[Question #820] Accuracy of reports and symtoms

51 months ago
Hey doc I had an oral encounter both give an take 2 months before..I have got the following test done elfa and rapid test at 2week -negative,
3 week cmia test result negative , 4 th week Cmia ,Efla,and HIV rapid test, hepatitis negative, 5,6,7,8week HIV rapid test negative. I have got blisters in my mouth which my local HIV Dr says are fordyce granule I have got an herpes simplex virus DNA detector test done at 2 months real time pcr method... results non detected.is herpes detectable at 2 months  I just want to know the difference between frodyce granule and herpes and are all the test conclusive enough specially for the herpes or should I get another test done and which one 
Edward W. Hook M.D.
Edward W. Hook M.D.
51 months ago
Welcome to the Forum.  Before I comment on your test results, let me assure you that the exposure you describe was very low risk for acquisition of any STI, including HIV.  No matter who your partner were, infections of the throat are uncommon and even when partners are infected, transmission rarely occurs.  Your test results, confirm this.  Your tests for HIV are definitive and show that you did not acquire HIV from your exposure two months ago.  You do not need more testing for HIV.

There are a very few reports of hepatitis tests taking up to three months after exposure to become positive BUT there are no reports of hepatitis acquisition as a result of oral sex, either giving or receiving.  Therefore, you can be confident you did not get hepatitis from the exposure you describe either.

As for herpes, we do not recommend testing unless lesions are seen.  No lesions, no need for testing.  Fordyce spots are normal and are not herpes.  I see no reason for continued testing if your doctor has identified your lesions as Fordyce spots.

I hope these comments are helpful to you.  EWH
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51 months ago
Dear doc... thank you for the reply... I am extremely relieved about my HIV status now.... but there is still a bit of confusion I have... firstly I am from a very small place so not that confident about the diagnosis of my doctor... so I just want to clarify few more things I had got an std panel test specimen source urine done.. the results are C trachomatis DNA detector -non detected,HPV DNA detector method polymerase chain reaction. - non detected and Hsv DNA detector method real time pcr Hsv-1 &2. Non detected... specimen source serum. Now what I want to understand is that even of my doc is wrong does these test prove enough that I dont have any std, or sti infections... my doc explained my that herpes infection are red and they appear for a week and go off while the spots I have are white or off white and are there for more than a month... these spots actually occurred when my mouth was really dry for 3 to 4 days ... and I was have huge anxiety problem .. couldn't sleep for nights ... my Dr had given me some medicine to suppress there granules ... will they effect my diagnosis...  just want to sure about the other std infections I don't want to spoils my wife's life bec of my mistakes 
Edward W. Hook M.D.
Edward W. Hook M.D.
51 months ago

It sounds as though your problem is anxiety, not STI.  The tests you received (several of which I would not have recommended (the tests for herpes and HPV) are designed to be used in any setting- small places or big.   Further, the test results only serve to confirm what I have already told you based on scientific fact- the exposures you describe were very low risk for any STI. 

Typically Fordyce spots are not treated as they are normal.  I do not treat these.  I do not know what you are being treated for but I would not be concerned that the treatment has any effect on your test results.

My advice is for you to make every effort to move forward without further concern.  eWH

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51 months ago
Hey doc thanks for the reply.... I am going to stop these test and move on on life... the only reason for axienty to was were ever I read it says u don't need treatment for fordyce granules .... and I had been taking these medicine so it made me doubt his capacity as a doctor thanks.... now after talking to u I would leave this 
Edward W. Hook M.D.
Edward W. Hook M.D.
51 months ago
Glad I could help to clarify thing.  Moving on is the right thing to do.  EWH---
51 months ago
Dear doc i am back again this time with a huge problem... I just got the reoprts of one test that i had got done a few days backk and the test was herpes simplex virus igg serum hsv 1+ 2  the reuslts of which came to <30.0 ... Above... Is that possible.. The result doesnt say iif its one or two... But i have no lesions near mr gentails pls adivce what should i do.. Very nervous
Edward W. Hook M.D.
Edward W. Hook M.D.
51 months ago
I am having a little trouble following your follow-up question about herpes testing.  The numerical values you report are not typical of those for the most commonly used herpes blood test, the HerpeSelect IgG tests for HSV-1 and -2.  In addition you note that the test you had was nonspecific and tested for antibodies to both HSV-1 and HSV-2, while to get a useful test you need to be tested with a type-specific test which would test for each type of antibodies separately.  Finally you note that the test value that you received was reported as <30.0 and when test results are reported as less (<) than it usually indicates that the person does not have the infection being tested for.  Thus I do not have the information needed to help you sort out your situation.

I would add however that when people are tested for antibodies to HSV the most common result is that they find that they have had the infection in the past and were not aware that they were infected.  Here in the United States only one in 10 persons with HSV-2 knows that they have the infection, the other nine having positive antibody test only.  I suspect this may be your situation, that you have a pre-existing HSV (1 or 2) infection that you are unaware of, unrelated to the exposure you posted about.

My advice to you is to be retested using a specific test for antibodies to HSV-1 and HSV-2. At that point perhaps we can provide you with more information.

In addition, I must inform you that this is the third reply to your questions. As per Forum guidelines we are permitted to only provide three answers per question. Thus if you gather more information or have additional questions I would suggest you start a new question. If the question is specifically about herpes it will most likely be answered by my colleague Terri.    This thread will be closed later today. EWH 
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