Should I keep testing?

[concerned0325]

I had an unprotected sexual encounter (oral sex) over 3 months ago.  Since then I have ordered the 8 panel STD tests 3 times from stdexpress.com and had them performed 30 days. 60 days and 93 days out.  All of the results have come back negative each time.

I would be celebrating these results if I didn't feel something funny going on.  I have had some intermitent back and groin pain, and some slight irritation under the head of my penis.  I have read these can be symptoms of herpes.  It seems like something is up, but I am not wanting to go to my current doctor until I know that STD's are ruled out.

1)  Should I move on based on these 3 consistant test results, or do I need to be retested?

2)  If I do need to be retested, should I change tests?  My lab tests read HSV 1 IgG Type Specific, and HSV 2 IgG Type Specific.  The provider claims they are type specific, but then on the notes that the Lab sheet sent me it notes under each of these that coinfection cannot be excluded without type specific testing.  Does this mean that it is type specific or not...and how accurate is the test...I mean both HSV 1 and HSV 2 are negative, so I am not worried about a "false positive", but actually a "false negative". Should I move on and drop it, or should I seek further testing, and if so what would you recommend?

Thanks for you help

[Edward W Hook, MD]

The testing for 4 months guideline assumes that you had an outbreak.  If you have not had an outbeak or suggestive lesions, I would believe the results that you have and try not to worry (which you seem to be doing a lot of)  EWH

[concerned0325]

Thanks for the response.  I should've mentioned that I performed oral sex on another male, which I am certain increases the chances of contracting HSV 2.  It is highly possible that I am just being paranoid, but do not want to infect my partner with a disease because of my carelessness.  

I am readind conflicting reports that say a person should wait 4 months (16 wks.) after exposure to be certain that anitbodies have formed.  Is it possible to have symptoms, but not have formed anitbodies yet?  I have tested 3 times for HIV, Chlamydia, Gon., HSV 1 & 2, and Hep...the 8 panel test.  All have come back negative.  Do you think that the 4 month timeline is accurate, or do you think I'm good?

[Edward W Hook, MD]

Welcome to our Forum.  Other than the blood tests for HSV you do not mention what tests were performed.  That said, you certainly do not need further testing for HSV as long as the tests were type-specific gG-based tests for IgG.  After 3 negative tests, you can be completely confident in the results.  Likewise, no need to change tests at this time if the tests were type-specific gG-based IgG tests.  The tests should however give independent results for HSV-1 and HSV-2.  If they give combined results, the wrong test probably has been done.

Regarding other STDs, if you have been tested for HIV or syphilis (blood tests), or gonorrhea or chlamydial infection, you do not need further testing either.  The performance of these tests is typically so good that a single test identifies nearly, if not all, infections.

Regarding your symptoms, sometimes after an exposure that, in retrospect, one wishes they had not had, persons tend to examine themselves and be far more attuned to genital sensations than in periods when they are not concerned.  This in turns leads to noticing what turn out to be normal sensations that might have been not noticed or ignored at other times.  Perhaps this was a contributor to your situation.  

Hope these comments help.  EWH