[Question #9906] Equivocal HSV2 IgG results 4 weeks after massage

28 months ago

On March 12, I(male) had an event with a erotic massage parlour girl. Both of us were naked. I had trimmed my pubic area that day. She sat on my groin for a few seconds after which we lied next to each other hugging with legs intertwined. My thighs might have rubbed against her groin or genital area for a minute. My penis might have grazed over her groin and thighs a few times. There was no genital to genital contact as far as I can remember. There was significant thigh to thigh contact.

12 days post the exposure I noticed two bumps apart from each other that stung a bit. One was on the groin where hair starts to grow. Other was on the groin close to the left thigh. They looked pale yellow or whitish. I popped them both and the open sores didn’t hurt much at all. They dried after 2 days. I sent pictures of the healing sores to a dermatologist and he said he recommended no HSV testing as they looked like folliculitis. Each bump around a hair follicle.

28 months ago

Day 8 to 14 post event - felt muscle pain and joint pain in my legs and continuous pain in my testes too. I still have muscle pull/pain in my thighs. Not sure if it is due to my anxiety or B12 deficiency or HSV. I tested 4 weeks post event. Results

HSV 1 - IgM 1.37 IgG 1.66

HSV2 - IgM 4.1 IgG 10.24

Multiplex urine PCR - HSV - not detected

Index values - -ve (<9), Equivocal (9 to 11), +ve (>11)

Other than this event, there was no risky event in the last 1 year and my last year IgG for HSV2 was -ve.

My questions -

1. Can someone test EV a year after they test negative with no risky event? Is the test that flawed?

2. If I had HSV2 for 90 days or more, I should have gotten a big +ve result and not a -ve right?

3. My guilt from this event and the anxiety from the EV results are driving me nuts with me attributing every muscle pull to HSV. This month has been the most anxiety filled month in my life after I read about Neonatal & Congenital Herpes

Terri Warren, RN, Nurse Practitioner

27 months ago

First, the experience that you had does not present a risk for the acquisition of HSV 2. It was very safe and herpes requires more of and a different kind of contact to be transmitted.

The IgG test is pretty high for a false positive but I have definitely seen false positives in your range.

The last time your tested and were negative - how long after any concerning encounter did you have the testing done? If it was less than 10-12 weeks, it could have been a false negative.

Where do you live - like what country? You definitely need a confirmatory test, like the western blot. I'm thinking you may not be in the US because you had a urine test done for HSV which is not usual in the US.

Terri Warren

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27 months ago

Thanks for your response, Terri. I haven’t tested positive. Result was equivocal. Please look at the index values in India that I had mentioned along with the results. Previous test that I had done 1 year ago was 4 weeks post a low risk event. So, I request you to answer my questions from the previous message and I have few more questions for you -

1. Do any of the symptoms in this message and the previous one sound like HSV to you? The 2 bumps appeared 12 days post the event and were apart from each other and weren’t on my penis.

2. My anxiety has been driving me nuts and I had constant pain in the legs (thighs). Could my anxiety be causing it or should I be concerned? I think i experienced a tingling feeling in both my arms and feet yesterday.

3. Given that I haven’t involved in any other risky behaviour in the last 6 months and this equivocal results, can I just ignore the EV results and move on? I’m planning to start a family with my wife.

4. Is the urine PCR of any use?

Please let me know if you need any more information for you to recommend my further course of action

Terri Warren, RN, Nurse Practitioner

27 months ago

I see your index value reported as10.4 and now I see that this is equivocal for the test range that your reported. I see you are out of the US. Upon review I see that as equivocal. But given your experience, I continue to believe that this was a low risk experience!

None of the symptoms that you describe concern me for herpes.

Constant pain in the thighs does not describe HSV to me

I'm not clear that the urine test is useful but good that it is negative. Tingling in the arms would have nothing to do with herpes - this is happening in the wrong nerve group to be related to genital herpes.

Without genital to genital contact, I believe that this experience is very unlikely to present a risk for herpes - at all.

Terri

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Terri Warren, RN, Nurse Practitioner

27 months ago

I just wanted to add a note for you here. I've had two patients now who have had positive urine tests for herpes and negative western blot tests, the gold standard for herpes antibody tests. So when you asked about the urine test, I will say that based on a small sample of two, if it had been positive, it would not have been of use as an accurate diagnostic tool.

Terri

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27 months ago

Thanks for the update, dear Terri.

Final set of questions (had asked one of them in my earlier message as well) as the EV result driven anxiety is just killing me -

Given that I haven’t involved in any other risky behaviour in the last 6 months and this equivocal result, can I just ignore the Equivocal result and move on? I’m planning to start a family with my wife. The result is driving me nuts.

Last Wednesday, I had a tingling sensation in my right leg. Next morning I noticed a small reddish bump in my groin with one reddish pimple around a hair follicle. Two days later, it has almost disappeared without any change in form. It had minimal pain when I noticed it. Nothing much now. Does it sound like herpes to you? Or am I just overthinking driven by anxiety and guilt ?

Terri Warren, RN, Nurse Practitioner

27 months ago

The bumps sounds nothing like herpes to me. I honestly think you are OK and should move on now, trying to put your guilt and anxiety behind you.

Terri

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