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weak hsv-2 positive?
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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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weak hsv-2 positive?

July of last year I gave oral sex to a girl, no other sexual contact. Within a few days small bumps appeared inside my mouth and have remained there ever since. I was told by 3 ENT doctors these were normal and oral swabs, biopsy plus blood work seemed to confirm this. About six months later small painless bumps appeared on my penis head and rectal itching started about a month after this. Rectal itching was thought to be a hemroidal issue and bumps on the penis were said not to be HPV on visual exam only.Burning in mouth began around March and more blood work was done. I was told I was HSV-1 positive and HSV-2 negative. I
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You describe no symptoms that suggest either oral or genital herpes. The blood test results apparently show that, like half of all people, you have been infected with HSV-1.  That infection probably was oral and acquired in childhood.  Most such persons are asymptomatic and never develop cold sores or other herpes manifestations.   From your description, there was no reason to suspect herpes as the cause, and that was confirmed by the 3 ENT docs.  Further, oral HSV-1 rarely if ever is acquired by performing oral sex, and your oral bumps probably had nothing to do with the sexual event you describe, despite the timing.

And most likely you are not infected with HSV-2.  You say that at least one blood test result was clearly negative, maybe two of them.  From the wording, I cannot tell whether the IgG test with the ELISA ratio of 0.8 is the first test or a repeat.  That number suggests it was the HerpeSelect test, for which 0.8 is entirely negative, not 'weak positive'.  A person with no HSV antibody can have repeated tests whose ELISA ratios vary from 0.1 to 0.9; variation in that range relates to variations in the biochemistry of the test, not small amounts of HSV antibody.

Further, even if there is an HSV-2 result higher than that, say an ELISA ratio over 1.0, probably it was false positive.  In people with HSV-1 antibody, a low-positive HSV-2 result often is false.  Your 'original doctor' seems to understand this and s/he is the provider you should listen to.  The ID specialist and the nurse you spoke with apparently do not understand the complexities of HSV antibody testing.

So most likely you have no HSV-2 infection.  (By the way, no blood test measures 'exposure' without infection.  A positive result means a person has been infected with the virus and still carries it.  A negative result means there has been no infection, even if a person has been exposed to the virus.)

At this point, I suggest you drop the whole thing, confident you have an asymptomatic oral HSV-1 infection that will never cause you any harm and that you probably will never transmit to anyone else, sexually or otherwise; and confident that you do not have HSV-2 or genital herpes.  But if you want to nail it down with even greater certainty, ask to have a blood specimen sent to the University of Washington clinical laboratory for a Western blot test, the gold standard tie-breaker for uncertain HSV antibody testing.  You can be confident it will show HSV-1 but not HSV-2.

Good luck--  HHH, MD
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Thanks for the feedback. Oral swabs were done within a few days of possible exposure and then again in November or December. The HSV bloods test were done in May and last week. Both showed a .8 igg for HSV-2. I was never told I had
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Avatar_n_tn
One other question I forgot to ask. If I choose to get a biopsy on the penile spots, which my doctor advised against but the urologist said he
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http://mitch678.checkoutmypage.com/index.php

Went ahead and posted a couple of pictures to get your take on these oral spots. I just feel better having an expert look at this rather then someone who may only see a handful of cases. Thanks again for everything.
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239123_tn?1267651214
I don't look at posted photos; in my mind it comes too close to practicing medicine from a distance.  In any case, I don't attempt to address non-STD problems anyway, and it is clear that whatever you have it not an STD and almost certainly not sexually acquired.  You'll have to follow up with your own health care provider(s).  I won't have any additional comments or advice.

HHH, MD

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Avatar_n_tn
I understand.

Could you PLEASE take a look at these test results though and tell me if I
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239123_tn?1267651214
I cannot tell exactly what tests were done.  Probably HerpeSelect IgG plus some company's IgM test.  If so, the result indicate you probably are not infected with either HSV-1 or HSV-2; the positive/equivocal IgM result are falsely positive.

Of course you can kiss someone.  Half the US population, and more than that in most of the world, has positive tests for HSV-1. Do you think half of all people should kiss other people?

HHH, MD
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