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Likelihood of HSV 2?
Hi Dr.
I am female and It's been almost 8 weeks since my unprotected encounter. July 26 I had oral and brief vaginal sex with him. About 3 weeks later, I felt some tingling/itching in my vagina and a felt a little feverish. A few days later, at 3.5 weeks, I went to my gyno and had an std panel done. She didn't see any lesions.
HSV 2 results: Herpes 2 IgG-HerpeSelect 0.19 and the Herpes Type 2 IgM: 1.50 under the "out of range" category. I've still felt a little itching and tingling sense then, including my tongue and lips (I have type hsv 1 bc I get cold sores under stress).
About a week ago, I was under a lot of stress (I think it's because her diagnosis finally sunk in). And I've been feeling itchy in my vagina (near the vulva) and butt, in the "boxer short" region and all over my body, including my arms and face. I still haven't noticed lesions and there hasn't been any pain. So at 7.5 weeks, I went and had the biokit done. It came back negative. The doctor told me that without lesions, he thinks it's unlikely that I would test positive at the 3-month mark. However, my vagina is still feeling itchy and I'm still itching all over. I've also had a little abdominal pain and loss of appetite. So my questions are:
1) Is it likely that I got HSV 2 orally? I felt what felt like prodrome coming and going on my lips and tongue in the past couple of weeks, but no sores.
2) Should I feel good about my biokit result at 7.5 weeks? I know 3 months is recommended.
3) Is it likely that antibodies are taking longer to form because I have hsv 1 orally? And could my symptoms be signs of just a very mild outbreak since I have hsv 1? What else could be causing the itching? And in my vagina and anus? I haven't noticed any unusual discharge nor any lesions.
4) If the itching persists, should I go see another gynecologist? Since the one I have was really disappointing and she also gave me the IGM herpes 2 test, which shouldn't be administered, right?
I am female and It's been almost 8 weeks since my unprotected encounter. July 26 I had oral and brief vaginal sex with him. About 3 weeks later, I felt some tingling/itching in my vagina and a felt a little feverish. A few days later, at 3.5 weeks, I went to my gyno and had an std panel done. She didn't see any lesions.
HSV 2 results: Herpes 2 IgG-HerpeSelect 0.19 and the Herpes Type 2 IgM: 1.50 under the "out of range" category. I've still felt a little itching and tingling sense then, including my tongue and lips (I have type hsv 1 bc I get cold sores under stress).
About a week ago, I was under a lot of stress (I think it's because her diagnosis finally sunk in). And I've been feeling itchy in my vagina (near the vulva) and butt, in the "boxer short" region and all over my body, including my arms and face. I still haven't noticed lesions and there hasn't been any pain. So at 7.5 weeks, I went and had the biokit done. It came back negative. The doctor told me that without lesions, he thinks it's unlikely that I would test positive at the 3-month mark. However, my vagina is still feeling itchy and I'm still itching all over. I've also had a little abdominal pain and loss of appetite. So my questions are:
1) Is it likely that I got HSV 2 orally? I felt what felt like prodrome coming and going on my lips and tongue in the past couple of weeks, but no sores.
2) Should I feel good about my biokit result at 7.5 weeks? I know 3 months is recommended.
3) Is it likely that antibodies are taking longer to form because I have hsv 1 orally? And could my symptoms be signs of just a very mild outbreak since I have hsv 1? What else could be causing the itching? And in my vagina and anus? I haven't noticed any unusual discharge nor any lesions.
4) If the itching persists, should I go see another gynecologist? Since the one I have was really disappointing and she also gave me the IGM herpes 2 test, which shouldn't be administered, right?
MEDICAL PROFESSIONAL
Thanks for posting those results. As discussed earlier, the IgM result is useless and meaningless. Your continued negative IgG result proves for sure you didn't catch HSV-2 11 weeks earlier. Your symptoms are due to something else -- and they don't sound like herpes anyway.
1) 11 weeks is fine. It is exceedingly rare for a negative result at that time to become positive later. If you were in the process of developing a positive result, the 11 week test would have been at least somewhat positive -- maybe not up at the true positive level of 3.5, but well over 0.22.
2) This test should be your final one. Do not have another test.
Please try to put your fear of herpes behind you. There is no chance you caught it during the encounter you are concerned about.
That will end this thread. Take care.
1) 11 weeks is fine. It is exceedingly rare for a negative result at that time to become positive later. If you were in the process of developing a positive result, the 11 week test would have been at least somewhat positive -- maybe not up at the true positive level of 3.5, but well over 0.22.
2) This test should be your final one. Do not have another test.
Please try to put your fear of herpes behind you. There is no chance you caught it during the encounter you are concerned about.
That will end this thread. Take care.
Hi Dr. Handsfield,
You told me to feel free to return with a final comment. So I had to go to my gyno for a followup last week on a pap smear (which was about 11.5 weeks since my last unprotected encounter). I asked him to do herpes blood work and he called me today with IGM and IGG results for hsv2 that came back very close to the one I did 3.5 weeks after that encounter. The IGM was positive again and the IGG negative.
