False Positve???

[roughyear]

Doctor Handsfield,

I am a 42 year old divorced male.  I last had sex, which was stupidly unprotected, in early February.  Approximately I month ago the woman i had sex with informed me that she had been diagnosed with trichonomas.  She believes that she contracted it from her Ex husband who she began seeing again after our encounter.  I was prescribed the standard antbiotic and antiparasitic just incase.  Approximately 3 weeks ago I began getting symptoms of kidney stones, ie.pain in back and side posible blood in urine.  I don't drink enough water so my urine is concentrated and i hink I am probably more than a little dehydrated.  I also experienced a mild burning sensation in the tip of my penis but not on the outter surfaces.  The burning occurs while I am sitting but goes away when I stand and move around.  There is no burning in the mornings when I wake up.  I began drinking more water and the burning all but went away though I still experience it milder than before.

On July 2, approximately 5 months after my last encounter i went to an online test center and had an comprhensive std test for my on peace of mind.  I now know you do not  recommend these test centers.  Again, I have had no symptoms but I tested "positive" only for herpes 2 with a score of 1.64 on the herpes select test.  My herpes 1 score was <.90.  With the above information how probable is it that enough background noise was created by the medication, dehydration and kidneystone symptoms to raise my score to a 1.64 rsulting in what I hope is a false positve result?  Should I retest?  If so, what test? Again the only symptoms i have had are those described above.



Thanks for your time and the information you have given to others.

[Edward W Hook, MD]

Dr. Handsfield and I share the forum.  You got me.  FYI, the reason we share the forum is because we have worked together for nearly 30 years and while our verbiage styles vary, we have never disagreed on management strategies or advice to clients.

Straight to your questions, focusing on herpes.  The Herpes blood test results must be taken in context.  By that I mean that all blood tests have both false positive and false negative results from time to time (the goal is to minimize this and know when it is likely, that is a large part of my job).  Now on to you:

1.  You do not have antibodies to HSV-1.  
2.  You may not have HSV-2 either.  There is an ongoing debate in the expert community about what the cut-off for a positive HerpesSelect antibody test should be with many arguing that the current cut off is too low and that, in low risk persons (thus this may pertain to you), the cut off should be in the neighborhood of 3.0.  Given your  "low positive" result, as well as the absence of any suggestive outbreaks, you have a more than 1 in 4 chance of being false positive.  Further testing with the HerpeSelect is unlikely to clarify things.  My advice would be to not worry further.  If you do want a more definitive result, I would suggest asking your doctor to request a HSV Western Blot test, the gold standard for herpes blood tests.

Hope this is helpful.  EWH   .

[roughyear]

Thanks,

The burning is actually internally and I wonder if it might just be some irritation from not being well hydrated.


Thanks for all your help,  You have given me a some peace of mind

[Edward W Hook, MD]

Sorry, I don't have any bright ideas about the external burning.  It is most unlikely to be prostatitis however.  Unless some other symptom develops, I suspect it will go away.  EWH

[roughyear]

As  both you and Dr. Handsfield both have excelent credentials, I will follow your advice with great appreciation and worry no further and I don't intend to face this problem again!  Thank you so much for voluteering your time to this service.

On a side note, do you have any suggestions or advice about the burning sensation in the tip of my penis? I have thought of prostatitus.

Again, Thank You!