Herpes Test Results and possible HPV

[lawrence43]

I was in a 3 month relationship with a woman and was tested for STD's with negative results.  We then had genital to genital contact (intracourse) once.  I had not had any previous sexual partners for many years. The woman's Doctor had previously tested her for STD’s two years ago, and the results were negative.  We are no longer involved in a relationship.

Eight days after intracourse I noticed a small papule (1-2 mm) on the tip of my penis.  My Dermatologist examined me and said I did not have Herpes symptoms.  He felt the papule was possibly caused by some irritation during the intracourse, or HPV, or a previous condition.  My Primary Care Physician confirmed my symptoms did not appear to be Herpes related.  The papule has remained about the same size (1-2 mm) over the past 5 months.  It has not itched, been painful or scabbed over.

I waited 16+ weeks and repeated the tests. The results were again all negative.  However, I am concerned because the IgG Index values for HSV 1 & 2 seem to have increased a lot.

9/17/2010:
STD Testing performed (Gon/Cly, Syp, Hep B-C, HIV 1-2, HSV 1-2) – All results negative
HSV-1 Ab IgG Index = 0.15 (Negative)
HSV-2 Ab IgG Index = 0.06 (Negative)

02/15/2011 (16+ weeks after possible exposure):
STD Testing performed (Gon/Cly, Syp, Hep B-C, HIV 1-2, HSV 1-2) – All results negative
HSV-1 Ab IgG Index = 0.38 (Negative)
HSV-2 Ab IgG Index = 0.45 (Negative)

What are the chances that I have contacted Herpes, but haven’t yet developed sufficient antibodies to yield a positive result?  Would the chances be significantly different if the index values were more stable over the 16 week period between tests?

What should I do to confirm, with a high degree of accuracy, whether or not I have acquired Herpes Simplex Virus 1 & 2?

Is there any test I can take (HPV or ?) to find out what caused the papule?

What is an appropriate remedy to remove the papule, or should I just wait awhile (how long?) to see if it goes away?

[lawrence43]

Thank you for your advise Doctor.  This matter is very significant and emotional to me.  I have sceduled a follow up appointment with a specialist at UC.  I plan to request one final test to confirm my HSV status.

lawrence43

[Edward W Hook, MD]

Sigh..................  There is really no medical reason for you to test further.  If you cannot accept this advice, then you can retest in the future.  Virtually everyone who has HSV and will develop antibodies does so by six months following exposure.  In your case, I am confident whther you test now, at 6 months or 6 years from now, the answer will be the same- that you i not get HSV from the encounter you described.  EWH

[lawrence43]

Thank you Doctor for your helpful comments.

Unfortunately, in retrospect, I am not confident the woman accurately disclosed her STD status.  She did say she had been previously sexually active.  And it appears I have been exposed to something.  What, I do not know.

For my own peace of mind, I would like to 100% resolve this HSV matter.  I am willing to take one additional follow-up test in order to do so.  It has been 20 weeks since exposure.  How long should I wait, and what test can I take to finally put this HSV matter to rest with a very high degree of confidence?

Thank you,
lawrence43

[Edward W Hook, MD]

Welcome to the Forum.  There is no suggestion whatsoever that you have herpes and no reason for concern.  You have not had an outbreak, you do not know that your partner had HSV (in fact your partner told you she had no STDs), and you have the opinion of several physicians who have told you there is no evidence of HSV and you have two negative HSV antibody tests.  It is absolutely normal for the antibody levels for HSV antibody tests (which I would not have recommended in the first place) to "bounce around" as yours have.  The results of both of your tests are unequivocably negative an should be believed.

There are no recommended tests for HPV.  A dermatologist could easily help you to remove the papule you describe. There are several ways to approach it, depending on it's likely cause and size.  Rather than generate unwarranted expectations, I would suggest that if you want it removed, you discuss it with a dermatologist.

I hope my comments are helpful.  EWH