HSV 1 Genital Symptoms...

[daylightcome]

Question on whether or not I should be concerned about Genital HSV 1.  

I am a 20's straight male.  I have been having unprotected oral and vaginal sex with my girlfriend for 2 months.  2 weeks ago, I've started to have problems with itching on my scrotum, anus and penis.    

I was tested for HSV 1 and II, and the results were as follows:

First Tests:
HSV I/II IGM = .49 (negative, useless, I know).
HSV I IGG = .10 negative
HSI II IGG = .16 negative

Second Tests (one week later):
HSV I IGG = 2.05 POSITIVE
HSI II IGG = <.91 negative.

I don't know when the exact date of concern would be since we have been having sex ongoing.   What should I make of the HSV I tests?  Since one test was negative and then a week later was positive, does this mean I have HSV I genitally?

[Terri Warren, RN, Adult Nurse Practitioner]

Given you partners results, it suggests that the second test is a false positive.  Have you had other sexual partners in your life, that is intercourse or receiving oral sex?  If no, then I wouldn't worry about it anymore.  If yes, then I'm just not clear what's going on.  My gut says you are not likely infected.  If you want more clarity and reassurance, I would suggest a herpes western blot.

This is the last post I'll make on this thread.  Best of luck to you.

Terri

[daylightcome]

Hi Terri:

The good news today is that my girlfriend's tests came back negative for HSV I and HSV II.    

So to finalize this question, in your opinion, should I get retested for HSV I to know whether I have it for sure?   The only possibility I can see is that:

A) My first test was a false negative, or the second a false positive
OR
B) My girlfriend's test was a false negative.

[Terri Warren, RN, Adult Nurse Practitioner]

I know you would like this to be very clear based on what you've told me, but it really isn't.  Let me tell you about a few of the fine points about HSV 1 testing.

First of all, the particular HSV 1 blood antibody test you've had done misses about 1 out of every 10 cases of herpes type 1 infection, so the first test that you had done could have missed your established HSV 1 infection and the second one picked it up.  However, your HSV 1 value falls into an area we call "low positive", that is, your index value of 2.05 falls between 1.1 and 3.5, a "low positive" value.  Sometimes, test values that fall into this range indicate a false positive - that is, the test says you are infected but you really aren't.  What this example points out is the fallibility of the HSV antibody test.  When the values are strongly positive, we trust and can interpret results with ease.  But when its like this, its more confusing.  
There are a few questions that i have:

Have you ever had a cold sore on your lip or in your nose?
Has your girlfriend been tested for HSV 1  and 2?  What were her results?  Has she ever had a cold sore?

When you answer these for me, I can provide you with more guidance and recommendations.

Terri

[daylightcome]

Some more info that may be pertinent:

The itching has been going on for about 2.5 weeks now, and is more generalized than localized.   I have some some red (maybe 3-4) non-raised bumps on my penis shaft.  This leads me to believe it is eczema (the symptoms that started to cause all this worry).  

There's also some raised bumps on my penis where the shaft meets the glans (on the bottom of the penis).  Not sure if this is normal?  I can see some veins there.

More info about the tests:

Test 1:  HerpesSelect (I think) ELISA. Was completed at my primary care doctor.  Was sent to the lab where they only requested the IGM (even though I requested type specific).   Three days later I called and she called the lab and requested the IGG.  It was sent to a lab in Texas.  Could the blood have been mis-handled, causing bad results?

Test 2: CAPTIA (I think) completed with tstd.org at LabCorp.