extreme anxiety please help

[Worriedorjustparanoia]

I am a F who was in a mono. reln with a M for 4 yrs. 3 yrs. into the reln. I was tested for HSV2, Chlam., Gonor., RPR, Hep. B & C. ---all negative. About 3 mos later we broke up. Over the next few months we had unprot. vaginal and oral sex about 5 times.

I had a full STD check again exactly 10 days after our last sexual encounter (unprotected vaginal & oral sex). My results came back pos. for HSV 2. I know that I contracted it from him b/c I have not had sex with anyone else since the original neg. HSV 2 test. Correct me if I'm wrong but I don't think I got HSV 2 during that last encounter b/c the infection would have been too new to detect antibodies.

my blood test results were:

****Chlamydia/GC RRNA TMA****
not detected:
CHL.TRAC rRNA    
N. GON rRNA      

non reactive:  
Hep B Sur AG          
HEP C   AB            
HIV-1/ HIV-2  Abs    
RPR                        

1)   I took these blood tests 10 days after my last unprot. sex encounter are they accurate or do I need to retest b/c took them too early?

2) If yes to #1, what would be the proper time to retest for each std for them to be accurate?  

3)  I read that tests for Chlam. & Gonor. are more accurate when a vaginal swab is taken rather than a blood test. Is this true? If so, do I need to retake those tests via swabs?

3)  My ex told me that he had PROT. vaginal sex & UNPROT. oral sex with each of 2 different girls prior to our last encounter. Which means he had sex with them while  HSV2 + . So, I basically had unprotected vaginal & oral sex with him once since he was with those 2 girls. I've heard it's easier to contract HIV if you have HSV2. I do not know his HIV status. Assuming he had UNPROTECTED sex w/ those girls what are the chances that I contracted HIV?

4)  I kissed a new man a wk after the unprot. oral sex. If I got  Chlam. or Gon. in my throat what are the odds that he now has it in his throat?  

It has now been 5wks since my "last encounter" mentioned above if that helps.

[Edward W Hook, MD]

Welcome to the Forum.  I would assume that you have herpes yet.  Before I can fully address your question I need to know what sort of blood test for herpes you had and what the numerical values of the tests are.  Unfortunately some of the blood tests for herpes yield falsely positive results.  This is particularly true for IgM blood tests. We recommend that if  a person is going to get a blood test for HSV, it should be a type specific test such as the HerpeSelect. Even then, it is important to know the numerical value of the result.  If you can get this information perhaps I help to interpret them.

As for your specific questions:
1.  Your gonorrhea and chlamydia tests were not blood tests.  The TMA test can be done on urine, a cervical swab or a vaginal swab.  Tests using each of these sorts of specimens are very good and you can be sure that you do not have gonorrhea or chlamydia.  Hepatitis C is not heterosexually transmitted and should not be a concern for you.  As for the other blood tests (HIV, RPR (syphilis), and hepatitis B, you should wait at least a month and preferably 6-8 weeks for HIV and 3 months for hepatitis B until testing to be "sure". having said that, each of these is very rare and should not worry you while you wait for test results.
2.  See above
3.  You have it wrong on several counts. For starters you assume that your ex has HSV but do not know that.  Irrespective however, your risk for HIV is low.  If your partner had HIV (and this is most unlikely) your risk of infection is only 1 in 1000 exposures.
4.  Zero.  You don't have gonorrhea or chlamydia and these infections are not transmitted by kissing.

You are clearly worried about your exposure with your ex.   My guess is that you don’t need to be but there is not reason not to get checked or, better yet, If you really want to address your concerns the most direct thing you can do is to ask him to get tested. If he doesn't have anything, you couldn't have gotten it from him.

Take care.  EWH

[Worriedorjustparanoia]

I had a IgG herpeselect type specific test for HSV 2 that gave a result of 1.22. I had a second one that rendered a similiar result that was slightly above 1.10. I was diagnosed with Genital herpes. A yr ago I had this exact same test and it was below .90. Since that original neg. test I've only had sex with my ex. No new parters. During the 3 yrs prior to that neg. Test I had only had sex with my ex. So he is the only person I could have gotten it from. After this incident I asked him to get tested for everything & he said he would but he hasn't. Even if he did & he was negative, tht doesn't mean I'm negative because he could have been infected from one of those girls, had sex with me 2wks later & infected me & now too early too detect RPR, HIV, or Hep B in either one of us correct?

