I noticed a red spotchiness on the head of my penis. This didn't itch and wasn't painful, but I had a new sexual partner recently, and though I used a condom, I wanted to make sure that it wasn't herpes. I went to a planned parenthood clinic for testing. The nurse who did her physical examination said it was what she normally sees (there were no lesions and I had no other symptoms: no itch, no pain, no fever, no flu symptoms, no swollen lymph nodes). Since there was no fluid to do a culture, she drew blood and put me on a 10 day bout of acyclovir.
In the next few days I did a little reading of my own and decided to stop washing my penis with soap. The rash began to clear up. Two weeks later my blood test results came back negative for simplex 1, and a positive result of 1.49 for simplex 2. I saw the nurse at PP again and she put me on acyclovir for repressive therapy.
In the next few days I developed a large pimple like bump just at the bottom of the shaft of penis. I decided to go to a doctor to get it examined and a swab taken for a culture. I told him my history and he said not only did it sound at all like a herpes infection, but the postule on the base of my shaft looked nothing like a herpes lesion and was almost certainly a bacterial infection. He took a swab of the yellow fluid inside after he squeezed it and I am waiting on the results. He also said that he didn't think the blood test was that reliable and that while I had probably been exposed to herpes I more than likely wasn't infected.
I don't know who to trust, and I don't know what to do next. I mean, do I inform a potential partner of what has been going on? Do I continue the Acyclovir? Could it be I have a bacterial infection along side a herpes infection? Friends of mine that have had herpes outbreaks in the past have said they are nothing like what I've had. If you could give me some guidance I would really appreciate it.
You can trust me. This is my specialty. It is certainly good to await your swab test results. If it is positive for herpes, then you have herpes. There is no such thing as being "exposed" to herpes and being not infected. However, your antibody test at 1.49 is what we call a low positive value. Anything index value between 1.1 and 3.5 is a low positive, and should be confirmed with another type of test. There are some false positives in this group of test values. The closer the index value is to 1.1, the more likely it is to be a false positive. So you need another test, and the one you need is called a herpes western blot. It will be easiest to do through Quest laboratory. The test code is 34534. If you want back up for going to your doctor with this request, you can go to www.ashastd.org and order a herpes test toolkit to take with you. Low positives are discussed in there, and it would be a good gift for your doctor to better understand herpes testing. Or you could just try asking if he would order it on your behalf. It will take a new blood draw. There are six states in the US that will not allow the test to be sent out of state (it is done only at the University of Washington). Let me know how you do with this, OK?
No, it is not true. Taking acyclovir daily reduces transmission by about half. This comes from a valacyclovir study, but we have no reason to believe that acyclovir is any different, when taken as directed. I would say your physician needs a herpes update, perhaps!
That's very good to know. I started a daily suppressive regiment about a week ago of 800mg per day. Is there any reason to believe that if I stay on this regiment that the acyclovir would affect in any way the outcome of a blood test in a few months?
Yes, the acyclovir could interfere with your antibody test. I would suggest that you consider stopping the acyclovir. If you get a rash that is swabbable, go back in and have it swabbed for herpes. If not, wait 4 months from a possible infection and retest using IgG
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