your immune system has mounted a robust response to this virus.  Now if you had an index value of 2.0, for example, I would suggest that you have a confirmatory test to be sure this isn't a false positive or you might have that value because you have a new infection and are passing through that low positive range on your way to a much higher number.  But at your numbers, this isn't the case.

Terri
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11 months ago
Thank you Terri.  Usually I wouldn't ask questions in a forum like this but with COVID19 I have had a hard time getting to the doctor.  I have a legion and the primary care doctor had me send them pictures.  They said it was Etopic Sebaceous Glands.  I wanted an in person visit, they sent me to the urologist.  The urologist burnt off what was there, I asked him if it was herpes and he said no.  I showed him a picture of the same area from 3 weeks ago, he said the picture was herpes.  I thought herpes would heal and leave nothing behind, he didn't have an answer for that.  The legions kind of looked like a line with a bulge on the 1 end.  The entire thing kind of reminded me of teeth, all shaped a bit differently.  The bulge looked like a cluster that came to a point with missing skin behind, it looked like it was made of bubbles, kind of like a blackberry.  I can't find any pictures online that look like it.  An online dermatologist said it was possibly a wart, then another said Etopic Sebaceous Glands.  Just really confused.  Do you know of any websites that would be good to compare pictures of herpes to (so many sites have misleading picures and examples)?  Also does this sound like herpes?  The index of 45 was found out around the 4 week mark.  Is there any way to know if this is herpes if it was caused by my most recent possible exposure? 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
11 months ago
without seeing the lesions, it would be impossible to say, I'm so sorry.  If they looked like bubbles, they could be blisters that represent herpes, but if you have herpes, you index value indicates that it is NOT new, it is well established.  Warts look nothing whatsoever like herpes - they are flesh-colored and are firm and are not anything like blisters.  Herpes lesions, if blisters, would break open - warts would not.  So tricky trying to diagnose things in this age of COVID

Terri
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11 months ago
Thats the problem, what i had looks nothing like any picture of warts or herpes that I've ever seen.  One place suggested irritated pearly penile papules but i thought they were around the head, mine are lower.  Whatever it was looked like bubbles to make something pointy then it just stayed there for at least 3 weeks.  No scabbing, you might consider what was behind it to be an ulcer, this looked a bit like hanging skin in front of it.   How long would it take for herpes blisters to break?  Also can you recommend any websites that have pictures of herpes and warts?  Preferably something that looks like a cluster so I can compare.  Once again I would go to doctor if it weren't for the stay at home orders but this is all I can do.
11 months ago
Also when you say not new do you mean older than 4 or 5 weeks?  I had never been tested before this and never had an outbreak before.  I've been with partners that have had cold sores though.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
11 months ago
Herpes blisters break usually within a day or two at the very most.  They are fragile. 
Herpes and sebaceous cysts look absolutely nothing alike.
I've attached picture of a group of herpes blisters.  WebMD has some reasonable herpes blisters on it, you could try that.  There are also websites staffed by dermatologists that can evaluate actual skin lesions for you.

Terri

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11 months ago
Thanks Terri.  What i have looks nothing like that.  I have an ulcer there now but not sure if that is natural or not, the urologist burnt off whatever was there so it might just be from that.  I do have some white things at the base that seem to appear and disapear a few hours later.  They leave a break in the skin but that doesn't last much longer than a few hours either.  Does that sound like herpes?

I've tried the online dermatologist, don't have much faith there.  Submitted a few times to first derm, each time they gave a different answer.  Is there a better one you can recommend?

Also can you answer this from before:

Also when you say not new do you mean older than 4 or 5 weeks?  I had never been tested before this and never had an outbreak before.  I've been with partners that have had cold sores, I've never had one that I know of myself.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
11 months ago
If you had something frozen off, an ulcer would be expected. Things that last only a few hours and disappear are not herpes. 
By not new, I mean not in the past couple of weeks.
I don't have a better suggestion.  I am assuming you took pictures of the things that concern you?  Could you send them to your PCP for evaluation?
This is my final post on this thread.  I do hope you can find out what's going on.

Terri

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