Please help with clarifications on my situation

[rackofnerves]

Background:
I am male, in early thirties

I have had approximately 10 partners (women) in the past 12 years, one partner steady throughout this time period.
Had vaginal sex with all of them throughout with protection (condoms), except for my steady partner which was mostly unprotected.

Had unprotected oral sex with one woman 6-7 years ago on one occasion, as well as another woman about 4 weeks ago again on only one occasion. Both times, the oral sex was performed on me only. There was also heavy kissing involved in the recent encounter (4 weeks ago) as well as some previous partners.  Also had unprotected oral sex with my steady partner many times.

At no point do I have reason to believe that any of my partners had an active herpes sore or legion.

To the best of my knowledge I've never had any herpes type symptoms or cold sores, except for minor itching around my genitals with nothing red or blistery or raw or scabby, and recently (1 week ago) I had a lot of what looked like smegma with no other physical symptoms on my penis - this was when I was sick with a flu and bacterial infection, fever and had not showered for 2 days or so.

I got nervous and went in to a lab for a few tests a couple of days ago. Here are the results:

1.
Name of test: HIV 1,2 and p24 antigen (ELISA)
Observed Value: Non reactive
Method: Enzyme linked flourescent assay

2.
Infections: HSV 1+2-IgGAb to Herpes Simplex Virus, serum by EIA
Observed Value: Reactive (2.9)

Non reactive: below 0.8
Indeterminate: 0.8 to 1.2
Reactive 1.2 and Above
This is a qualitative test

3.
Infections: HSV1+2-IgMAb to Herpes Simplex Virus, serum by CLIA
Observed Value: Negative (0.64)

Negative 0.0 to 0.9
Borderline 0.9 to 1.1
Positive Above 1.1
This is a qualitative test

Now I don't know how to interpret these results. I see that I did not test positive for HIV which is great.
According to the Igm test I assume that means I haven't had a recent infection, but I've read too many times about why this test is useless. Not sure how useless it is in my case.
According to the IgG test, from what I understand, I have tested positive for either HSV 1 or HSV 2 or both. I also understand this test should have been type specific, but right now this is all I have.

Please use my sexual history and test results to give me an idea of what I may have with what probabilities. As I've mentioned, I haven't experienced any symptoms to the best of my knowledge.

Thank you.

[gracefromHHP]

told you to ignore the results back on 1/23.

grace

[rackofnerves]

So it's fair to say that I should just ignore the positive Combined IGG results and assume the test is flawed with a high false posititve rate? Also it's been almost 7 weeks since the unprotected oral so that would have most probably shown up in the latest type speclific tests I just did - right?
Grace - thank you for all your help. You are a great source of information about this strange virus. I wish I'd known more about herpes before all the stupid things I've done putting myself and others at risk.    

[gracefromHHP]

there's really no need for any further testing. if you had contracted hsv1 from oral sex, odds are you would've had very obvious symptoms within a few weeks afterwards.

grace

[rackofnerves]

So I managed to find a lab that could do type specific IGG testing for me. I sumbitted my blood yesterday (13 Feb /2010) and recieved results today.  I was told that I tested negative for both types of HSV. My HSV1 score was 0.29 and my HSV2 score was 0.22. I don't know what method was used to do the test, it was done wth SLR Religare in India. If you recall my combined IGG score was 2.9 (positive), that was done with another lab in India.  That test was drawn on 21st Jan 2010. My last risky sexual encounter was kissing and unprotected oral on Dec 29 2009. My second last risky sexual encounter was on Oct 20 2009. Do you think I am in the clear here? I haven't had any herpes like symptoms (blisters on my genitals or lips or even bad rashes or dots). In the past 3 weeks though I have been extremely stressed about herpes after learning so much about it through your thorough and indespensible websites and forums. As a result I think I may have been washing and obsessing way too much down there. Combined with the excessive humidity and heat and sweat my foreskin went a bit red and quite itchy at times. I also produced quite a bit of dry stuff that looks like smegma as could very well be but I don't remember it being so much before and dry. I'm afraid it may be a mild yeast or fungal infection. Never did I see blisters though. Please give me your input and thoughts now that I have some negative type specific IGG results, although my combined IGG result was positive.  

[rackofnerves]

Well thanks for doing all you could do. I couldn't find any info on the chances/probability of a false positive with the combined IGG. I found a few posts though where a positive on a combmation IGG test was followed by negatives on the type specific tests. That is sort of reassurng to me for now.

[gracefromHHP]

there is nothing more I can add.

grace

[rackofnerves]

I don't have access to type specific igg testing where I live currently but I did get a negative IGM result recently and a positive combined IGG result of 2.9 where anything over 1.2 was considered positive. I am very concerned that I have HSV1, HSV2 or both. I will be able to do a type specific test in maybe 2 months. I've never had any cold sores and any sort of bumps, legions or blisters on my genital area.
Do I need to be overly concerned?
Is 2.9 a definite sign of Herpes or is there a high false positive rate associated with the combined IGG test? If so what are the probabilities the results are entirely bogus?
Please, please give me something to chew on.

