Need advice, symptoms and test results

I originally posted on the free forum but have not received any more correspondence. So I thought I would ask here
Here is the link to my original post.
http://www.medhelp.org/posts/Herpes/Question-about-tests-and-symptoms/show/1778564
(please don't judge, I already know I don't deserve any help, the single worst mistake I have ever made in my life)

Just to add an update to that post I did get my results for the swab test on what I thought were sores. It was negative. I expected that as the sores disappeared by Saturday. I also did get my 12 weeks blood tests done today so I am hoping to have the results Friday or Monday.

Basically all of my tests (for everything) have been negative except for the type specific igg hsv1. Both times I was tested for hsv1 (5 weeks and 7.5 weeks) the results were 1.6. And my type specific igg hsv2 tests (all three) have been <.2.

I guess my question would be does this sound like herpes? My doctor says it is not and I do have an appointment with a dermatologist Wednesday. I have never had any "classic" symptoms, no blisters I guess I should say. I have however noticed lately that I have sores in my mouth that could be canker sores but some of them look like blood blisters or cuts with dried blood but I dont remember biting my inner lips or cheeks. But that doesnt mean it doesnt happen I guess.

So what do you think? If my bloodwork is negative (12 weeks, well actually 11 weeks 6 days, does that matter? close enough to 12 weeks?) is that conclusive enough?

[Terri Warren, RN, Adult Nurse Practitioner]

Your HSV 2 result is definitely negative.  Your HSV 1 result is in the low positive range (the very slight increase in the number is not significant.)  If you were our patient, I would order a western blot for you to see if the low positive HSV 1 is real or not, but I wouldn't do it until 16 weeks past exposure.  Because you've never had a cold sore, if the HSV 1 test is really positive, confirmed by western blot, we can't know where your HSV 1 infection is, only that you have it.  

Terri

[Terri Warren, RN, Adult Nurse Practitioner]

If your blood work is negative at 12 weeks, I would say you have better than a 80% chance that that is accurate.  However, with a single sexual encounter, I would say the real chances of you becoming positive between 12-16 weeks is incredibly small.  I think you could safely stop testing now if you wish.

Do you have a history of cold sores ever in your life?  

Your symptoms honestly don't sound anything like herpes to me.

I know you are feeling very guilty about this, and perhaps some of your worry and perception of symptoms is confused by your guilt and shame.  I'm hoping that the dermatologist yesterday  helped to clear up your concerns about what really is and is not going on in your genital area.

Terri

[Panicing247]

I do not remember ever having cold sores before. I know that my mother does get what appear to be cold sores from time to time but I have never asked her about them. Do you think that the hsv1 is a recent infection because of the low results?

Just to clarify I do not see the dermatologist until next week. Hopefully by then I will have my 12 week results.

Would another type specific test (ie not western blot) at 15-16 weeks, if it is negative, be conclusive?

And one last one, sorry, are all of my other tests conclusive as well if they are negative at 12 weeks?

[Panicing247]

And yes the guilt and shame is almost too much to handle. I have never done anything like this before and just want it all to go away.

[Panicing247]

Sorry just to clarify. I meant all of my other std tests, hiv, syphillis (syphilis) and hep b & c, etc.

[Panicing247]

I got my test results back, they are:
Syphilis, negative
hep-b, negative
hep-c, negative
urinalysis, negative
igm, negative (i know why do they keep running this)
igg type specific hsv1, 1.7 (up .1 from previous tests)
igg type specific hsv2, <.2 negative

They were supposed to run an hiv 1&2  test as well but somehow they missed it. I will have the results for that on Monday. Not really expecting it to be positive but would have been nice to know.

They did print out on the results sheet where the igg tests were done , ARUP Lab, Salt lake City.
Some more info about test for hsv2

CPT code
86696

LOINC Code:
7912-9

These are for hsv1
CPT Code:
86695

LOINC Code:
7909-5

Are these reliable?
All my tests conclusive? Should I repeat at 16 weeks?

[Panicing247]

Thank you Terri. I am beginning to feel better about this. Is it because the numbers are so low for hsv2 at this point that you think it is definitely negative? I know it sounds like a silly question. If the numbers were higher would you worry about delayed seroconversion?

One last question about my other tests and i believe i am done. Do you think those are definitely conclusive as well?

[Panicing247]

Terri

How do I have my doctor order the western blot? What information do I need? What do they cost? I think I would like both hsv1 and hsv2. If they are both negative at 16 weeks how accurate is that? Is there still a chance of delayed seroconversion? Sorry for all the questions. Just trying to cover all my bases.

