[Question #7667] STD question for Dr. Handsfield and Dr. Hook

1 months ago
Hey, I have posted a question a few days ago. Terri answers the question and gives me great help.
I read so many posts by Dr. Handsfield and Dr. Hook on Medhelp, and today I have a follow-up on my last question.
So I want Dr.Handsfield or Dr.Hook to answer the question.
Doctors, if you could see my last thread, I should have know my situation.
My first test in the small city was positive, S/CO value was 1.4, 2 days later, I took another, it was 1.2. But 5 days later, I took the third, it was 1.9 now. It is a ELISA test, produced by a company call Dia.Pro
I was totally confused, and I read some posts by Dr. Handsfield, the link was https://www.medhelp.org/posts/STDs/Possible-HSV-2-Exposure/show/1616016
Doctor, I don't have HSV I and cold sore before, I don't have anything strange on the first 14 days: no pimples, no sores, no blisters, the 3,4,5,6 test was negative(80% by then) and the value of the 6 week was 0.06(COI), my intercourse was fast and protected. In a post, you answer that one should move on and doesn't catch HSV2 in that accident.
But 3:00 a.m. Feb 18, I found a cut-like sore(0.5 cm long) at the back and the base of my penis. 7:00 a.m. I found it developed scab and can't take a swab. Can recurrent herpes heal that fast?
1. Doctor, I can't afford a WB test, based on all these, do I have herpes?
2. Is it normal for the index value to increase that fast? 0.7 in 5 days?
3. In some cases, you don't recommend blood test if no lesions in the first 14 days. Is it no primary outbreak that rare?
4. The seroconversion is a point from negative to positive. Is it the index value suddenly jumps to positive or it needs a process to add slowly?
5. Have you seen any patients without HSV I who was negative at 6 week, then positive later?
6. When herpes was asymptomatic for years, then have an apparent outbreak. Is it the outbreaks afterwards still symptomatic?
7. How long does recurrent herpes takes in the minimum?

1 months ago
8. In a post, you said that it was too late for lesions to show up in the 3 month? Why? Can that fit in my situation?
1 months ago
9.Dr.Handsfield said that the clinical experience of is that there is a miniscule chance a blood test would later pick up an otherwise unknown infection.  
Have you seen anyone that doesn't have a primary outbreak and later was picked up an infection by blood test? 
Edward W. Hook M.D.
Edward W. Hook M.D.
1 months ago
Welcome back to our forum although I’m sorry you found it necessary. Ms. Warren is our HSV Expert and we agree with the advice she has already provided you. Because you chose to post again with these repetitive questions I will provide a single brief reply however if there are further questions regarding herpes please direct them towards Ms. Warren.  And either Dr. Handsfield or I will provide for the responses related to herpes. Straight to your questions.

1.  As Ms. Warren has already told you it is very unlikely that you acquired herpes. Your test results Are in a range were false positive test results are relatively common.
2.  The index values for these tests fluctuate substantially on a day to day basis. The fluctuation in your tests do not raise concerns.
3.  Occasionally persons do acquire HSV to without experiencing a primary outbreak. This is relatively uncommon. The absence of a characteristic primary outbreak following your low risk exposure should be reassuring and suggests that you did not require herpes at that time.
4.  Thw test values increase as antibody levels increase. This occurs over time. Thus for a person who acquires herpes, you would expect index values to steadily increase until they plateau, typically a number of weeks after they become positive.
5.  Yes, tests can take several months to become positive 
6.  In addition to periodic symptomatic recurrences, current data indicate that virtually all persons who have genital herpes due to HSV-2 regularly have a asymptomatic shedding of the virus as well.
7.  The most typically persons with recurrent episodes of genital herpes have their lesions resolve over a period of 3 to 5 days.
8.  This question is a bit hard to follow. Most typically when persons acquire genital herpes lesions appear within 7 to 10 days following exposure.
9.  This question was answered earlier.  Occasionally persons acquire genital herpes and are unaware of it until they find their blood test is found to be positive.  This scenario does not appear to apply to your situation.

This concludes my reply to this thread. Should you have further questions regarding genital herpes please direct them to Terri. In concluding however I agree with Terri  that the nature of your exposure was low risk and it is unlikely that you acquired genital herpes from this episode. I urge you not to overthink this or continue to worry. In the thread. EWH

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