IGM = 1.33 and IGG .22
So I have still felt itching and a couple of itchy bumps and such and I just want to be absolutely certain before I can take my mind off of this.
So my last questions are:
1) Was a little after 11 weeks too soon for testing? Would antibodies have started to develop since the test I did at 3.5 weeks? How likely is it that I wouldn't have developed antibodies at a little after 11 weeks?
2) If I were to get some FINAL testing, when would you recommend that I do, and what kind?
Thank you again for your help.
You told me to feel free to return with a final comment. So I had to go to my gyno for a followup last week on a pap smear (which was about 11.5 weeks since my last unprotected encounter). I asked him to do herpes blood work and he called me today with IGM and IGG results for hsv2 that came back very close to the one I did 3.5 weeks after that encounter. The IGM was positive again and the IGG negative.
IGM = 1.33 and IGG .22
So I have still felt itching and a couple of itchy bumps and such and I just want to be absolutely certain before I can take my mind off of this.
So my last questions are:
1) Was a little after 11 weeks too soon for testing? Would antibodies have started to develop since the test I did at 3.5 weeks? How likely is it that I wouldn't have developed antibodies at a little after 11 weeks?
2) If I were to get some FINAL testing, when would you recommend that I do, and what kind?
Thank you again for your help.
MEDICAL PROFESSIONAL
There is nothing in these comments that changes my opinion or advice. I would not have recommended the Valtrex treatment, but if your symptoms didn't improve while taking it, that is additional evidence against herpes.
IgM antibody testing for HSV is useless; see this thread for further discussion of it. Although 5 years old, the information remains accurate. You also can use this forum's search function for additional discussiont; try entering "HSV IgM" and see what you find.
http://www.medhelp.org/posts/STDs/Confusiion-over-other-IgM-Herpes-posts/show/248394
I remain confident you don't have HSV-2. But see my "bottom line" advice in my initial reply; have another HSV-2 IgG blood test at the 3 month mark. You can expect it to remain negative, after which you can put your concerns about genital herpes to rest. Feel free to return with a final comment to let me know the result of that test -- but until then there is nothing more I can do and I won't have any comments.
IgM antibody testing for HSV is useless; see this thread for further discussion of it. Although 5 years old, the information remains accurate. You also can use this forum's search function for additional discussiont; try entering "HSV IgM" and see what you find.
http://www.medhelp.org/posts/STDs/Confusiion-over-other-IgM-Herpes-posts/show/248394
I remain confident you don't have HSV-2. But see my "bottom line" advice in my initial reply; have another HSV-2 IgG blood test at the 3 month mark. You can expect it to remain negative, after which you can put your concerns about genital herpes to rest. Feel free to return with a final comment to let me know the result of that test -- but until then there is nothing more I can do and I won't have any comments.
not sure why my word was blocked there, but I was just saying that the biokit I took on Friday only took a bit of blood from my finger instead of drawing blood from my arm
Thank you for the advice, Dr.
Ok, so I am still left with the vaginal itching, a little anal itching, and the itching in the boxer short region (especially near the tail bone and butt), and itching above the waist too. What else could explain it? It feels like it has to be something beyond stress?
When I went to my gyno at 3.5 weeks and she didn't see lesions, she gave me the 10 day perspiration to Valtrex for an OB just so that my mind could be at ease. I took it for 5 days because it was making me depressed and I wasn't having symptoms anymore. Do you think that could have prevented an OB from coming on then?
Also, I went to an std doctor yesterday because of the persistent itching and I wanted him to check for lesions. He told he didn't see any but that I should take his biokit for peace of mind. I told him I had just taken it somewhere else, and he said that his test was more accurate than the biokit I took, because the one I took only used the finger *****. Can that be correct?
I decided that I need to calm down (4 weeks from today will be 12 weeks). But the continuos itching (although I feel less of it when I'm not thinking about it), along with the positive IGM a few weeks ago with my obgyn's diagnosis had me accepting the fact the I have hsv-2...but now the evidence seems to be telling me otherwise (ie. the negative biokit friday, no lesions, your opinion, etc).
Should I just wait things out?
Thanks again, Dr.
Ok, so I am still left with the vaginal itching, a little anal itching, and the itching in the boxer short region (especially near the tail bone and butt), and itching above the waist too. What else could explain it? It feels like it has to be something beyond stress?
When I went to my gyno at 3.5 weeks and she didn't see lesions, she gave me the 10 day perspiration to Valtrex for an OB just so that my mind could be at ease. I took it for 5 days because it was making me depressed and I wasn't having symptoms anymore. Do you think that could have prevented an OB from coming on then?