[Terri Warren, RN, Adult Nurse Practitioner]

Unfortunately, Quest labs is no longer offering western blot to the general public.  I can still order it for patients or you can contact UW and have them send your doctor a testing kit.  

Im a little confused because you did say your HSV 1 was positive at 1.7.  Is that not correct?  That is a low positive that we would normally confirm.

Terri

[Panicing247]

Im sorry about that, I can definitely see why you were confused. I guess what I am asking is if the western blots are negative or positive at 16 weeks that is conclusive right? If they are negative there is virtually no chance of missing a delayed seroconversion correct (especially for hsv2)?

Also are you saying that I definitely dont have HSV2 because the numbers are still so low (<.2 at 12 weeks)? If I got a regular hsv2 type specific test instead of western blot and it was still negative or <.2 at 16 weeks would that be conclusive or should I just spring for the western blot?

How much does the western blot cost for each test, is it the same price if you order it or if my doctor orders it?

If I am positive for both since my wife and I have only had sex once within 24 hours after said occurrence what are the odds I gave her something?

And the last question, are my other tests conclusive? The HIV 1&2, HEP B & C and the others I listed (all negative at 12 weeks out)

Sorry i know there are a lot of questions but if you could please answer I would greatly appreciate it.

[Panicing247]

My doctor called shortly after I typed my last response. I asked him several questions about my tests and their conclusiveness. He seemed to be pretty confident that the only thing I had was HSV1. No HIV or Hep or anything else. He did agree that the HSV1 is a low positive. But he also recommended no more testing. I asked about testing at 16 weeks and he said "If thats what it will take for you to believe me". I asked about the western blot for both HSVs and he was not aware of it, only for HIV. He said he would look into it and see if it will be covered by insurance, if it was not he would let me know the price and how to do it.
So I guess what do you think Terri? Please see previous questions as well, thanks so much.

[Panicing247]

Can you tell I am obsessing? One more question. If everything I have going on were truly symptoms would you expect me to have tested positive on my blood tests for hsv2 at this point?

[Panicing247]

One more note, the ARUP lab thing was actually for the HEP B surface AB test. They had to send it out as their testing equipment was down in house.

I know the low positive issues for HSV2 and how often they turn out to be negative but is that the same thing for HSV1? Is the rate of actually being negative the same?

[Panicing247]

If hsv1 was truly positive would you say that it is a previous infection since I tested positive for it so early (5 weeks) and the numbers havent really changed in 7 weeks?

[Terri Warren, RN, Adult Nurse Practitioner]

I honestly couldn't say for certain since your test was 5 weeks out, and by 3 weeks, 50% of people are positive.  

Terri

[Panicing247]

Thanks Terri. Any comments on the other questions?

[Panicing247]

Ok my next question is if this were an initial infection of hsv1 say either orally or genitally wouldn't I have had some "classic" outbreak symptoms, like bistering and open sores? Everything I have had the doctor says does not look herpetic.

[Terri Warren, RN, Adult Nurse Practitioner]

I would expect that you would have had more symptoms, yes, many people do

Also are you saying that I definitely dont have HSV2 because the numbers are still so low (<.2 at 12 weeks)? If I got a regular hsv2 type specific test instead of western blot and it was still negative or <.2 at 16 weeks would that be conclusive or should I just spring for the western blot?

I think the regular test without the western blot for HSV 2 is fine for you.

How much does the western blot cost for each test, is it the same price if you order it or if my doctor orders it?

I think the test is about $150 but Quest said they were changing the price so I'm not certain at this time.  The cost would be the same either way, but I don't believe your doctor can order it from  quest, but he could order the testing kit directly from UW.

If I am positive for both since my wife and I have only had sex once within 24 hours after said occurrence what are the odds I gave her something?

If you are indeed positive, the odds that you gave it to your wife with a single intercourse is quite low, I can't give you an exact number because there are many variables to that question.

And the last question, are my other tests conclusive? The HIV 1&2, HEP B & C and the others I listed (all negative at 12 weeks out)

All except syphilis which can take up to 90 days to show up in a blood test.


iHope these answers are helpful for you.

