Can you solve this mystery?

[PFG1980]

Teri -
I have a confusing situation. I'm a 33yo male and about 2 months ago I noticed some small sores on my penis shaft, just below the head. I'd say it was the classic description of herpes, a small cluster of open cuts. I went to a walk-in clinic and told the doctor that I feared it was herpes and he looked quickly and said, "Yes, it is." Because I wanted to know when I'd gotten it (recent from my current partner?) I asked for a blood test. The results were negative. So I assumed it was from my current partner. We had been together for about 6 months, but my partner was then tested and it came back negative. I was then retested and it again came back negative:
HSV-1: .12
HSV-2: .30

If not from my current partner, the last time I could possibly have gotten it would have been last November -- 8 months before I had these sores. But then why would I still be testing negative? And in those 8 months, I didn't have any symptoms. Maybe they could have been subtle and I missed them, but I'm also *very* alert when it comes to STDs and illness in general.

Also, I know it wasn't from any earlier than last November because I've previously had 5 other HSV blood tests, going back 7 years. They were all negative and I don't have all of the results saved, but I did find 2 of them:
HSV1: .10
HSV2: .08

HSV1: .09
HSV2: .03

What alarms me now is that my HSV-2 score seems to have risen dramatically. In looking around online, it seems that the only people who are negative but have HSV-2 scores like mine also have HSV-1 and there's cross-reactivity going on.

Something weird is happening here. If I got it from my partner, it makes no sense, because my partner is testing negative and has never had symptoms. If I got it from the previous partner, then I never had any symptoms for 8 months and in all that time I didn't seroconvert. Or maybe (what I hope but doubt) I somehow don't have it and something else is going on.

Thanks in advance for your time.

[shadow3680]

could be fungus ? I would retest in 3 months and those results should be conclusive use herpe select igg 1 and 2 type specific
did u have any other symptoms ? if so list them
good luck

[Terri Warren, RN, Adult Nurse Practitioner]

I'm not coming up with any other possibilities here.  I think you should probably retest at some point, given your symptoms.  Might be worth getting clearer on your hSV 1 test results.

Terri

[PFG1980]

OK, now I'm getting nervous again. Another possibility I thought of: I've seen a lot of test results posted on here where the HSV-2 score for someone is less than 0.90 but still elevated -- like .40, .50, .60 etc. It seems that when this is the case it's usually because they are positive for HSV-1. So they'll have a score of like 1.8 for HSV 1 and .55 for HSV-2. Like there's some cross-reactivity going on.  Is it possible that, as you suggested, I have HSV-1 and that the test isn't picking up any antibodies to it BUT that there's still cross-reactivity going...giving me an elevated but still negative HSV-2 score?

Something is off here. If I got it from my partner, my partner should be positive. If I got it earlier, I should have a positive score by now (and probably should have had symptoms before this July). If it's something else...well, what else could look like that? I have a history of eczema elsewhere on my body, fwiw,.

[Terri Warren, RN, Adult Nurse Practitioner]

Another possibility is that you have HSV 1 genitally and the test missed it, which it does one of 10 times.  If you have new infection, it could have missed it because you tested too early.  You may test positive in a few months, or again, it might not be herpes.  Your new description of the lesions does sound more like herpes, however, than your previous one.

Terri

[PFG1980]

Appreciate the reply. No, a swab wasn't done. The doctor looked for no more than 2 seconds and said it was herpes. I didn't see blisters, no. They were three ulcerations, each a small circle. Scabbed over and flaked off in about 3-4 days. They were bunched together.

I am 99.99999% sure my partner didn't have any other partners in the months before this happened. There's no reason for me to even suspect this would be the case, other than the fact that you never know anything for 100% certain, I guess. My other thought is if my partner somehow has it, is one of the people who never tests positive, and gave it to me.

[Terri Warren, RN, Adult Nurse Practitioner]

All of your blood tests are negative, including the 0.30 HSV 2 test you had most recently.  There is normal variation among index values (the number you get from a test result).  Was any swab testing done from the lesion? If not, it certainly should have been.  

The one possibility here, if indeed you do have herpes and there hasn't been enough time for antibody to be produced, is that your partner just got infected and hasn't herself had enough time to produce antibody either but passed the virus on to you.  That's a stretch, but the only way that seems reasonable for you to really have herpes and then both of you test negative for herpes antibody.  More likely, the lesions were not herpetic.  When you described little cuts, that isn't what we would normally see first  -normally we would see little blisters first.  Did you see any of that?

Terri