Herpes or something else?

[Concernedguy57]

I will try to keep this short. On June 5th I was with a girl I met recently. We fooled around a little which included me fingering her for a brief time. My fingers eventually ended up in her mouth/lips, and on her breasts. I did kiss her briefly, and sucked on her breasts. That was the extent of activity.
A few days later I felt some fatigue. One week after exposure I developed pain (8 out of 10) in my right knee. At this time I was not thinking of anything sexually related. I went to the doctor June 12thand he ordered an X-ray of the knee and a blood test to rule out Lyme disease. The X-ray and blood test were negative. That night while on the Internet I read something about Reactive Arthritis. I spoke to the doctor and he ordered full STD tests including HSV.  Throat cultures and urine tests were also performed. All test came out negative .
In the mean time the following symptoms were present. Headache, earache, body aches, mild sore throat (post nasal drip) lower back soreness, mild joint tenderness and swelling, mouth sores ( inside top lip- not painful) and a slight white film and bad taste in mouth. I also notice a couple of small white spots in mouth (was able to remove with toothpick)
On July 9th I was giving prescriptions of the following. Zpak 5 day course 250 mg, valtrex 500 mg( 4 tabs every 12 hours 1 day then 1 daily for 2 weeks. The diagnosis was- Allergic Rhinitis, mouth sores, STD exposure, Viral Syndrome. After taking the first dose of Zpak and Valtrex, I felt much better. (I am/was thinking the Zpak was what
worked
I saw a Rheumatologist about knee pain. His diagnosis was (Episodic right knee arthralgia/Arthritis may have had Reactive Arthritis or a Viral Syndrome). Knee pain lasted approximately 5-7 days
The mouth sores persisted (no pain) so the doctor sent me to the ENT. Results were pretty much negative. Sores wer Fordyce Spots?
I had another HSV blood test  10/29 (16 weeks post exposure- I had been on an off Valtrex) the results wer 1.16 HSV 1 positive and negative HSV 2.
After the doctor called with the positive results I did not sleep well that night. The next day I felt prodome. I took per doctors recommendation 2000 mg 2x for one day. I currently have clusters of bumps on my top lip and check of face. They are on the same Side. The doctor says the bumps do not look like herpes. The bumps are not painful and have not ulcered (to me they do look like early HSV photos I see on Internet) could the Valtrex be delaying or terminating the outbreak? I have not had pain with sores.

Question 1. Is it likely to get HSV1 from this exposure (kissing for a minute or two?
2. Was the symptoms I experience a primary HSV outbreak? I do not believe I had bumps or sores during these initial symptoms.
3. How likely is the 1.16 IGG HSV1 test positive.
4. What coul be causing the bumps on top lip and cheek?
Sorry for length - wanted to give you all information

[Life360_Dave]

Hi and welcome.
1. If she did not have any lip sores at the time your risk would be close to zero as shedding does not occur that often.
2. no
3. not likely, most likly a false positive.

[Concernedguy57]

Hi thanks for the reply and welcome.
I did not notice any sores on her lips, but in hindsight I remember her not wanting to kiss the week earlier :(
1. Any idea what the clustered bumps on my lip may be. Again they do not hurt and have not blistered or become an ulcer. ( I took Valtrex when I thought I felt prodrome. Will Valtrex halt progression of breakout and stop blisters and ulcers from forming completely
2. I read that HSV1 can cause flu like symptoms And also joint pain. Again I felt better after taking Zpak and Valtrex after first day of treatment. (Maybe bacterial infection and Zpak cured?)
3. A little concerned about initial negative HSV 1 igg and then low positive test (1.16)
To restate, what exactly happens to a HSV breakout while on Valtrex. Does it stop blisters and ulcers and crusting from occurring completely or just make the progression more mild?

Thanks again for taking the time to help all of community who have questions

[Concernedguy57]

Grace, do you have any comments to my questions that could help me?

Thanks in advance

[Life360_Dave]

1. If the bumps are white heads, this is not a herpes sore as are clear liquid filled that open and can be very painful as the lips are full of sensing nerves. If they are still there, you can have them swabbed to test what they are.