Terri

[Panicing247]

Thank you so much Terri for answering my questions. You had mentioned that I could have you order the western blot for me. How does that process work? Can you private message me that info?
How long does a prodrome last for oral herpes? I feel like my lips have been burning for almost two months now, is this typical? No cold sores or blisters that I can tell but occasionally there is redness on the edge of my lips. Nothing majorly red. Could it be my sebhorrheic dermatitis instead? There is usually some small flakes of dry skin on my lips.
Thanks again

[Panicing247]

Hi Terri a couple of more questions.
Is it possible to get hsv1 orally and genitally at the same time?
In regards to the western blot, does the test cover both hsv1 and hsv2 or are they separate? Meaning I have to pay for two tests.
If I do indeed test negative on both (please god I hope I do) is that indeed confirmatory that I don't have either? I mean what is the likelihood of the antibodies being missed by delayed seroconversion?

Thanks Terri I hope these are the last questions I have. Please see previous question about ordering western blot as well.

[Panicing247]

Sorry one more, if the red area on my penis returns does it have to blister or have some sort of sore to be swabbed or can they just swab the red area?

Both times it showed up there were no open sores. It did go onto the ridge of the penis head and sometimes there were sharp pains at the ridge of the penis head like someone was stabbing it with a needle or something. But those were not constant. My dermatologist, sorry forgot to mention what he thought it was, said it was psoriasis, but the red area was gone when he saw me. He said herpes would not present itself on the shaft as well as the ridge of the penis. Do you agree with that?

I looked at pictures online for psoriasis nothing looked like what I had but flexular psoriasis did look like what is going on in the creases of my groin.
Please see previous questions as well. Sorry I know you are extremely busy and I truly appreciate all of your input.

[Panicing247]

Bump...sorry

[Terri Warren, RN, Adult Nurse Practitioner]

Sorry, I missed this.  

Yes, it is possible to get HSV 1 orally and genitally at the same time.
The western blot covers both HSV 1 and 2, yes.  You  just call me office, set up a phone conference and we will order the test for you.  You need to become our patient before we can order you any testing, but we can do that on the phone.
It is possible to do a swab test on simply a red area, doesn't have to be a sore.
Herpes can show up anywhere on the shaft of the penis or head of the penis or base of the penis.  

Terri

[Panicing247]

Thank you Terri. Sorry for the bump. I am going to call UW to see about ordering before I call you. I thought it was odd that the dermatologist said it would not cross over like that.
One last question (I probably know the answer), would herpes cause just a red area like what I am describing, below the head of the penis (including part of the edge of the head) about 1/2 inch wide and 3/4 to an inch long, without blistering or sores? Or does it only present red with blisters and sores?

I will only try to post again with test results.

[Terri Warren, RN, Adult Nurse Practitioner]

Normally, herpes would present with a few more symptoms than just a red area, but not every single time.

Terri

[Panicing247]

Since the red area has appeared twice, weeks apart, would you have expected it to have blisters or sores at least once?

Through all of this and thinking more and more about what happened that night and sorry for details but I was only inside her for a lot less than 30 seconds. Probably even more like just a few seconds to 10 seconds at most. I started to ejaculate rather quickly. Does this lower my chance or keep it pretty much the same? I was never inside her again. Definitely not worth all of this BS not that anything would be.
Also with the oral she only went up and down 2-3 times then something happened with her jaw. Does that lower the risk as well for contracting hsv1 genitally?
Thank you for answering my multiple questions.

[Panicing247]

Just called pathology department at testing center and they said they use a bio rad test. Is this a good test or is it comparable to say the herpeselect? Should I go somewhere else to have another test?

[Terri Warren, RN, Adult Nurse Practitioner]

I don't know anything about the bio rad test, never heard of it.  You can get a herpeselect test online without a provider's order, I might suggest sticking with that one, myself.  

Your risk (and thank you for the very clear description of your contact) is very low.

Terri

[Panicing247]

The Bio Rad test I guess is the BioPlex HSV. The website for ASHA has it listed on some herpes testing chart.

I had another type specific test done and again it was <.2. But I may try to get the herpeselect test. I am ordering the Western Blot test today. My doctor signed off on it. If that is negative at 16 weeks how conclusive is it? Have you seen anyone test positive after taking it at 16 weeks? This is killing me.

The rash in my groin has come back full on (not that it ever really went away). Doctor did a swab of some spots yesterday so i am hoping to hear Monday about the results. He thinks it is folliculitis. He gave me some antibiotics. He also does not agree with the derm that it is psoriasis. Not sure what he thinks it is though. He told me to use Domeboro powder as well for the creases in the groin.

[Panicing247]

I had a herpeselect test done today along with a full panel for stds (hiv, syphilis, gon, chlamydia, heb b, hep c) mainly because it was cheaper to do all than just herpeselect, hiv and syphilis. I used getstdtested.com and went to a quest lab. It is 15 weeks and 4 days post encounter. Will these tests be conclusive?