[rackofnerves]

Well my main concerns posting on here initially were my last oral encounter which was unprotected. If I am at low risk for HSV2 and HSV1 genital that's good. Like I said there were no symptoms whatsoever on the girl. I feel I am being a bit paranoid. Every other encounter before this does not bother me too much as they have been protected with condoms, brief and involved almost no skin to skin contact. In addition none of them ever showed symptoms and nor have I or my steady partners in years. I suspect from my positive IGg score and past history + lack of symptoms that I may be HSV1 oral positive, almost definitely HSV1 negative and most likely HSV2 negative. What do you think? I don't really know if I should follow up with any tests but I might in a couple of months anyway.

[gracefromHHP]

It's very unlikely you'd get hsv2 from receiving oral sex. not many folks have it orally to start with and those who do, it doesn't shed very often so the odds of transmission to a partner are incredibly low.  

If you had contracted hsv1 genitally from the last oral sex encounter a month ago, odds are you would've had symptoms by now.

follow up with the proper blood test for peace of mind and go from there.

grace

[rackofnerves]

Doing some more reading it seems that the chances of getting HSV2 in the case of a male recieiving oral sex only from a possibly infected female, from one isolated incident are extremely low? Did I read that right? Is there any sort of statistic to quantify this? 1%? 5%? 20%? Please give me something even if approximate.

[rackofnerves]

I'm a bit confused by your post. Are you saying it's likely I don't have HSV1 at all or that it's likely I don't have HSV1 genitally? How about HSV2 transmission chances?
If it's unlikely I have HSV1, and the combined IGG is a ratio of HSV1/HSV2, that would mean that the HSV2 number is even smaller than the HSV1 number since my combined IGG number was 2.9. Correct or makes no sense at all?
I don't plan on having multiple partners going forward due to the anxiety it has created in my mind the last few days. All this reading about herpes is new to me unfortunately and I cannot afford this sort of uncertanty in my life, I value my relationship with my steady partner way too much. I just want to get to the bottom of this and deal with the results. Hopefully my results are negative and I won't have to think of this ever again.

[gracefromHHP]

fyi - condoms are only 30-40% effective at preventing transmission of herpes. I'd recommend periodic herpes igg blood testing if you typically have multiple partners.

1 - typically it's hsv1 genitally from receiving oral sex. typically it presents with very 'classic' symptoms you aren't going to easily overlook because you don't have hsv1 orally to take the 'edge' off of things for you.  no symptoms within a month post encounter, not likely you contracted hsv1 from it.

2 - we don't have those sorts of stats since so many adults have hsv1 orally to protect them from hsv1 genitally.

grace

[rackofnerves]

Grace or anyone feel free to post answers:

I can't seem to dig out the information I'm looking for, so can you please post what you know here-
1. If there are no symptoms within the first 4 weeks of Herpes after an incident of receiving unprotected oral sex from an asymptomatic woman who may or may not have herpes, what are the probabilities of contracting herpes?
2. In general what are the probabilities of contracting Herpes from an asymptomatic woman during unprotected oral sex, regardless of whether one has had any symptoms?

[rackofnerves]

Again thank you for the reply. I really wonder why those tests are even offered to adults given the cost and anxiety they create. A person without much knowledge might infer that they are positive for HSV 1, HSV 2 or both. Now you just told me you can't determine any of that which is a little reassuring given what I initally thought was the case. At least I don't know for sure I'm positive and can get on with things until I get retested a few months later. As of now I am not totally in the clear but I'm guessing given my lack of symptoms and brief and mostly safe encounters other than my steady partner (except for 2 instances of unprotected oral - one 6-7 years ago and one 4 weeks ago) I don't have too much reason to worry right now. Again thank you for your help, and informing me of the high false positive rates of these tests. I still have to wonder if there is even a little bit one can infer from these tests given that they are so widely used.  

[gracefromHHP]

there is absolutely NOTHING you can infere from the test results you have had done. they aren't type specific and they have a high false positive rate.

grace

[rackofnerves]

Thank you for your reply Grace. I understand the test done was wrong, but I think I need to wait a bit longer to get retested since it's been 4 weeks since the last encounter. With my current test, i.e. Positive result for the combined IgG and negative for IgM, I just want to infer as much as possible. Is is very likely that I have either HSV 1 or HSV 2 or both? Or is it equally likely I have neither? I read in some places that the combined test is a ratio of HSV 1 antibodies to HSV 2 antibodies and so even if both results are later found out to be negative in a type specific test their ratio could be quite high giving many false positives in a combined IgG test. Please, I know the test is wrong, but I would like to make at least a little sense of my tests. I really appreciate your help.

[gracefromHHP]

you had the wrong blood testing done. you had a combined igg test which is useless since it doesn't differentiate between hsv1 and hsv2. You'll need to repeat your testing with better testing.

grace