[Question #7584] HSV2 scare for Dr Handsfield please

1 months ago
Hi Dr Handsfield

In November you answered a question for me about heavy frontage and a home test result for chlamydia.  
I basically was involved with a very risky sex worker who sat on top of me with no penetration but heavy frontage with lots of vaginal fluid all over my penis. She basically massaged me with her labia until I ejaculated. There was no penetration but lots of vaginal fluid all over my penis. 

Anyway I have had no symptoms at all and it is 3 months later.  For some stupid reason I decided to do a home rapid test for HSV2.  The test came with a control line and 2 other lines being T1 and T2.  A test line for IGG and another for IGM antibodies I would imagine.  I am not sure which of the T1 or T2 test line was for(not sure which one was IGG or IGM)

The T2 line became immediately positive as the buffer solution ran thru it and the T1 remained non reactive. The control line also reacted to show the test had worked. 

1. My question is do you think its likely that I contracted HSV2 from this exposure? Or is it possible that these home Herpes tests are unreliable?  I can tell you that I am highly confident that I didn't have HSV2 before this episode and I have been in a monogamous relationship for 7 years before this mistake I made. 

2. What percentage of people would get symptoms after exposure because I haven't had any at all?

3.  What do you suggest I do as I am panicking now? I have slept with my wife afterwards a few times and she has not made mention to me of any symptoms either. 

The company i bought these tests from including the chlamydia test that gave a weak positive which u said is almost guaranteed false is probably not very reputable.  I live in a country with a very high rate of STDs and Hiv.

Thanks in advance


1 months ago
Sorry I see Frottage got changed to Frontage for some reason. Please read Frontage as Frottage
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
1 months ago
so I answer the herpes questions here.
I'm sorry that I don't know anything about the test method that you had done - not the sensitivity or specificity or false positive rate.  it would be good to know if the IgM or the IgG line came back reactive. The IgM test is terrible and should be disregarded in the face of a negative IgG test, done 12 weeks after a concerning encounter.
While frottage is not risk-free, I think it is lower risk than some other things you might have done. 
I am curious how you are so certain that you didn't have herpes prior to this encounter - did you have a negative blood test?
About 80% of those infected with HSV 2 don't have symptoms that they recognize as herpes, but many actually do have symptoms so it's difficult to answer question 2.
Is it at all possible to get a better test somehow?  Western blot tests can be shipped from anywhere to the University of Washington if you think that would be possible for you?

Terri
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1 months ago
Hi Terri. I assumed I have never had it before as I have never ever had a symptom and my wife goes for regular pap smears and has never had anything said to her by her gynae.

That's the problem as I am not sure which line it was. The IGM or IGG. I threw the test away. There were 2 lines. 1 came back reactive. That was the T2 line.

I have read that some of these tests also can't recognize HSV1 to HSV2? Or they pick up other virus antibodies like chicken pox etc and show positive ?

I am really confused because I didn't think Frottage would be that risky and I thought it would be really unlucky to acquire HSV2 from from 1 episode?

I guess I should go to a doctor or pathologist to get a definitive answer because I am a little confused. 
1 months ago
Sorry I also wanted to say. If I was infected a few months ago isn't it quite common to have some sort of sero conversion illness or at least a bout of herpes show up a few weeks after infection when the body recognizes the virus?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
1 months ago
Yes, I think you would be wise to follow up with a clinician who might be able to order a test that will give you a clearer answer. 
And yes, some tests can't distinguish between HSV 1 and HSV 2 and they scare the heck out of people!
Frottage is not that risky but not risk free, as I mentioned before. 
About 80% of those infected with HSV 2 don't know that they are infected so it's likely true that not everyone who gets infected has symptoms.  I do think that the fact that you haven't had any symptoms AND that it was a single encounter speak strongly in your favor.  I hope you might let us know who this turns out with better testing.  And feel free to ask another question if you wish.

Terri
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1 months ago
Thank you Terri.
If IGM tests are so useless I don't know why any rapid test manufacturer would want to add that line to the test. Surely its a little careless and perhaps the company producing these may not be that reputable if they are willing to risk false positives on the IGM test line?  I have a feeling the test was rubbish but nonetheless am still worried 
1 months ago
Sorry Terri last question. Would a regular check up at a gynae pick up an HSV2 in a woman? 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
1 months ago
No, a regular checkup at a GYN would not identify herpes if no lesions were present.  Herpes can be detected by swabbing a lesion or by doing an accurate antibody test.  Those re really the only two options.

Terri
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