Incubation Period related question

[worry75]

A little over 12 weeks ago, I had protected vaginal sex but (stupidly) performed unprotected oral-vaginal and oral-anal sex on a female who was an ex-colleague. I also received unprotected oral sex on my penis. Unsure of her recent sexual history, I have since then been worried if I have contracted herpes due to the oral sex.

4 weeks post exposure, I had some soreness in my anus. I got it checked at a local GUM clinic and they told me it is piles. I inisisted on a culture test, which later came back as negative. I was not initially convinced that it was not herpes and was worried for 4 weeks before I realised that the symptoms around my anus may be nothing to do with herpes coz I did not "receive" anal sex of any type.

This made me realise that my symptoms, if any, should be around my mouth (as I performed oral sex) OR on my penis (as I received oral sex in this area).

I have never had cold sores in my life before. 8 weeks post exposure, I had a blister on the inside of my lower lip, which, again the GUM clinic diagnosed as a normal blister.

The doctors at the GUM clinic told me that they were convinced that I do not have herpes.

My question is that since I am well past the incubation period (3-4 weeks) without any herpes symptoms (as per the doctors) can I get on with my life with the conclusion that I have not contracted herpes?

I would like to get a type specific check done but not sure of a clinic that offers thes same in UK.

[worry75]

I contacted the lab where I got the igg blood test done and they told me that they use the "ELISA Chorus analyser" method. What worries me is that the following link mentions that the HSV2 ELISA test used in the UK is very insensitive (50%).

http://herpesdiagnosis.com/blood.html

Now I do not know whether "ELISA Chorus analyser" method is same as HSV2 ELISA test and wondering if my test results are only 50% accurate.

Does anybody know?

[worry75]

Sorry one more question...are you saying that based on the -ve test, I donot have HSV1 or 2 and that I can resume "un-protected" penetrative/oral sex with my regular partner without the fear of transmitting anything to her? and live normally without the fear of transmtting anything to my kid?

Appreciate your responses to the previous question along with the question in this post.

[petal130]

No matter what, some folks who come here convince themselves they have herpes, regardless of testing and factual advice that's been told to them.  Move on from herpes; you've tested negative.

As to kissing, your point is? If it's oral herpes, 1 in every 2-3 people you kiss has oral herpes, including people like your Mom and other loved ones. Oral herpes is not considered an STD, as many of us get it in childhood, and too, most of us never have recognizable symptoms to know it. By the time we make it to the old folks home, about 90% of us will have oral herpes.

[worry75]

Well, it was a single encounter only in the sense that I did indulge with this female after that day but on that day the oral sex was performed few times (may be receptive only once but I performed few times). Is it still a single exposure?

Also, there was a lot of kissing involved.

[petal130]

ob = outbreak.

Oral sex is considered low risk for any STD transmission, let alone a one-time encounter. You'll read that on the expert's forum as well as Dr. H and H both reiterate this frequently.
http://www.medhelp.org/posts/STDs/Oral-Sex/show/629160

Here's another great post by Dr. Handsfield that will give you some perspective of the low odds of transmission of a single exposure to genital HSV2 (and oral is even less a risk). Scroll down to his second response.
http://www.medhelp.org/posts/STDs/HSV-Clarifications/show/1306350

[worry75]

Hi Grace,

Sorry did not understand the following statement from your response. What do you mean by "ob"?

"Odds are you would've had a very obvious ob if you were herpes negative and then contracted it"

Also, why do you say mine was a low risk encounter?

[gracefromHHP]

It's a very small percentage of folks who don't produce detectable antibodies. You've had a very low risk encounter to begin with .  You've had negative blood tests. Odds are you would've had a very obvious ob if you were herpes negative and then contracted it - you've had no symptoms that sound worrisome for herpes.  You've followed up on things with providers who have all thought you didn't have herpes.  

please do not confuse your anxiety with real risk.  

[worry75]

Hi Petal,

Thanks for your response. I call it the worst virus only coz there does not appear to be any conclusive test baed on which (nor a fixed time frame after which) people like me can put the exposure behind and move on with their lives coz

-- I may never produce anti-bodies OR
-- Test might be -ve on one day and +ve on the other

[petal130]

Oh good grief - the worst virus?? It's a mere skin condition for the many millions of folks who have it - many who never have a symptom

As to the worst viruses: How about rabies? It kills 55,000 people a year. Or Influenza? Try hundreds of thousands annually, up to millions in a pandemic year. And HIV? How about two million deaths annually.  Can't say you'll find those stats about herpes...

I highly recommend the homepage of WHO for more information about any disease. Herpes is clearly not a deadly, or for that matter, serious virus.

At this point your posts are highly anxiety driven. As to Dr. H's post, it's the glass half full, or empty in your case:

"The giant majority of people who are negative at either of those times can be confident they do not have HSV-2.  But almost all infected persons eventually develop positive tests, even if it takes 6 months or longer."

As Grace stated: "it's just not worth a half year of your life waiting for test results when you can get them sooner.  Terri Warren , HHH and Dr Hook all don't recommend repeat testing either if you are negative at the 4 month mark unless you have symptoms that are still bothersome that need further evaluation and at that point we recommend lesion cultures anyways."

