Testing Question

[stockspeculator]

Doctors,


I had unprotected vaginal sex, testing dates: All testing(2 &12weeks) done through TSTD.ORG (labcorp)

2 weeks and 12 weeks  
Hiv antibody
Hsv1
Hsv2
Syphilis
Gonorrhea
Chlamydia
Hep b
Hep c

All negative, except hsv1 Positive.

Additional testing: Hiv finger prick at NYC health at 15weeks negative.
                                  Herpes IGG done at labcorp 16 weeks hsv1 positive, hsv2 negative.

In addition the girl agreed to be tested a bit after 9 weeks. I don’t know her activities before or after.
She came in negative hiv, hep b&c. positive hsv1 4.78 positive hsv2 1.70.

Questions

1) As far as hiv, is any additional testing needed? (6 months)
2) Does having hsv1 affect hiv antibody testing?
3) Is the Herpes IGG done at 16 weeks reliable?
4) Is it true that 98% of people would seroconvert at 16weeks and the test is considered 97% accurate?
5) Is a western blot necessary? And if I decide to do it when would it be considered conclusive?

I have seen on prior posts that blood tests trump symptoms. So the tingles are to be disregarded, and the sweat pimples (singles ones) on butt and legs should also be accepted as pus/folliculitious as per the Dermatologist.

I have a partner that I want to protect.
Please advise
Thank you

[H. Hunter Handsfield, M.D.]

1,2) The level of risk to which you were exposed is irrelevant, and that includes your partner's HIV and HSV-2 status.  YOUR tests prove YOU weren't infected.  Obviously nothing else matters.

3) It is safe to have sex with your partner.  You aren't infected!

4) HSV WB is gold standard only for the purpose of confirming positive results.  If the IgG is negative, the WB is always negative.  Don't waste your money.

You came here for reassurnace and you have it.  The news is good, but you seem to be arguing with it.  This isn't a debate; I won't have any further commenst or advice.

[stockspeculator]

Thank you Doctor,

Just one follow up please.

1) The fact that she tested negative to HIV at just under 10 weeks is reassuring I assume?

2) What are the chances that her hsv2 1.7 is a false positive?

3) The reason for the extra concern is my partner wants to get pregnant, so I want to be extra careful ( p.s. I would never engage in this behavior again)

4) I was referring to hsv2 on the WB test. I have seen u refer to is as the gold standard and since Herpes can hide especially in hsv1 positive people, I was considering it.

Thanks for your thoughtfulness and reassurances.

[H. Hunter Handsfield, M.D.]

Welcome to the forum and thanks for your question.  Thanks for reading other threads for questions similar to your own.

Going first to your closing comment/question:  indeed test results overrule symptoms in judging the chance someone has HIV or other STDs.  This is especially true for HIV; your test results prove unequivocally you did not acquire HIV during the sexual exposure you are concerned about.  That conclusion isn't qutie as rigid for some of the others STDs.  But combining the inherently low risk from any single exposure and lack of symptoms with your negative test results, they amount to 100% proof you were not infected with any of the infections for which you were tested.  In fact, you have bee rather seriously overtested; it is time to stop.  And you are exactly correct that "the tingles are to be disregarded, and the sweat pimples (singles ones) on butt and legs should also be accepted as pus/folliculitious as per the Dermatologist".

To your specific questions:

1) No, don't have any more testing.  Below is the link to a thread that discusses HIV test reliability at various intervals after exposure, and explains why testing at 6 months is never necessary.

2) There are no blood test results of any kind that have any effect on the reliability of HIV testing.  The HIV tests are just about the most accurate diagnostic tests ever developed, for any medical condition.

3,4) Yes, 16 weeks is reliable for HSV-2.  The figures you quote are actually a bit too optimistic; the HSV-2 IgG test isn't that good.   However, as noted above, it is not just the test result but the combination of exposure history, test result, and absence of symptoms that suggest herpes that make me 100% confident you were not infected.

5) I don't know whether you're asking about Western blot for HIV or HSV-2, but neither is necessary.  For both infections, WB is not intended to confirm negative results on the standard tests, but only to confirm positive or equivocal results that don't seem to make sense.

So all is well, no worries.  Please continue (or resume) unprotected sex with your regular partner and don't have any more testing of any kind.

Here is the thread on HIV testing:  http://www.medhelp.org/posts/show/1704700

Regards--  HHH, MD