[Question #8191] Do I need another Test
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47 months ago
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I had a sexual encounter with a woman on July 31st. I performed oral sex on her and placed my penis (no condom) in her labia only a few seconds (about 5 strokes/ 5 seconds). She told me that I didnt penetrate her. I told her that she needed an STD test before we could have regular sex.
After the test, she told me that she has chlamydia and herpes type 2. Her herpes is 23.00 on 1.09 scale positivity scale igg. I looked at her vagina and she has absolutely zero lesions. She said that she has never had a lesion.
After the test, she told me that she has chlamydia and herpes type 2. Her herpes is 23.00 on 1.09 scale positivity scale igg. I looked at her vagina and she has absolutely zero lesions. She said that she has never had a lesion.
On day 16 after the exposure, the string under my tongue became sore (tense). On day 17, there was a white lesion on the string of my tongue (left side only). My doctor took a look and he say it didnt look like herpes. I took a pinch of salt and rubbed it on the lesion. It stung a little bit. However, the odd thing is that a spec was removed. In the next few days, specs would come off when I rubbed it with salt. After this, I saw 2 small dots that made up the lesion. Eventually, It got smaller with time and went away in a 2 week period. This this sound like herpes?
After a month later(8/31/2021), I tested negative for both chlamydia and HSV 2 IGG.
I want to move on. However, Im still concerned about herpes. How definite is the IGG test at 1 month after a possible exposure? Do I need another test? if so, when do I need to take it?
In summary, please answer the below questions:
Does my white lesion under my tongue sound like herpes?
How definite is the IGG test at 1 month?
Do I need another test? If so, when?
Thanks,
MM
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Edward W. Hook M.D.
47 months ago
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Welcome to our Forum and thanks for your questions. I’ll be glad to comment. The exposure you describe was very low risk for most STIs such as gonorrhea, chlamydia HIV, or trichomoniasis. In general as a rule, no penetration translates to no risk for infection. STI‘s which causes genital lesions such as herpes however are an exception to that rule and may be transmitted even without penetration. Lesion infections are transmitted through direct contact with an infected site. Even then however most exposures do not lead to transmission.
Most single explosion exposures to partners with genital herpes do not result in acquisition of infection and I have had patients who have had unprotected contact with sexual partners with herpes for years without becoming infected. On the other hand, there definitely is a risk, particularly with repeated exposures which can be reduced in several ways. Correct and consistent condom use dramatically reduces the risk for infection and your partner can reduce her risk of transmission of infection by taking OK viral therapy daily to reduce outbreaks and asymptomatic Viral shedding.
In answer to your specific questions:
1. HSV-2 rarely causes oral infections and the lesion that you noted under your tongue sounds nothing at all like herpes.
2. Your negative HSV IgG test is strong but not definitive evidence that you did not acquire herpes. Having said that, your risk for acquisition of infection is low. If you were going to develop lesions this would have typically occurred within 8 to 10 days following the exposure. The absence of lesions and your negative blood test indicate that you did not acquire herpes.
3. At this point my recommendation is to assume that you were not infected and move forward without further testing. The HSV IgG test is a relatively good but not great test which sometimes gives false positive results. The bulk of the evidence and you were circumstance suggest that you were not infected. I would not worry further.
I hope this information has been helpful to you. If there are further questions or clarification is needed please feel free to use your upped it to follow-ups for that purpose. EWH
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47 months ago
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Doc,
If I wanted a more definitive test, what is the minimum time needed for another test?
At the 8 week mark?
Or perhaps the 12 week mark?
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Edward W. Hook M.D.
47 months ago
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Currently available IgG blood tests detect all the infections they are going to detect by about three months after infection. No matter how long you wait, the most widely used blood tests for HSV-2 still miss 5-7% of infections when compared to the gold standard, the Western Blot test performed at the University of Washington (instructions for specimen submission available at the University of Washington Virology lab web site).
I really think however that when all is considered, my advice remains to understand that you were not infected by the encounter you have described and to move forward. I would not bother to test more. EWH
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