[Question #7834] Questions about Genital Herpes Test

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51 months ago
Hey, Terri. I am living in Shanghai China. I have contacted you on your website yesterday.
It has been 6 month since my only exposure to HSV 2. It was protected oral and vaginal sex with a sexworker Here is my symptoms:
1. 
In the 21 day: several small cut-like sore along my right groin(sent pictures to 2 online doctors, they said it wasn't) 
And after that, I found some similar sore in this area several times(always on the right). My city  doesn't offer PCR test, so I don't have swab. This is my only sex intercourse. Does this sound like herpes to you? And I found 2 patch of skin in this area that is always red.
2.
In the 3 month, after doing sports, I found a 1cm cut-like sore with at the end of my penis. It grew scab over night. Never see it ever again, even after having my 2nd vaccination.
3.
I feel hurt and inch on my penis without lesions or sores. I have read a thread on Medhelp. One man with negative igg test has a postive HSV II urethra swab. Is this possible? Does this imply herpes to you?
Here is my test:
6 week, all negative for Capita and Roche Elecsys(HSV II Igg value 0.06) (IMPORTANT: 0.5~1 is the grey zone of Elecsys test)
12 week, HSV II Igg positive value(1.2, 1.4, 1.9) (a test made in Europe)
16 week, all negative for Capita and Roche Elecsys(HSV II Igg value 0.073)
Here is my question:
1. Do you think I have genital herpes? And do you think I should have a Western Blot test? I can pay extra money, I am living in Shanghai, all state-owned hospital, can you help me have one?
2. I have read the virus must be messaged to the skin. Do you think the lesions in my right groin is herpes? Should I go to another city to have a swab test?
3. My city doesn't offer Herpeselect test. Should I trust Capita and Elecsys test?
4. Have you seen some men who have negative Capita test but later picked up by Western Blot?
5. Should I have one more Igg test in the 6 month?
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Terri Warren, RN, Nurse Practitioner
51 months ago
1. 
In the 21 day: several small cut-like sore along my right groin(sent pictures to 2 online doctors, they said it wasn't)
If you acquired new herpes at the encounter with the sex worker, first lesions would be on the penis, not in the groin.

And after that, I found some similar sore in this area several times(always on the right). My city  doesn't offer PCR test, so I don't have swab. This is my only sex intercourse. Does this sound like herpes to you? And I found 2 patch of skin in this area that is always red.
And not just red
2.
In the 3 month, after doing sports, I found a 1cm cut-like sore with at the end of my penis. It grew scab over night. Never see it ever again, even after having my 2nd vaccination.
Herpes would not appear and disappear over night.  This is not consistent with herpes at all.

3.
I feel hurt and inch on my penis without lesions or sores. I have read a thread on Medhelp. One man with negative igg test has a postive HSV II urethra swab. Is this possible? Does this imply herpes to you?
It doesn't, no.

Here is my test:
6 week, all negative for Capita and Roche Elecsys(HSV II Igg value 0.06) (IMPORTANT: 0.5~1 is the grey zone of Elecsys test)
12 week, HSV II Igg positive value(1.2, 1.4, 1.9) (a test made in Europe)
16 week, all negative for Capita and Roche Elecsys(HSV II Igg value 0.073)

I understand that you are confused by these test results.  Because  these are not tests we use in the US I can't really speak to their accuracy or issues with low positive results specifically, but if it is anything like the US tests, there are definitely false positives in the low positive range (which yours appears to be)
Here is my question:
1. Do you think I have genital herpes? And do you think I should have a Western Blot test? I can pay extra money, I am living in Shanghai, all state-owned hospital, can you help me have one?
I don't think you have herpes, but if you need the western blot to feel more certain and have piece of mind, I can likely help you get the testing done.  You would need someone to draw your blood, and spin it down and it would need to be shipped the fastest way possible to the US.  We would have to have a video conference together for me to order this test for you as well.

2. I have read the virus must be messaged to the skin. Do you think the lesions in my right groin is herpes? Should I go to another city to have a swab test?
If you have a lesion you are concerned about you could go for a swab wherever you can get one.  I don't think the lesion in the groin is herpes, no

3. My city doesn't offer Herpeselect test. Should I trust Capita and Elecsys test?
Yes, it's what you have to go on, right?
4. Have you seen some men who have negative Capita test but later picked up by Western Blot?
Yes
5. Should I have one more Igg test in the 6 month?
You could but if you have another low positive , will it help you?