Lastly, even if you had HSV1 or HSV2, it surely is not the end of the world. I have genital herpes and lord knows if it's the worst thing that happens to me I will be VERY fortunate!

[worry75]

The more I learn, the more I feel this is the worst virus one can get exposed to.

Reading the journal posted on your profile, it appears that the blood test can be -ve on some days and +ve on the other.

http://journals.lww.com/stdjournal/Fulltext/2003/04000/Time_Course_of_Seroconversion_by_HerpeSelect_ELISA.7.aspx

This is just adding to the confusion

-- Firstly, it is possible that one may never produce anti-bodies
(Source: http://www.medhelp.org/posts/STDs/Herpes-Testing-Question/show/246178)

-- The tests themselves are not reliable as one might get a +ve on somedays and -ve on the other (even well over 365 days)

(Source: http://journals.lww.com/stdjournal/Fulltext/2003/04000/Time_Course_of_Seroconversion_by_HerpeSelect_ELISA.7.aspx)

Is there any hope at all for people like me without any symptoms? How can I put this behind with possibilities like above?

[worry75]

Hi Grace,

After posting my previous question to you, I did a search and came across the following answer from Dr.HHH which confirms my worst fear that some people never produce anti-bodies. Your views please?

http://www.medhelp.org/posts/STDs/Herpes-Testing-Question/show/246178

[worry75]

Hi Grace,

Thanks for your continued assistance in answering my queries.

I was speaking to a local support group and was startled to learn that a -ve blood test may not be all good news coz sometimes anti-bodies are never produced at all (even if the virus is present) which is why the blood tests are no good. They said that sometimes it can take upto an year to ser-convert and if one does not sero-convert after one year, they will never do so even if the virus is present in the body.

This made me feel depressed even more and was wondering if I will never know conclusively whether  I am carrying HSV1/2 or not?

[worry75]

Hi WarOnTheTerraces,

Thanks. I am however still worried that I may be sero converting slowly and may have to wait up to an year to confirm.

No. my gum clinic did not offer the test. I asked but they said they do not offer the test. I had to go private and shell out £200.

[gracefromHHP]

statistically 1 out of every 3 kids has hsv1 orally before they step into kindergarten. It's very common.  http://www.ashastd.org/herpes/herpes_learn_oralherpes.cfm  has terrific info on hsv1 orally for more reading.

grace

[WarOnTheTerraces]

Congratz worry, did your gum clinic offer the test to you or did you have to ask? I had to go privately and pay £160 for my test...

[worry75]

The awareness about herpes has made me paranoid and extra anxious.

As a parent, I want my kid to be as clean from viruses (however common) as possible

I am now worried that my 5 year old kid will contract this COMMON virus (type 1) at school. How likely is this to happen?

[gracefromHHP]

nope, no difference at all.

If I was in your shoes, I'd be dancing out in the streets with joy myself.

[worry75]

I guess I did not wait for the exact 4 calendar month mark mark....I feel I tested a week too soon..

Exposure was on Apr 23rd and tested on Aug 16th...So, a week less if you consider calendar months...but completed 16 weeks and 2 days at the time of testing. Would that make any difference? I have always been confused about the mark. Is it 4 calendar months OR 16 weeks or 120 days?

Many Thanks for answering.

[gracefromHHP]

you can get false negatives but the risk of such is low at the 4 month mark which is why we recommend testing then.

it's just not worth a half year of your life waiting for test results when you can get them sooner.  Terri Warren , HHH and Dr Hook all don't recommend repeat testing either if you are negative at the 4 month mark unless you have symptoms that are still bothersome that need further evaluation and at that point we recommend lesion cultures anyways.

[worry75]

Thanks Grace. That's very re-assuring. Please can you elaborate on why you say there is no need to re-test coz my questions still remain :

-- That only 70-80% seroconvert at 4 months. Am I in the other 20-30% of people?
-- That there is a possibility of false negative from the IgG test

Many Thaks in advance.

[gracefromHHP]

no reason for more testing. time to put this behind you.

congrats on being negative!

grace

[worry75]

Here are my IgG test results done at 16 weeks and 2 days.

HERPES SIMPLEX ANTIBODIES                                                                                                        

H.S.V. I (IgG)                Negative 0.534 Index (Pos = > 1.0)                                                                  

H.S.V. II (IgG)               Negative 0.329 Index (Pos = > 1.0)

Do I need to re-test at 6 months AND 12 months considering the following:

-- That only 70-80% seroconvert at 4 months. Am I in the other 20-30% of people?
-- That there is a possibility of false negative from the IgG test

[gracefromHHP]

no your child doesn't have a std that they got from coming in contact with your urine.

if he has mouth ulcers, take him to be seen.

grace

[worry75]

In a freak incident, my kid may have come into contact with drops of my urine in the toilet. He has the habit of touching his feet and putting his hands in his mouth. 4 days later, he has complained of mouth ulcers on either side. I am terrified that he may have contracted an std from me.  Are the ulcers due to an std that he may contracted from this episode? Thanks in advance

PS: I am awaiting my test results for chlamydia etc., and waiting for 16 weeks to complete for my hsv test