The HIV is a western blot as well.

My latest pcr swab was negative as well.

Also my western blot kit for hsv should be here this week. Thursday will be 16 weeks. I plan on taking it after that. How conclusive will those results be?

[Panicing247]

Ok got my western blot test kit in the mail today. Going tomorrow morning for the blood draw.

Tomorrow will be 16 weeks to the day.

Still waiting on my herpeselect test results, hopefully today or tomorrow. I realize the western blot takes a while to get results but I was wondering how conclusive these results are if they are negative?

I realize that my HSV1 could still be a true positive though.

[Panicing247]

Terri

Got my results back from the online testing.
Everything, except for HSV1, is negative.
Did have kind of a freak out moment because my first result for the Syphilis RPR said 1:8 Abnormal but then the confirmatory FTA-ABS test said I was non-reactive.

Sorry to keep asking but these tests were taken 15 weeks 4 days past possible exposure. How conclusive are they?

Also my results for HSV1 were 1.58. Down from the 1.7 and 1.6. Still going to do the western blot tomorrow. That will be 16 weeks 1 day.

Going back to the swab of a sore area. It feels like the sore area on the penis shaft may be back. At least it feels sore (although not as sore as it has) and irritated in the same spot but does not appear to be as red. The small blood vessels appear to be inflamed but still no lesions or wounds or fluid. It has been this way for three days now. SHould I go in and have them swab the area?

[Terri Warren, RN, Adult Nurse Practitioner]

I think the tests at this point are very conclusive!  The tiny variations in the herpes tests are completely normal - I don't think they are hardly ever exactly the same as each test is compared to a control value which is always different.

If the western blot is negative, you should consider yourself negative.  Period.   This is my last post on this thread.

Terri

[Panicing247]

Thanks Terri for all of your expertise.

If I could ask one last question and I swear that is it, just want to rule out one last thing. On this site I have read where people have tested positive by culture or swab and not tested positive on blood test, possibly falling in to that 5% or so that never will test positive on blood tests. Even after a long time of blood testing, I mean like several months.
So my last question is since I have tested positive for HSV1 does that pretty much rule me out of that 5%? Does that 5% mean you will never test positive for either even if you have them? Or can you test positive for one and never test positive for the other even if you have it?

Thanks again for your insight and help. You really do provide a great service here. I will post my western blot results when I get them as well.

[Terri Warren, RN, Adult Nurse Practitioner]

Generally, the test picks up HSV 2.  It misses HSV 1 more often.  So that is good in terms of your results.

Terri

[Panicing247]

Got my Western Blot results.
Positive HSV1
Negative HSV2

While I am thrilled that I do not have HSV2 I am still not happy that I have HSV1. I have a feeling that I have it genitally and I am pissed at myself for not getting in to see the doctor the last time the red area appeared last. I do have a question.

My numbers for HSV1 have been pretty consistent  every time I have tested (11 weeks worth of testing). Between 1.58 and 1.7. Is there anything in these numbers that state that this is more of a longstanding infection as opposed to an acute or am I grasping at straws here?

[Panicing247]

And just to let you know time frame my blood was drawn at 16 weeks 5 days for the Western Blot.

Along with my question above, I am definitely negative for HSV2?

[Terri Warren, RN, Adult Nurse Practitioner]

There is nothing in your ELISA results that would tell us when you got infected, no.

You are definitely negative for HSV 2 by the best testing we have.  

56% of the US population has HSV 1, you are not alone.

Terri

[Panicing247]

What is the percentage of people who have it genitally?

Lets say that I had HSV1 orally and acquired HSV2 genitally. Could my previous HSV1 infection be slowing down my seroconversion or are you pretty confident that I do not have HSV2?

And my last question is is it more likely that I passed on the virus to my wife from kissing and then later that night when she performed oral on me it got transmitted to my penis? Or could I have gotten it from the few seconds of oral from the other woman?

[Terri Warren, RN, Adult Nurse Practitioner]

What is the percentage of people who have it genitally?

We don't know that

Lets say that I had HSV1 orally and acquired HSV2 genitally. Could my previous HSV1 infection be slowing down my seroconversion or are you pretty confident that I do not have HSV2?

Slightly

And my last question is is it more likely that I passed on the virus to my wife from kissing and then later that night when she performed oral on me it got transmitted to my penis? Or could I have gotten it from the few seconds of oral from the other woman?

Both are unlikely.

This is my final post on this thread.

Terri