Taking antivirals inhibit the virus from multiplying and aide in healing thus limiting outbreaks.
2. Yes first time symptoms can be flu like but would take more than one day to be benificial.

3. Youll need another test to rule out the false positive but contacting herpes from what you describe is unlikely. Valtrex wont stop the healing cycle of herpes outbreaks. The blister is like any other blister that needs to heal and scab over. The scab is part of the healing process as is a temporary bandage so to speak while the new skin is forming underneath.

Grace mostly replies on weekends ive noticed but she may pop up once in a while.

Again, from what you describe the risk to contract oral herpes would be close to zero risk.

[Concernedguy57]

Life 360 thanks again for the additional answers to my questions. Could you please verify your answer #2? I am not sure what you mean take more than 1 day to be beneficial. The flu like systems started about 1 week after incident and last 3-4 weeks until I took the Zpak and Valtrex. (So I am not sure if I had a bacterial infection or viral- maybe primary jerpes outbreak

Thanks again for the great service you provide

[BrightHerpes]

early detection is the key. don't try to guess diagnose yourself. Conduct test and hit me up. i can be of help by recommending what to do. thanks

[Concernedguy57]

I have some additional questions. I had a confirmatory blood test approximately 3 weeks after previous low positive 1.16 IGG HSV 1 test. Yesterday This test came back equivocal at .96. Could anyone explain why this may happen? I indeed hope to be HSV1 negative but question some symptoms I am having.
I have been on and off Valacyclovir. My doctor put me on it due to "viral Syndrome " (read previous post)I did not have obvious blisters or sores  I remember asking him about bumps on my lips he told me he did not believe it to be herpes. I recently felt tingling on my lips and after a day or so took 2000 mg 2x day for one day.(per doctors instructions 1.16 test) these bumps never blistered or became ulcers. Maybe due to valacyclovir?
1. If this HSV1, what could cause my body from making more definitive antibodies?
2. Is there a chance I do not have HSV1?   Could anything else be causing these symptoms especially with the low positive and equivocal blood tests.
3. Was the original flu like symptoms a primary breakout although I did not have associated lesions?

[Concernedguy57]

Can Terri or Grace help with these questions?

Also for every bit or research I find on the Internet I find a contradictory response. Can someone please tell me if Valacyclovir will affect a IGG blood test? I have read that it only stops the virus from reproducing and does not affect antibodies. I have also read differently

[Concernedguy57]

Anybody have any thoughts/comments!

[Concernedguy57]

Bump

[Life360_Dave]

Taking antivirals will not turn a positive into a negative but would delay showing a positive.

[Concernedguy57]

Thanks for the reply Life360.
That is where i am confused. I have also read that antivirals have no affect on the production of antibodies. Antivirals only stop the virus from replicating. If that is the case, why after 6 months has a blood test come back equivocal (.96) and why 3 weeks earlier was it slightly positive (1.16) antibodies are going down. Wouldn't they be increasing if there was an infection. Or even at a much higher number

[Life360_Dave]

Those are boarder line numbers. Only when they reach the 4 or so could a conclusion be made. These would be the nature of the tests your having and that why we advise the Western Blot for final confirmation. Testing with the WB, 3 months post any exposure or 3 months stoping antivirals would be conclusive.

[Concernedguy57]

The WB is what I am planning on taking. I guess I just need to figure out the last time I took antivirals( I believe I have that date)

Thanks

[Concernedguy57]

So I went to see an ID doctor for an expert opinion(it appears most PCP's are not very knowledgable regarding HSV) Upon entering the room the first thing she stated was "I don't think you have Herpes" (she had reviewed lab results prior to my consultation) after listening to my explanation of exposure risk she said she would run IGG HSV 1/2 test again. She also ran Chlamydia Gonnornea and Syphiliss tests ( the last Syphiliss test was done too early)

Again the HSV IGG test came back equivocal 1.09 I believe. She told me again "I don't believe you have herpes. At this point "you should move on"

I am prepared to do that but have questions still

1. Why did I have a negative test one week after exposure, and then 3 tests that were a very low positive (1.16,)  and two equivocal tests. Is there herpes antibodies in my blood and why?