Also, I went to an std doctor yesterday because of the persistent itching and I wanted him to check for lesions. He told he didn't see any but that I should take his biokit for peace of mind. I told him I had just taken it somewhere else, and he said that his test was more accurate than the biokit I took, because the one I took only used the finger *****. Can that be correct?
I decided that I need to calm down (4 weeks from today will be 12 weeks). But the continuos itching (although I feel less of it when I'm not thinking about it), along with the positive IGM a few weeks ago with my obgyn's diagnosis had me accepting the fact the I have hsv-2...but now the evidence seems to be telling me otherwise (ie. the negative biokit friday, no lesions, your opinion, etc).
Should I just wait things out?
Thanks again, Dr.
MEDICAL PROFESSIONAL
Welcome to the forum. Yes, it's the wrong one -- but an honest mistake. It will be moved to the SDD forum.
You are unnecessarily concerned about herpes. You probably have read that herpes catn cause itching and similar nonspecific symptoms, and that's true. However, this is mostly because herpes lesions itch -- not because itching alone suggests herpes. Also, an initial HSV outbreak would not cause continuing symptoms this long; 2-3 weeks is the maximum. Still further, 3 weeks is too long for onset of new herpes symptoms; usually it's 2-5 days, rarely more than 10-14 days. And the initial HSV infection, if it causes symptoms at all, causes quite painful sores and lots of them. For all these reasons, I agree exactly with your doctor ("without lesions...it's unlikely that I would test positive at the 3-month mark").
1) I'm not sure where your concern about oral herpes comes from. All symptoms you describe are genital not oral. Of course oral herpes would not cause genital area itching.
2) Although it can take 3 months for HSV-2 blood tests to turn positive, in the large majority of cases it takes 6 weeks or less. Your negative blood test results so far confirm my belief that you didn't catch herpes.
3) Having prior HSV-1 has no effect on time to positive HSV-2 blood tests. Prior HSV-1 can make new HSV-2 infections milder, but would not prevent all lesions. As for other causes of the itching, I can only guess. But genitally focused anxiety sounds like a good bet. In other words, your worry about herpes may be magnifying otherwise normal body sensations that otherwise would go unnoticed. However, it is conceivable you have some other genital area infection, e.g a yeast infection.
4) You give no reason to suspect your own gynecologist is not on top of this. I do not recommend you go doctor shopping. If the itching or other symptoms persist, or you otherwise, remain concerned, it seems wisest for you to return to your current doctor and follow her advice. I agree the HSV IgM test is not useful, (You've done your homework -- thanks!) But many doctors don't understand this issue, and you should not fault your doctor for being unaware of that detail.
Bottom line: Herpes is an unlikely explanation for your symptoms. Since you probably will remain concerned about it, I will not try to talk you out of a 3 month blood test. But you can expect it to remain negative. In the meantime, continue to work with your doctor about other explanations for your symptoms.
Regards-- HHH, MD
You are unnecessarily concerned about herpes. You probably have read that herpes catn cause itching and similar nonspecific symptoms, and that's true. However, this is mostly because herpes lesions itch -- not because itching alone suggests herpes. Also, an initial HSV outbreak would not cause continuing symptoms this long; 2-3 weeks is the maximum. Still further, 3 weeks is too long for onset of new herpes symptoms; usually it's 2-5 days, rarely more than 10-14 days. And the initial HSV infection, if it causes symptoms at all, causes quite painful sores and lots of them. For all these reasons, I agree exactly with your doctor ("without lesions...it's unlikely that I would test positive at the 3-month mark").
1) I'm not sure where your concern about oral herpes comes from. All symptoms you describe are genital not oral. Of course oral herpes would not cause genital area itching.
2) Although it can take 3 months for HSV-2 blood tests to turn positive, in the large majority of cases it takes 6 weeks or less. Your negative blood test results so far confirm my belief that you didn't catch herpes.
3) Having prior HSV-1 has no effect on time to positive HSV-2 blood tests. Prior HSV-1 can make new HSV-2 infections milder, but would not prevent all lesions. As for other causes of the itching, I can only guess. But genitally focused anxiety sounds like a good bet. In other words, your worry about herpes may be magnifying otherwise normal body sensations that otherwise would go unnoticed. However, it is conceivable you have some other genital area infection, e.g a yeast infection.
4) You give no reason to suspect your own gynecologist is not on top of this. I do not recommend you go doctor shopping. If the itching or other symptoms persist, or you otherwise, remain concerned, it seems wisest for you to return to your current doctor and follow her advice. I agree the HSV IgM test is not useful, (You've done your homework -- thanks!) But many doctors don't understand this issue, and you should not fault your doctor for being unaware of that detail.
Bottom line: Herpes is an unlikely explanation for your symptoms. Since you probably will remain concerned about it, I will not try to talk you out of a 3 month blood test. But you can expect it to remain negative. In the meantime, continue to work with your doctor about other explanations for your symptoms.
Regards-- HHH, MD
Also, I just realized I posted this to the HIV forum. My apologies for that!
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
