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HSV1 antibody count rising
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The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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HSV1 antibody count rising

I am in a relationship with a woman where we have oral/vaginal sex regularly.

On December 11, I had protected oral/anal sex with an escort. A couple of days later I felt a general tingling/warm sensation in my genital area. I had no blisters, no lesions, no visible marks, just the sensation.

I got tested a week later to establish baseline results. I tested negative to all STDs with hsv1 igg coming in at 0.51 on a negative result.

I did have two milia/millium growths removed on my penis, but my dermatologist was positive it was milia, nothing STD related.

To ease my mind, I got retested blood tests on January 3rd. I figured this was 4 weeks from encounter and more accurate results. I was positive for chlamydia (surprised they tested blood not urine, but I took the 4 pill Zithromax and am not worried as that will clear itself up).

However, my hsv1 result came in as equivocal, with a score of .904. While I know that is essentially negative, I am worried for two reasons

1- it's only been four weeks, so I know I need to wait longer and retest
2- should I be worried I am building antibodies, and that is why it moved in a two week span from .51 to .90?  

I have not had sex with my gf since the encounter, as I explained what happened and we are waiting. But that said, am I right to be worried that my igg test ticked up because I have it and am building antibodies?
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Welcome to the Forum.  I'll try to help.  The December exposure describe was low risk for herpes- most people do not have herpes and condoms are the best possible protection for infection.  That you experienced a brief period of tingling a few days after your exposure is unlikely to be HSV- typically when persons experience tingling related to HSV, lesions develop within a few hours and most people who acquire herpes develop lesions with their initial episode.  

The herpes blood tests can certainly "bounce around" depending on a variety of factors such as test conditions in the lab.  I anticipate if you re-test, the level will be lower than it was before.  Were it continuing to increase however, it could indicate recent acquisition of infection.  Your most recent level is so low that it would not concern me- at that level well over 80% of tests are actually negative despite their "indeterminate" or "low positive" status.  This is a weakness of the test.    

If I were you I would not be worried. If you do decide to retest, testing 2-3 weeks after your last test would definitively be substantially higher if you had acquired HSV.

I hope these comments are helpful. EWH
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H. Hunter Handsfield, M.D.Blank
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