Welcome to the forum.
The herpes blood tests are very reliable -- more so than examination even by an experienced doctor, such as a dermatologist. With negative tests for both HSV-1 and HSV-2 12+ weeks after the last exposure, both by a standard lab-based test and Biokit, herpes is exceedingly unlikelhy.
That said, taking anti-HSV drugs like valacyclovir (Valtrex) sometimes can delay development of a positive blood test. To be maximally certain, I advice you take no more such treatment and have a final HSV blood test at 6 months. But I'm certain the result will remain negative.
I also agree you should have a PCR test in the event you develop another penile "cut" or blister. But I'm pretty sure that won't happen.
I hope this has been helpful. Take care- HHH, MD
Great, thank you.
I just wanted to add that the single 7 day Valtrex course I took was after my initial symptoms. I took the course from 3 days after symptoms until 10 days. My negative Herpeselect and Biokit test was at day 88 after symptoms. So there were 78 days between the ending of Valtrex course and my negative 12.5 week test. I have not taken any additional Valtrex.
Questions-
1. Let me know if this new information changes your recommendation, or if I should still take the final test at 6 months post symptoms to get the most certain result. How much more accurate would this be compared to testing at 4 or 5 months?
2. I was planning on taking a Herpeselect and Biokit for my final test. If I instead decided to get a western blot , how much more accurate would the result be?
3. What is the probability that the 6 month result would turn positive after a negative 13 week negative IGG test and Biokit?
4. How likely I contracted HSV-2 from receiving oral sex or am I only at risk for HSV-1?
Thanks again.
1) This information doesn't change my opinion or advice. There are no good data on how long HSV treatment can delay seroconversion, only experts' best guesses. I haven't a clue whether 4 or 5 months would be equally reliable, and therefore suggest you stick with 6 month testing.
2) That is not how the WB should be used. HerpeSelect and Biokit are more sensitive than WB. The purpose of WB is to confirm uncertain IgG tests, not to be the main standalone test. In other words, negative HerpeSelect and Biokit tests will be stronger evidence you didn't catch HSV than WB would.
3) Nearly zero, in my opinion.
4) HSV-2 is almost never acquired by oral sex, since few people with HSV-2 have oral infections; and when they do, asymptomatic viral shedding and overt oubreaks are uncommon.