2. Could the fact that I was on Valacyclovir for a couple of months ( did not start taking until one month post exposure) have any impact on results? My ID doctor (and  I read elsewhere ) that Valacyclovir has no affect on HSV antibody production) (grace I know you have stated otherwise- there seems to be a lot of conflicting reports/information regarding herpes

3. Should I take my ID doctors recommendation and move on or do I need to have a Western Blot or Bio Kit Assa?

[Concernedguy57]

PS the STD tests were negative

[HowardH]

1) The reasons for low value false positive HSV test results are unknown. It has nothing to do with having "a little bit" of HSV antibody, and it is not because of cross reaction with other herpes related viruses.

2) Anti-HSV treatment sometimes blunts the antibody response, but not indefinitely.

3) You definitely should "take my ID doctors recommendation and move on".  Adding up all the available information -- a virtually zero risk exposure, symptoms that weren't at all typical for herpes, and your blood test results -- you can be certain you don't have HSV1.

Time for you to move on. Best wishes.

[Concernedguy57]

HowardH, thank you for the comments. The main reason I have been hung up on this is that HSV 1 is transmitted through kissing and we did kiss. Also a negative  result to low positive and equivocal results (seems weird that would happen if nothing was going on)

Just wanted to say that the service you and others provide is very much appreciated by myself and I'm sure all who use this site

Happy Holidays

[Concernedguy57]

Well it appears my ID doctor was not honest with me. When she called me with the results she stated that everything came back the same. (Inferring equivocal results) when I asked her for the numerical value she stumbled a bit and did not come up with a number right away. After a minute or so she said it was 1.09 and that I should move on. As usual I called the office and asked for the report for my files. Imagine my surprise when I read the following

HSV 1/2 PCR DNA (1 negative, 2 Negative
HSV IgM 1/2 combination < .91

I know from my research that both of these test were incorrect to run. Does anyone have a thought on why she would have run either of these test based on the previous information I provided?

As a recap I have had the following IGG test results

1 week post exposure HSV 1,2 both negative
4.5 months post exposure HSV 1, 1.16 positive) HSV 2 negative
5.5 months post exposure HSV 1  .96 equivocal HSV 2 negative
Starting a month post exposure the PCP prescribed Valacyclovir for "viral Syndrome" no sores/lesions were present. I was on and off valacyclovir during the first 2 months post exposure

Do I need to continue testing (my ID doctor said no and to move on although I am not sure of my confidence in her after her decision to run the above referenced tests)

[Concernedguy57]

Bump

And one additional question

An ulcer appeared rather quickly on the inside of my lip. I have read that herpes inside the mouth usually appears on the hard surfaces (roof of mouth/gums) and that canker sores usually appear on softer surfaces (lips/cheeks) is that a true assessment?

[HowardH]

All the evidence continues to support the conclusion you don't have HSV2 and probably not HSV1. From your description, I see no basis your statement that your ID doctor "was not honest with me"; and I suspect she did the extra tests because of your obvious anxieties -- in order to help convince you that you don't have it. And what's it matter if you do? Oral HSV1 should be viewed as a natural human condition, nothing that should cause worry or concern.

I've never heard the soft/hard tissues story for lesions in the mouth. But a single lesion inside the mouth usually is just a canker sore.

Time to move on from this long discussion of a trivial health problem. There won't be any more comments, at least not from me.

[Concernedguy57]

HowardH, I do not deny there is some anxiety with my condition. With all due respect, from everything I've read on these forums and elsewhere, (Grace and Terri would confer) the  two test that were run by the ID doctor should not be run when trying to diagnose HSV. (PCR DNA blood test and IGM combination test) my understanding is that the blood test should be site specific and an IGG. And the PCR DNA blood test should not be run at all as HSV is not in the blood. I also understand that the appropriate testing considering I had one low positive (1.16) and one equivocal (.96) would have been another IGG test or better yet a Western Blot. In my opinion the two test that were run were a waste of money.

I truely appreciate the time you and others put into this site and service. You are a blessing to many

[HowardH]

Sorry, but I have to trust an ID specialist's judgment about the correct tests over the opinion of an anxious non-medical professional.

But thanks for the thanks.  We're all just volunteers trying to help people.  Happy new year.