Herpes Expert Forum
positive test result? Or too early to tell?
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positive test result? Or too early to tell?

I'm a male who had unprotected oral contact with a female. Link to STD thread here: http://www.medhelp.org/posts/STDs/Inital-Herpes-or-something-else/show/1925880#post_8993289

Just had an IGG test ( Herpeselect) at 7 weeks.(I know it's early, but I felt the need to DO something) Results were:
HSV I :  1.10 as positive....is that true for this test? Or is it >3.5 as I've seen on this site? I've read the odds of an oral to genital HSV II transmission are pretty low, so these results are surprising. I've never had any oral symptoms, once in a while I'll get what seems to be a blister in my mouth but that's it, never anything outside. So the odds of it being preexisting seem low to me.

I got this test through a paid third party, as my own doctor has been not very sympathetic. He told me at first that there was no blood test for herpes, then told me I was diagnosing myself and that I did not have herpes.

I saw him for a third time for a bad fungal infection (jock itch). I tried pointing out something I was concerned about ( some round scarring/senstitive spot on the tip of my penis that had been there early on and is still there ) and he asked me right out if I should see a psychologist to help me deal with my neurosis. He also said something like “well, you made poor choices” did I now? So I deserve it. Thanks doc. So I'm firing him and looking for someone who'll just recognize that this is something that concerns me.

I just want to protect my current partner. I had some symptoms that I had chalked up to maybe being related to the fungal infection, which cropped up soon after my encounter. Now I'm not so sure. In between any future testing I'm thinking I should be on antivirals just in case? (If additional testing is warranted.)

I'm a bit low right now, I don't have anyone to talk to about this. I know I screwed up, but to screw up and pay for it against pretty long odds somehow seems worse.
55646_tn?1263664409
It sounds like your interaction with your physician was something  less than satisfactory. When people have concerns about STD's the concerns are real and can be difficult emotionally.

It is difficult for me to understand your test results from what you posted.  Are you saying that your HSV 1 result is exactly 1.10?  I doubt that.  I think you might be looking at the reference ranges that are sometimes listed.

I went back and read Dr. Hook's response to your questions.  I really do agree with him that your risk here is for HSV 1, not HSV 2.  and the chance that you already have HSV 1 is about 56%.  And if you already have it, then you would very likely never get it again, in a new place, like genitally.

Since you had an antibody test at 7 weeks, and it is truly positive,  you can never know if you were infected prior to this encounter or got it from this encounter.  However, you aren't describing symptoms that sound like herpes to me.

It is certainly a possibility that you had HSV 1 without specific symptoms prior to this encounter.  

Has your regular partner ever had a cold sore?  If yes, then they are likely infected with HSV 1 already.  

Terri
18 Comments
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Avatar_m_tn
wow that makes no sense..something wacky happened when i cut & pasted, sorry about that.
let's try again:

my test results were
HSV I: 1.10 as positive, but I've seen references to >3.5 being positive on this site, with anything under that bring a "low positive" and possibly needing retesting....is that true or am I confusing something?

My interaction with my doctor was really disheartening. i had a fabulous doctor prior to this (who retired) and the difference really shows. When it seems your doctor isn't in your corner, you really feel alone.

I have a long term partner of 15 years. I have never seen a cold sore on her.
What should my next move be?
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Avatar_m_tn
sorry, it did it again!

Is this a low positive needing retesting?

HSV1: <0.90    HSVII :2.34 H
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Avatar_m_tn
I'd also like to add that I've had a total of 4 sexual partners prior to this, the last one being 15 years duration.

I have had an ongoing issue with an area at the tip of my penis since this encounter, it's started out as a raised puffy area, sort of like a crescent, and now looks like a circular/oval area slightly smaller than a dime, it appears to be scar tissue.This area becomes irritated easily, and is pretty tough to see otherwise. I tried to show it to my prior physician, he barely glanced at it. I had assumed it was something fungal, possibly related to the jock itch,(it all started around the same time) but I've been hitting that area pretty heavily with a prescription cream and it hasn't gone away. This doesn't seem like herpes to me, but I'm no expert.

I'm assuming a dermatologist would be best to show this to, rather than a urologist?
I'd also like your opinion on going on antivirals to help protect my current partner, and whether or not I could come off them just to test further (if such testing is warranted)

thank you!
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Avatar_m_tn
Hi Ms. Warren,

I'm going to be switching physicians, I'm meeting with a new doctor this week. I'd still like to know if you think I should seek additional testing.
to recap, my week 7 results were: HSV1: <0.90    HSVII :2.34 H. (sorry for all the above typos resulting from a cut & paste, I realize that was confusing)

does such a strong HSV I negative make it more likely my HSV II result is accurate?

I know you and Dr. HHH believe my risk was primarily for HSV I, but this low positive for HSV II is still worrisome, even with the odds stacked against it.
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55646_tn?1263664409
Have you ever had a herpes antibody test before this?  Perhaps you have had herpes for a while?  At any rate, your positive is a low positive and needs confirmation with another test, preferably western blot.  I'm not seeing as much relationship with the HSV 1 result as we used to - not sure why.

Terri
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Avatar_m_tn
nope, I've never had reason to believe I had an possible infection before, although i suppose some people don't.

the contact was very brief, when combined with the low probability of HSV II infecting me by that route, makes me feel as if I've possibly won some sort of herpes lottery. I guess it happens.

