What now

[ohno150]

I took part in risky behavior - spent some time with an escort about three weeks back.

I now have burning around the corner of my mouth and chin and near my eyes sometimes. It is not going away and has been three weeks. I went to an online company and orderd an HerpeSelect test. These are the results.

Herpes Simplex Virus Type I IgG Test (HerpeSelect) 1.13 0.00-0.90 Positive
Herpes Simplex Virus Type II IgG Test (HerpeSelect)  <0.90 0.00-0.90 Negative

What should I do now? So stupid but need to move forward. I guess I need to tell my wife - time to be truthful.

[Terri Warren, RN, Adult Nurse Practitioner]

Yes, I would wait until 10 weeks before looking at a western blot test.

Terri

[ohno150]

Terri,

I had a followup test at 33 days post exposure - i know I should wait 3 months - but I thought I would test to see how my results are changing from my last Herpeselct test at the 3 week point. This time it came back equivocal with a value of 1.0. for HSV-1 and Negative again for HSV-2. Do you recommend western blot to confirm - I guess that should be done after at least 10 weeks?

[Terri Warren, RN, Adult Nurse Practitioner]

If you test positive for HSV 1 without symptoms in either location, you can't know if your infection is oral or genital.  I don't think three weeks is long enough from exposure to testing accurately for HSV 2.  56% of the population between 14 (as I recall off hand and 49) have HSV 1.

Terri

[ohno150]

I have not had cold sores before.

She provide some oral sex, mainly licking the scrotum area. There was no oral sex performed on the shaft itself (thought I was protecting myself that way - stupid).

So one question I have is how do i know if it is genital or oral HSV-1 - is there a test for that?

Also, it has only been 3 weeks since I had this test and the test and HSV-2 was negative. Do you think that was enough to rule out HSV-2?

Finally, i have been reading that 60-80% of the population have HSV-1, is that true? Is this something I could have had for a long time and not even known about it?

[Terri Warren, RN, Adult Nurse Practitioner]

Well, the HSV 1 value is a low positive, but positive technically, though just barely.  Have you ever in your life had a cold sore on your lip?  What kind of sexual contact did you have?  Were you the giver of oral sex to her?  Was she the giver of oral sex to you?  
A low positive can be present for one of three reasons:
1) it is a true positive and you are infected with HSV 1 - unknown for sure if new or old infection
2) it is a false positive and if testing was done in the future or confirmatory testing was done in the future, it would be negative
3) you are in the process of seroconverting, which means you are moving from being not infected, to being infected and making an antibody response.

At this point, it isn't possible to say.  However, I would think if you were newly infected, you might have more symptoms than just burning in the facial area.

As for telling your wife - that's your call, but I think you should think this question through for your personal wife situation:

Would she prefer to know what happened and not take sexual risks with you or would she prefer to possibly get infected without knowing.  Its really difficult, and I'm not pretending to have all the answers, by any means.

Terri