[Question #732] Blood test results after recent exposure

52 months ago
Greetings,
Last November I received unprotected oral sex from a female prostitute in a massage parlor, lasted about a minute. Three days later, in a panic, I visited my Dr. who gave me a shot of penicillin and meds to ease my mind. I showed no symptoms other than an achy feeling in my genitals. Subsequently took blood tests at 3 week and 8 week intervals-both came back positive for HSV1. My Dr. stated that this had to have been an old exposure due to the lack of IGM (no detection) and the presence of IGG (unknown level) in both tests during this time frame. He also confirmed this with an Infectious Disease specialist. It has been 5 months and I still have no major symptoms (sores, discharge, painful urination). Do you agree with my Dr.'s evaluation? Also, in your opinion, should I take a third blood test at the 6 month period to rule out any other possible infections? Thank you.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
52 months ago
Well, here's the deal.  By three weeks from new infection, 50% of people have produced antibody to that new infection, at least that is true for HSV 2 so I'm guessing it is also true for HSV 1, so the antibody that they detected at 3 weeks could have been from the new infection.  Are you able to get an actual copy of the test to look at the index value (it's a number associated with the test).  If the index value for HSV 1 is high then it is unlikely to be from a new infection acquired from the CSW.  The absence of IgM says nothing - IgM testing is poor and has many issues. 

In terms of the herpes test being negative for HSV 2, I think you can count on that one as HSV 2, even if someone has it orally which is unusual, is rarely shed from the oral cavity.  Get me your index values and I may be able to give you some thoughts about new vs. old infection with HSV 1.

Terri
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52 months ago
Thank you Terri, I will send you the results in the near future, once I obtain them. On another note, would  the presence of HSV1 antibodies orally (prior to this incident I have had canker/ mouth sores sporadically since a young age) prohibit a "new"  HSV1 infection genitally?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
52 months ago
Yes, it is very unlikely that if someone has HSV 1 orally that they would get it genitally.  However, canker sores are not caused by herpes - canker sores and cold sores are different and have different causes.

Terri
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52 months ago
Hi Terri,

I was able to obtain the results. The index Value for HSV 1 was 6.0. Is it  now safe to say that this is indeed an "old" infection ? Also, is it possible that these occasional sores (once, maybe twice a year) inside my mouth (cheeks, gums, tongues) are outbreaks from the HSV 1? Thank you so much for your input. 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
52 months ago
Good job on getting those test results.  Yup, this does suggest a well established infection vs. a new one.  Normally HSV 1 causes sores on the lip edge or in the nose but it is also possible they could cause sores in the mouth.  If you get another, you could have it swab tested right away and try to find out.  It would be nice to know where you have HSV 1, yes.

Terri


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