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Possible herpes exposure and lack of testing methods available locally
Hello Doctor,
I had unprotected and protected oral sex and condom protected vaginal intercourse with a few prostitutes over a short time span. 10 days after I started having pain in my scrotum and underneath (prostrate?), and in the groin area. The glands have also been sensitive and a bit red at the ridge, but without lesions. A venereologist said at that time that I would not have HSV. An urologist concluded my sperm tubes were inflammated and prescribed me cyprofloxacine and anti-inflammatory. I also took zythromax and cefixime myself. The pain did not go away initially, although now it is disappearing in the scrotum. However, I developed some pain in my lower back; the tip of my penis remains sensitive with some tiny red spots on the ridge (no ulcers or lesions). I also started having some irritation of my lymph nodes (arm pits) now. I now started taking zivorax. However, I may not see further symptoms because of this reducing certainty on HSV infection. 2 days ago I did a herpes test (ELISA IgM and IgG), now 2 1/2 weeks after the first pains. I will get results tomorrow. The problem is I live in an Arabic speaking country, they have no tests that differentiate HSV1 and 2, so I may get false positive or false negative results with the IgM and IgG is (too) early.
Questions:
1) What HSV risk was I exposed to? One of the sex workers used lip stick; could the latex condom have been damaged and subsequently oral sex or intercourse have passed HSV?
2) Could unprotected oral sex have passed HSV1? Only some saliva touched my glands.
3) What is your assessment of the symptoms and risks?
4) If my wife finds out my action or a disease she will go back with kids to her country, a disaster for me. What should I do in regards sex with her? Based on neg. / pos. test results, what action would you recommend?
4) I really want to order a Herpeselect or similar test through international shipping. From where is this possible? I can’t find anything.
Many thanks
I had unprotected and protected oral sex and condom protected vaginal intercourse with a few prostitutes over a short time span. 10 days after I started having pain in my scrotum and underneath (prostrate?), and in the groin area. The glands have also been sensitive and a bit red at the ridge, but without lesions. A venereologist said at that time that I would not have HSV. An urologist concluded my sperm tubes were inflammated and prescribed me cyprofloxacine and anti-inflammatory. I also took zythromax and cefixime myself. The pain did not go away initially, although now it is disappearing in the scrotum. However, I developed some pain in my lower back; the tip of my penis remains sensitive with some tiny red spots on the ridge (no ulcers or lesions). I also started having some irritation of my lymph nodes (arm pits) now. I now started taking zivorax. However, I may not see further symptoms because of this reducing certainty on HSV infection. 2 days ago I did a herpes test (ELISA IgM and IgG), now 2 1/2 weeks after the first pains. I will get results tomorrow. The problem is I live in an Arabic speaking country, they have no tests that differentiate HSV1 and 2, so I may get false positive or false negative results with the IgM and IgG is (too) early.
Questions:
1) What HSV risk was I exposed to? One of the sex workers used lip stick; could the latex condom have been damaged and subsequently oral sex or intercourse have passed HSV?
2) Could unprotected oral sex have passed HSV1? Only some saliva touched my glands.
3) What is your assessment of the symptoms and risks?
4) If my wife finds out my action or a disease she will go back with kids to her country, a disaster for me. What should I do in regards sex with her? Based on neg. / pos. test results, what action would you recommend?
4) I really want to order a Herpeselect or similar test through international shipping. From where is this possible? I can’t find anything.
Many thanks
MEDICAL PROFESSIONAL
Because you are using such different numeric values, I'm a little confused, and I"m also confused with what you just wrote here.
Terri
Terri
Doctor Terri,
In principle that is correct. It comes out now as a borderline case just negative / doubtful. However, as I said before, I tested early at approx. 3 weeks after the last contact. As I mentioned that I don't have an old infection, and with the IgG of 9 it would seem that with the early testing that this is a IgG that has started to go up (from possibly 0 or very low before until 9 now) and will likely continue to do so and be positive if I would test again in say a month or so. Otherwise, without any new or old infection, the current test result for IgG should have been lower isn't it? Is my reasoning correct, or not?
Thanks for your advice
In principle that is correct. It comes out now as a borderline case just negative / doubtful. However, as I said before, I tested early at approx. 3 weeks after the last contact. As I mentioned that I don't have an old infection, and with the IgG of 9 it would seem that with the early testing that this is a IgG that has started to go up (from possibly 0 or very low before until 9 now) and will likely continue to do so and be positive if I would test again in say a month or so. Otherwise, without any new or old infection, the current test result for IgG should have been lower isn't it? Is my reasoning correct, or not?