Terri
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51 months ago
Hey, Terri. Thank you for your response.
I want to talk more about the single cut-like sore at the end of my  penis. A little worried that I haven't made myself clear. It was 3 month after my exposure. It was the night after I have doing very severe sport all day. I found the sore, about 3 a.m. in the morning. I felt very itch in that area, and I woke up. I found the sore. It was at the end and the back of my penis. It was open, filled with a little water and along one wrinkle of my penis. It didn't have a red base. It was about 1cm long. In 9 a.m., when I woke up, I found it has developed scab, I use a little needle to poke it, can't feel anything.
1. Do you think the sore was herpes?
2. Based on your experience, have you seen some patients who have a positive result of one brand of test, and then have a negative of another? What was their state proved by Western Blot?
3. I don't have HSV I before, if I caught it, does that mean that it must be so severe that I can hardly ignore it?
4. I have a baseline test at 3 week, the lab doesn't offer the value. Will it be useful if I ask for the result at 3,4,5,6,16 and then compare it?
5. Are you familiar with Roche Elecsys Test? At the lab, from my blood was drawn to the result came out, it only took 30 minutes. I know  it was clear by FDA, but should I raise concern about its accuracy?
6. Positive result of one brand and negative result of 2 other brand. Does this mean anything? Will it be useful if I try to have a test by other brands like Euroimmune or Dia.Sorin?
7. Is 3 month possible for the first outbreak?
8. From your email, I know that you have helped some people in China to have a Western Blot before. I am sorry I ask every lab in Shanghai, and none can help me. If you recall the detail of your previous case, can you tell me?

PS:
Terri, my county doesn't allow blood to be drawn and spin for personal purpose. I think I can't find a place to draw and spin my blood. I am planning to go to Hong Kong to find a hospital to have a Western Blot. Please don't close the thread, I will post my result as soon as it is done. 
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Terri Warren, RN, Nurse Practitioner
51 months ago
1.  I doubt it.
2.  Negative
3.  A first outbreak of HSV 1, when you've never been infected before, could be remarkable or very mild - it varies greatly from person to person
4.  It would only be helpful if all the results are positive.  It would not be helpful if all are negative.
5.  I am not familiar with it
6.  If you are positive, what was the index value, or do you not know it?  If two negatives followed the positive, infection seems less likely but if we are talking about HSV 1, all the IgG tests are not terrific.
7.  an outbreak 3 months later would represent a recurrences, not a first outbreak
8.  I have helped people in China to get the western blot, yes, but honestly, I don't even recall the city of their residence.

Terri
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50 months ago
Hey Terri. I got a new situation here.
I found a single blister, the same size of a mung bean, at the end of 4th toe of my right foot.  Maybe because of the obsession, I always like to scratch my feet. My only exposure was 6.5 months ago, I am quite worried about autoinoculation. Based on your experience, do you think it is Herpes?
And there is another thing. Yesterday, I found 2 cut-like sores on the seam between my butt and my waist. But what worried me most was that I have multiples small ulcers in the same area in the 14 day after my exposure. 2 experienced doctors said the pictures did look like herpes.  I don't have contact in that place, just protected vaginal and oral sex. Is it possible that it is Herpes? I mean I was worried that it was transmitted by quilt or something else. 
Terri, and there is one thing that occurs to me just now. Yesterday, after I found the sores in the beam, I touched the sore, and I scratched my feet without washing my hands. Should I worried about it?

Today is Saturday, and tomorrow is Sunday, the doctors don't work. So I can't have a swab test. Can it be too late to have a swab on Monday? 
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50 months ago
Hey Terri.  I have an important update.  In the morning, I found the single blister at the end of my toe was filled with water. But in the night, I found it was obviously filled with less water.  And I don't think it has broken so the water went out.  It seems that the water was absorbed by my skin.  Does this change your opinion on this blister? 
And the sore on the seam between my butt and waist,  should I care much about it?  Based on your experience,  have you seen a male who has vaginal and oral sex and have herpes on the butt area? 
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Terri Warren, RN, Nurse Practitioner
50 months ago
I think the thing on your toe really doesn't sound like herpes to me.  Lesions or sore in the gluteal cleft, the area you are describing, could be herpes and should be swabbed tested.  If someone is infected through vaginal sex, recurrences could be in the area that you describe later, yes

Terri
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