HELP - TESTING

[tygrrr]

I was tested for EVERY STD known to man on 5/21 - Negative.  I've been with one person 6 times since then.  The last time (9/3), we were particularly active and there was not enough lubrication.  Since then I've had an open sore, maybe just a tear and he has developed HSV2 symptoms such as red lesions on his penis.  He went to the dr. and was told he does have HSV2.  Is it possible that he contracted this before we were first together and I haven't gotten it yet or still?  His testing numbers were low.  Can you please give me some insight into how he would have gotten it if I tested negative in May and he SWEARS I AM THE ONLY PERSON HE HAS BEEN WITH SINCE APRIL?  

[Terri Warren, RN, Adult Nurse Practitioner]

You mention that the swab test was positive = was that his swab test or your swab test?  And positive for what, HSV 2 or HSV 1 or was it typed?  Are you saying that his HSV 2 swab test was positive?  I'm just not completely clear about what's gone on here.  Also, did you actually see test results for yourself that were negative for HSV 1 and HSV 2?  When you say his test numbers were low, is that blood test numbers, IgG?  If you can provide that info, I can give you a better answer.  Thanks!

Terri

[aeiou1]

It is very possible that he had it and did not previously pass it to you.  It is also possible that when you were tested for every STD known to man, it did not include herpes. It almost never does, even if you ask to be tested for "everything." HSV infection is so common that the current "standard of care" actually recommends NOT testing for it unless there are active lesions.  It's utterly inexplicable from a public health standpoint, but it saves costs.  Both of you could have been carrying the virus.  There's no way to really know when either of you got it, though antibody tests can possibly distinguish a newer infection. Within the first few weeks of infection, detection of early antibodies (IgM) may potentially be useful, because the absence of IgG, but presence of IgM may indicate a new infection. But IgM testing is not type-specific, and you can have HSV 1 or 2 present in the genital area.  

Research indicates that 70% of HSV infections go undetected because neither patient nor doctor recognize the signs or symptoms. More than half of HSV infections do not present according to the usual profile. The friction burn or "tear" you describe could very well be herpes.

The only way to know for certain is to directly ask for blood testing. Type-specific blood tests such as Western Blot, Focus Technologies HerpeSelect,  ELISA or Immunoblot test for both HSV-1 and HSV-2 and can distinguish between the two types of HSV. Active viral shedding is not necessary (unlike swabbing for PCR or Viral Isolation tests) in order to detect HSV infection. That means they work even if you are not currently having symptoms. There is only one U.S. lab that processes blood samples for the Western Blot (University of Washington) so you may have to wait a week or more for your results (for Canadians, the WB can be processed at lab Virdae Clinic), and if you want WB, you may have to ask for it specifically.

There is plenty of information online about how to prevent transmission of the virus, but be a careful info consumer. Anything that tells you that you can't pass the virus when you don't have active lesions is WRONG, so question the validity of that source. Viral shedding can occur when you have no outward symptoms. It is also possible for you to spread the virus to other sites on your body.  If you are inspecting your genitals, be VERY CONSCIENTIOUS about washing your hands afterwards. You do not want to spread it to your eyes, nose or mouth, and it's too easy to just scratch an itch and introduce the virus to another site, particularly the vulnerable mucous membranes.

Neuropathic pain is a common, but usually unrecognized, symptom of herpes infections. You can have low-back pain, pain through the buttocks and down the legs. Most doctors aren't even aware of this, even though it's adequately documented in the literature.

Herpes is basically an untreated epidemic, worldwide.  There is no cure, though antivirals can help minimize outbreaks.  If you get the neuropathic pain, you'll probably have to educate your doctor, because most are simply not current on the literature.  Opioids and anti-inflammatory medications are of little use, but neurontin (gabapentin) may help.

Physical and mental stressors can trigger new outbreaks, so be kind to yourselves.  If you've both got it now, fussing over who had it first isn't going to be helpful. Keep your immune systems robust, get plenty of sleep and water, and keep your stress down.

Hope that helps.

[tygrrr]

OH - and swab test was positive.