Thanks for your advice
MEDICAL PROFESSIONAL
Well, OK, lets assume that. Based on these results, then to me it looks like you are not infected. Is that how you read this?
Terri
Terri
For some reason the interpetation in the test results is written on the test result paper as less than 9 being negative, 9 - 11 doubtful, and more than 11 positif. I had a score of 9 on the IgG (and 4 on the IgM). I am aware that in the US these test results are indicated in terms of 0.9 - 1.1 as doubful, and I guess one can assume that they simply leave out the decimal here but that otherwise this is the same. Hence, with decimals as in the US my test result would be 0.9 for the IgG and 0.4 for the IgM. I hope you have any further feedback based on this.
MEDICAL PROFESSIONAL
I believe that there should be some decimal points in there. How about if you double check and then repost the correct results with the decimal points included, please. That way I can be of the most help to you.
Terri
Terri
Doctor Terri,
I received the results. As I said before, I tested approx. 3 weeks after the last contact. The Elisa IgM gives a 4 (negative), whereas the the Elisa IgG gives a 9 (borderline negative / doubtful, since doubtful is 9 - 11). I know the IgM has a lot of false positive and negative, so I am not much considering that test. It could be that the IgM has gone down though, and that the IgG is going up at this stage. As I mentioned that I I don't have an old infection, and given the IgG of 9, it would seem that given the early testing that this is a IgG that started going up and is likely positive if I would test again in say a month or so. Otherwise, if I didn't have a old infection (which would have shown in this test) the current test result for IgG should be lower isn't it? Is my reasoning correct, or not?
Thanks for your advice.
I received the results. As I said before, I tested approx. 3 weeks after the last contact. The Elisa IgM gives a 4 (negative), whereas the the Elisa IgG gives a 9 (borderline negative / doubtful, since doubtful is 9 - 11). I know the IgM has a lot of false positive and negative, so I am not much considering that test. It could be that the IgM has gone down though, and that the IgG is going up at this stage. As I mentioned that I I don't have an old infection, and given the IgG of 9, it would seem that given the early testing that this is a IgG that started going up and is likely positive if I would test again in say a month or so. Otherwise, if I didn't have a old infection (which would have shown in this test) the current test result for IgG should be lower isn't it? Is my reasoning correct, or not?
Thanks for your advice.
Dear Doctor Terri,
Woudl it perhaps still be possible to get your advice on the above follow-up questions? In particular on the interpretation of the IGM and IgG test results (taken approx. 3 weeks after last contact) which I will get today in the possible combinations IgM - IgG: neg / neg, neg / pos, pos / neg, and pos / pos I could really use some advice how to interpret the results. I am obviously very anxious about this right now. I will send them over to you as soon as I get them. If you have any further suggestion on the protection that Zovirax might give against viral shedding so I can take this into account in my decisions and what to do and not to do, that would also be great.
Many thanks.
Woudl it perhaps still be possible to get your advice on the above follow-up questions? In particular on the interpretation of the IGM and IgG test results (taken approx. 3 weeks after last contact) which I will get today in the possible combinations IgM - IgG: neg / neg, neg / pos, pos / neg, and pos / pos I could really use some advice how to interpret the results. I am obviously very anxious about this right now. I will send them over to you as soon as I get them. If you have any further suggestion on the protection that Zovirax might give against viral shedding so I can take this into account in my decisions and what to do and not to do, that would also be great.
Many thanks.
Dear Doctor, Thank you for your reply.
I never had a cold sore in my life, and neither had my wife so I might not have HSV1 protection.
May I still follow-up with a few clarifications?:
1) I did both the IgG and IgM tests. The IgC may be negative given that only 2 1/2 weeks passed, unless I did have a past oral HSV1 infection that I am not aware about. If negative, I could redo it after 3 months. But what weight could I attach to a negative IgM test result at this stage, or a positive IgM test result (given that this test is supposed to measure new infections)?
2) Do you think the fact that I am now taking 1 gr of Zovirax per day at this moment would give a reasonable protection against shedding and hence against possibly infecting my wife, in case I would be infected? or does this not provide good protection in case of a new infection? And if after let's say the coming 2 weeks I would reduce this to 500 Mg until I would have been able to redo the IgG after 3 months, would this give a reasonable protection for that period?
3) I am keen to do a HSV 1 and 2 separate testing because I know that the risk of infection of the partner in case of HSV1 is much lower so the protective measures in case of a HSV1 would be different than in case of HSV2 (or of course of none). I did not understand fully your suggestion regards teh University of washington. I can of course have blood taken here and analysed, a professional lab can do that where I live. They could also do the test analysis if I would give them the test. The problem is to get a test set sent over here. Do you think the Un. of Washington would do that through e.g. Fedex if I pay them the costs of the test and shipping? That would be great. Do you have any contact or should I just check the site and call them?