I read an earlier reply you wrote about chances of transmitting to an uninfected partner, for me, that's a 3-4% chance over the course of a year (2x a week for 50 weeks...I do appreciate the 2 week vacation) which translates to less than 1% per encounter when on antivirals? And condom use will cut that in half.....

I'm just trying to find the best way to tell my partner about her chances for possible infection.She'll probably ask for me to have another IGG test,
BUT....
since it looks like I'm going to have the WB anyway...I'd rather just do the WB and know for sure.

one more thing, do antivirals have an effect on testing.?

thanks so much for your reply, it means a lot.
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55646_tn?1263664409
Yes, antivirals can definitely impact testing.  How much antiviral treatment did you take and how long ago was the contact?  

Yes, I think you can wait to get the western blot before discussing this with your partner.  But that means, in my opinion, no sex until you get the results.  If you do end up confirming a positive, I really do not believe you acquired HSV 2 from the encounter that you describe.  

I really don't think another ELISA will help you.  
Have you ordered the western blot in some way?  It takes about two-three weeks for results to come in.  Sometimes less.

Terri
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Avatar_m_tn
I haven't had any antiviral therapy as of yet...it was a "while I'm waiting" thought.....maybe not a good one?
I'm going on 10 weeks, post contact. so i have a bit to wait for a WB, sadly enough.
I met with my new potential physician today. A meet and greet type of thing. She seemed supportive and listened to my concerns. When I said I had had third party testing, she indicated she wasn't a fan of herpes blood tests as she's found them to be inaccurate. She said she wouldn't ordinarily order one, but if I wanted her to she would in my case. I think I'm going to take her up on that when it's time for the western blot. (I didn't bring up the WB, I wasn't prepared with any info about it. accuracy, etc)
She did say she wouldn't prescribe antivirals on the basis of a blood test, but perhaps she'll change her mind for the WB. I really don't want to be sitting around waiting for an outbreak that might never come.

She ended by saying that a lot of people come in with similar concerns, it was very common, and I wasn't alone. I think she may be a keeper. It was a nice change from hearing I need to see someone about my neurosis.

I already discussed things with my partner, usually the best thing to do is also the hardest. I'm a very lucky man.
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55646_tn?1263664409
I think not taking the therapy now is essential in getting an accurate test.

I'm glad your discussion with your new physician worked well.  However, I think her herpes knowledge is also lacking.  The blood tests are very good ways to diagnose people with herpes!  And people SHOULD be treated with antivirals to reduce the risk of transmission, based on an antibody test that is positive (and not in the low positive range).  I think it is best to think of this like HIV infection.  We diagnose people with HIV by a blood test (or saliva test).  and we treat based on blood tests alone- we don't want people to have symptoms!  Herpes is very similar in many ways.  We understand that a positive antibody test equals infection.  And we know that most herpes is transmitted when people have no symptoms.  So wouldn't it be smart to treat them, even if they have no symptoms, to reduce the risk of infecting someone else?  

This kind of thinking is very frustrating to me.  But if you are happy with her, that's great.  Just remember that you don't know if you have herpes or not, based on the antibody test that you had done.  At 2.4, there is a 50-50 chance that you have herpes.  

Terri
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Avatar_m_tn
I know what you're saying. I think I'm just relieved that she listened and wasn't openly dismissive when there wasn't something there she could see with her own eyes.

Friday night I had an issue with redness and swelling along the right side rim of the head of my penis. It's seemingly identical to the redness/irritation I had that brought me to post here originally. It's even in the same spot. This continued into saturday so I went to the ED hoping to get a swab done. No such luck. The doctor said since I had no visible lesions, swabbing wouldn't do any good. Although it seems early for a 2nd outbreak (if I even have herpes) seeing a nearly identical set of symptoms gave me a little hope of getting this resolved. I felt a rush to go because this came and went so quickly the first time I was worried I'd miss something if I waited.
I'll keep an eye out for blisters over the next couple days.
In the end  I was prescribed a hefty dose of keflex..
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55646_tn?1263664409
I'm not clear why you aren't obtaining the western blot, but let's not post any more until you do.  Then, we can talk over your results.

Terri
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Avatar_m_tn
Ok, I thought we had to wait for 16 weeks for WB? I've got a bit longer to wait.
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55646_tn?1263664409
aaaaah, yes, forgot about that.

Terri
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Avatar_m_tn
after my June 2nd post, i developed a blister/pimple close to my eurethra. Noticed it developing late sat. night. when I had a slight stinging while urinating. Tried to get into the doctor for monday, but wasn't able to get an appt until Tuesday afternoon for a swab test, which came out negative.

I know 24-48 hrs is preferred for a swab test, how much of a drop in accuracy is there around 72 hours?

I tried talking to my doctor about supporting me in getting a WB, she's still singing the same song about blood testing being unreliable, and wouldn't really listen to what I had to say about the WB.

I've read here about becoming a phone patient of the clinic, is that something you still do? There's no shortage of local quest labs I can get a draw from.
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55646_tn?1263664409
Yes, we still do phone consults, for sure.  And we can order the western blot for you.
Terri
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Avatar_m_tn
Great, I'll be in touch.
thank you.
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55646_tn?1263664409
OK

Terri
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Terri Warren, RN, Adult Nurse Pr...Blank
Westover Heights Clinic
Portland, OR
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