Advice and where to test

[VictorSP]

10 months ago I had a sexual encounter that involved oral sex on me - from her - for a few seconds, some kissing and that's about it. Within 10 days, I had prostatitis. I have been on antibiotics for that since then (10 months ago) And a month later, a red rash on the shaft of my penis. It went after a few days. Saw a doctor - he said it's fungal. Used fungal cream. The rash went, but came again a couple of weeks later. Saw another doctor - he said, it's just fungal. Don't worry.

After a few months - 6 to be precise - of this, and continued prostatitis and stress - (and HIV, syph, etc tests on a regular basis, all negative) finally insisted I have a hsv test. It was for igm and igg - and I am based in China. Results came back pos for igg hsv I and pos for hsv II igm. I freaked out. Doctor said it may be wrong, and that at 6 months post exposure, I should be pos for hsv II igg if it's true. Repeated test twice over the next month. Same results. Saw several doctors - some said just accept it. Others said results may be wrong.

Still get the occasional rash on my penis. For a day or two. Three at most usually. No breaking of the skin. No itching. Just little red patch, or a few dots in an area.

Now I'm back in the UK, and wondering if I can confirm the results I had before. It is now 10 months post-exposure. Is there anywhere I can do the herpeselect test you recommend? What else can I do?

Thanks!

[H. Hunter Handsfield, M.D.]

First and perhaps most important, you should totally ignore the HSV-2 IgM antibody test result.  It does not indicate HSV-2 infection (search other threads for more discussion) and your symptoms in no way suggest herpes.  However, I cannot tell whether your IgG test was type-specific, not knowing what tests are done in China.

Your plan/desire for a truly type-specific test, like HerpeSelect, is the right way to go.  Britain's genitourinary medicine clinics are excellent, by and large; there are several in London and at least one in most other mid- to large urban area.  Any GUM clinic will have access to type-specific HSV tests, and you can rely on a high level of expertise about herpes among the professional staff.

Good luck--  HHH, MD

[VictorSP]

Thanks for that. They said the test was type specific. As I say though, the only positive igg was for herpes I. The herpes II was positive for igm only. What does that mean? I have always had cold sores, so that explains the herpes I I suppose.

[H. Hunter Handsfield, M.D.]

If the IgG was non-type specific (which, in China, it probably was), the HSV-1 positive result could mean HSV-1, HSV-2, or both.  Based on your history of cold sores, most likely you are positive only for HSV-1, but a truly type specific test is necessary to know for sure.

HHH, MD

[VictorSP]

I was told specifically that the test was type specific for the last test - which I took at an international clinic... where the results were the same. HSV-I igg pos. HSV-I igm neg. HSV-II igg neg. HSV-II igm pos. Would you expect the HSV-II igg to be positive at 6 months plus if I had it?

[H. Hunter Handsfield, M.D.]

If you are certain your tests in China were type specific, then you don't need any more testing; the HSV-2 IgG test would be positive by now.  However, I can understand the anxiety you might feel about the IgM HSV-2 result.  If you want still further reassurance, follow up on my initial advice about HSV testing at a GUM clinic.

HHH, MD