4) In general, for my understanding, are only the penis glands receptive to HSV1 transmission through oral sex or also (and as much) the rest of the penis and scrotum (assuming there are no small injuries)? And how come latex apparently provides such a poor barrier to HSV2 with intercourse?
Many thanks still for your clarifications.
I never had a cold sore in my life, and neither had my wife so I might not have HSV1 protection.
May I still follow-up with a few clarifications?:
1) I did both the IgG and IgM tests. The IgC may be negative given that only 2 1/2 weeks passed, unless I did have a past oral HSV1 infection that I am not aware about. If negative, I could redo it after 3 months. But what weight could I attach to a negative IgM test result at this stage, or a positive IgM test result (given that this test is supposed to measure new infections)?
2) Do you think the fact that I am now taking 1 gr of Zovirax per day at this moment would give a reasonable protection against shedding and hence against possibly infecting my wife, in case I would be infected? or does this not provide good protection in case of a new infection? And if after let's say the coming 2 weeks I would reduce this to 500 Mg until I would have been able to redo the IgG after 3 months, would this give a reasonable protection for that period?
3) I am keen to do a HSV 1 and 2 separate testing because I know that the risk of infection of the partner in case of HSV1 is much lower so the protective measures in case of a HSV1 would be different than in case of HSV2 (or of course of none). I did not understand fully your suggestion regards teh University of washington. I can of course have blood taken here and analysed, a professional lab can do that where I live. They could also do the test analysis if I would give them the test. The problem is to get a test set sent over here. Do you think the Un. of Washington would do that through e.g. Fedex if I pay them the costs of the test and shipping? That would be great. Do you have any contact or should I just check the site and call them?
4) In general, for my understanding, are only the penis glands receptive to HSV1 transmission through oral sex or also (and as much) the rest of the penis and scrotum (assuming there are no small injuries)? And how come latex apparently provides such a poor barrier to HSV2 with intercourse?
Many thanks still for your clarifications.
MEDICAL PROFESSIONAL
We know that condoms reduce the transmission of herpes by about 30% so they are not perfect, but they certainly help. I don't think the lip stick has anything to do with this.
Have you ever in your life had a cold sore on your lip? If yes, then it is very unlikely that you would get HSV 1 genitally as well. If you've never had a cold sore, then it is possible that you are infected orally and don't know it, that's pretty common and would also be protective. If you've not previously been infected with HSV 1, then you could get it genitally through receiving oral sex, even if she did not have a cold sore, yes.
I think your risks are low but not zero.
I understand that the risks are very great for you, and I'm afraid I can't guide you on what to do about your wife. There is a lot to balance - her suspicions if you don't have sex, the risks to her if you do, her anger if you disclose - these are things that I'm afraid only you are qualified to decide. I believe you've covered all the bases with antibiotics for bacterial infections, this one is tougher.
Are you able to get blood drawn there and would a provider ship it for you? If yes, then you could go to the University of Washington website for herpes western blot and order a testing kit to be sent to you.
If you've ever had a cold sore, a non-type specific test will be positive for HSV. If the test is completely negative at 2.5 weeks, it still is not definitive. If it is still negative at 3 months, then I would feel reassured, if I were you.
Terri
Have you ever in your life had a cold sore on your lip? If yes, then it is very unlikely that you would get HSV 1 genitally as well. If you've never had a cold sore, then it is possible that you are infected orally and don't know it, that's pretty common and would also be protective. If you've not previously been infected with HSV 1, then you could get it genitally through receiving oral sex, even if she did not have a cold sore, yes.
I think your risks are low but not zero.
I understand that the risks are very great for you, and I'm afraid I can't guide you on what to do about your wife. There is a lot to balance - her suspicions if you don't have sex, the risks to her if you do, her anger if you disclose - these are things that I'm afraid only you are qualified to decide. I believe you've covered all the bases with antibiotics for bacterial infections, this one is tougher.
Are you able to get blood drawn there and would a provider ship it for you? If yes, then you could go to the University of Washington website for herpes western blot and order a testing kit to be sent to you.
If you've ever had a cold sore, a non-type specific test will be positive for HSV. If the test is completely negative at 2.5 weeks, it still is not definitive. If it is still negative at 3 months, then I would feel reassured, if I were you.
Terri
You are reading content posted in the Herpes Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