When I was screened for the stds they only drew blood & did a papsmear (only one swab was inserted in me during the procedure). I was not asked to give a urine sample so I assumed the Chlam & Gono. Tests were blood tests.

Also was testing 10 days after exposure too early to detect Chlam & Gono. b/c I've read that Chlam can take up to 6wks to detect.

Also I read, that u can get chlam & gono in the throat from performing unprotected oral sex on someone who is infected with it & I in fact know someone who was diagnosed with Gono. in the throat before. If u can get it in the throat why can't you passing it to someone else's throat by kissing them while infected in the throat?  

[Worriedorjustparanoia]

After confirming I have HSV2 and that he is the only person I could have gotten it from as explained in my earlier post.
1) Isn't it easier for someone with HSV 2 to contract HIV??????

2) Considering all this new info., does this change your answer to question #3???
I have never had any outbreaks that I am aware of & no symptoms of any kind. I asked my ex if he's experienced any herpes symptoms & he said no. However I do remember him get "ingrown hairs" fairly often which my doctor said people who have herpes 2 & do not know it can mistake herpes 2 for ingrown hairs.

[Edward W Hook, MD]

I repeat, you have a lot of mis-information.  STDs such as gonorrhea and chlamydia are not passed on by kissing.  This is not a debate however, you can believe me or not, just don't expect me to argue with you.  Furthermore, if you check with your doctor you will find that they did the gonorrhea and chlamydia test at the time your Pap smear was taken.  The TMA test is not done on blood,  I detect RNA in gential secretion of urine specimens.  I know this as I did the studies which lead to its approval at the FDA.

As for herpes, your HerpeSelect results are in the range in which over 80% of results are false positve and in fact most (4 out of 5) people who  have HerpeSeclect values at the level you do do not have herpes.  You did not mention any outbreak suggestive of HSV which also makes it likely that your blood test result is false positive.  My answer to number 3 is unchanged.  If you want a defvintive test, get a Western blot assay from the University of Washington.  I predict the result will be either negative or eqivocable which, in your case should also be considered as negative.  EWH

[Worriedorjustparanoia]

Thank you for all of your help,  this has calmed my worries somewhat. However, I'm a little confused about your statement "The TMA test is not done on blood, I detect RNA in genital secretions OF urine specimens" ... What does that mean? Because I did NOT give a urine sample at the time of the screening. Did you mean "and" rather than "of"?  

Also, is there a more accurate test than the Herpeselect assay that I could take to determine if my test was a false positive test? I don't want to tell future potential partners that I have HSV2 if this was a false test & I really don't have it.

Thanks again for all your help.

[Worriedorjustparanoia]

Sorry, I just re-read your post ....is the Western blot assay for HSV 2  or HIV ????.... I'm uncertain since immediately before that sentence you referred to question 3 which mentioned both HSV 2 & HIV. Thanks again!

[Worriedorjustparanoia]

Hi doctor, I really want to thank you again for answering all my questions & being so patient, this website has really reduced my anxiety about this. I wanted to update you that I called my doctors offfice this morning like you mentioned in your earlier post & the nurse confirmed that the Chlam & gono. Tests were by vaginal swab. I asked if tht would have detected the infections after 10 days of last encounter she said i have to come in for an appt & speak to the doctor. In your opinion am I definitely clean or should I retest because it was too early to detect?

Also please see question above about Western blot. Thanks again.

[Worriedorjustparanoia]

Forgot to mention that I have been urinating more often then usual & I feel like I don't completely empty my bladder after urinating & I had one episode  of intense vaginal itching that lasted a few mintues about a week after the encounter. Does that change your answer to retesting?I mentioned the urinary problem to the doctor when he diagnosed me with herpes & he said that if I did not have a UTI then herpes could be causing that problem. He tested my urine & said everything was fine. What are your thoughts on that since you thought my hepreselect test my have been false?  

[Edward W Hook, MD]

Your rapid fire questions are a bit overwhelming.  Please try to slow down.  Answering your questions in the order they appeared:

1.  Yes I meant genital secritons OR a urine.  This could include testing a PAP smear specimen.
2.  As I said, you could also be ttested for herpes with a Western blot assay from the University of Washington. this is more expensive and takes several weeks to come back.
3.  There are Western blot assays for both.
4.  Believe your 10 day test resutls., They are reliable.
5.  This sounds more like a UTI than anything else.  Again with respect to gonorrhea and chlamydia you should believe you test results.  If your docotor did not test you for trichamonas, this could also cause such symptoms

EWH