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Questions about HSV2 Tests and Symptoms
Doctors,
Two months ago, I began feeling irritation around the tip of my penis. I also noticed that the opening of my urethra was redder than usual. The irritation only bothers me when I am walking (like my underwear is made of sandpaper). I cannot pinpoint a particular event that may have caused this. It has, however, persisted without improvement for 10 weeks.
Four weeks ago, I went to my GP. He did urine tests for gonorrhea, Chlamydia and white blood cell levels. All negative. He then prescribed Difulcan and Metronidazole. These had no effect. He then suggested using Aquafor and cortisone cream. These had no effect. My GP then did a HerpesSelect test. Last week, I tested negative for HSV1 (a score of .9) but positive for HSV2 (a score of 2.2). I am shocked because I have never had anything like a lesion or outbreak. My doctor prescribed Acyclovir (10 days). Four days in, I see no change in symptoms.
I am extremely confused. I have had sex with only one woman over the last 5 years. During the first 2 years of our relationship, we had unprotected sex. During the last 2 years, we have always used condoms. My girlfriend has never experienced any outbreaks and she tested negative for HSV2 three years ago.
(1) What is the probability of a false positive in my situation? In your opinion, is it worth the financial and emotional costs (getting my hopes up) of having a Biokit test? Is it plausible that my symptoms are totally unrelated to the HSV2 test? (2) If I do have HSV2, when will the irritation end? My doctor suggested that I may have had an outbreak in my urethra 2 months ago and my current symptoms are leftover nerve damage. My symptoms have been the same every day for two months. Could I be having recurrent outbreaks in my urethra? Is nerve damage common from HSV2? How can I notice an outbreak in the absence of external lesions (to avoid infecting my girlfriend). (3) If it is not HSV2, what can explain my symptoms? Prostatits? I am getting depressed.
Two months ago, I began feeling irritation around the tip of my penis. I also noticed that the opening of my urethra was redder than usual. The irritation only bothers me when I am walking (like my underwear is made of sandpaper). I cannot pinpoint a particular event that may have caused this. It has, however, persisted without improvement for 10 weeks.
Four weeks ago, I went to my GP. He did urine tests for gonorrhea, Chlamydia and white blood cell levels. All negative. He then prescribed Difulcan and Metronidazole. These had no effect. He then suggested using Aquafor and cortisone cream. These had no effect. My GP then did a HerpesSelect test. Last week, I tested negative for HSV1 (a score of .9) but positive for HSV2 (a score of 2.2). I am shocked because I have never had anything like a lesion or outbreak. My doctor prescribed Acyclovir (10 days). Four days in, I see no change in symptoms.
I am extremely confused. I have had sex with only one woman over the last 5 years. During the first 2 years of our relationship, we had unprotected sex. During the last 2 years, we have always used condoms. My girlfriend has never experienced any outbreaks and she tested negative for HSV2 three years ago.
(1) What is the probability of a false positive in my situation? In your opinion, is it worth the financial and emotional costs (getting my hopes up) of having a Biokit test? Is it plausible that my symptoms are totally unrelated to the HSV2 test? (2) If I do have HSV2, when will the irritation end? My doctor suggested that I may have had an outbreak in my urethra 2 months ago and my current symptoms are leftover nerve damage. My symptoms have been the same every day for two months. Could I be having recurrent outbreaks in my urethra? Is nerve damage common from HSV2? How can I notice an outbreak in the absence of external lesions (to avoid infecting my girlfriend). (3) If it is not HSV2, what can explain my symptoms? Prostatits? I am getting depressed.
I apologize Dr. Hook but I have one very quick question to set my mind 100% at ease (I should have mentioned this in my last post but I rushed directly to my computer to give you the update when I learned of the negative result). I took a 10 day cycle of acyclovir that ended two and a half weeks prior to my blood being drawn for the Western Blot (this was the only suppressive therapy I have ever taken). Would this influence the results of the test at all? Once again, I appreciate your patience and commitment to serving (admittedly) anxiety-ridden people like me.
Thank you again from the bottom of my heart and I will end the thread here.
Thank you again from the bottom of my heart and I will end the thread here.
MEDICAL PROFESSIONAL
Glad we could help and sorry that the path to the correct answer was so circuitous. Take care. EWH
Dear Dr. Hook,
I wanted to write and provide you with an update. Following your advice, I had a Western Blot test done. The results revealed that I am negative for HSV-2. I do not have any further questions but do want to thank you tremendously for the effort you put in here. I do not imagine you make much money from your extensive work on this forum but I just wanted to let you know that it helps more people than you can possibly know. Without your (and Dr. Handsfields) comments, I would have never pursued the BioKit or Western Blot tests and would have lived the rest of my life in constant fear of infecting my partner and wondering if every genital tingle or itch was an outbreak. I am more grateful than you can ever know.
I also wanted to post an update to provide encouragement for those who frequent these forums and may find themselves in a similar position with respect to HSV-2 testing. I hope it will encourage people to proactively pursue their own diagnoses.
Once again, Dr. Hook, thank you. This site (and the expertise you provide on it) are truly a god-send.
I wanted to write and provide you with an update. Following your advice, I had a Western Blot test done. The results revealed that I am negative for HSV-2. I do not have any further questions but do want to thank you tremendously for the effort you put in here. I do not imagine you make much money from your extensive work on this forum but I just wanted to let you know that it helps more people than you can possibly know. Without your (and Dr. Handsfields) comments, I would have never pursued the BioKit or Western Blot tests and would have lived the rest of my life in constant fear of infecting my partner and wondering if every genital tingle or itch was an outbreak. I am more grateful than you can ever know.
I also wanted to post an update to provide encouragement for those who frequent these forums and may find themselves in a similar position with respect to HSV-2 testing. I hope it will encourage people to proactively pursue their own diagnoses.
Once again, Dr. Hook, thank you. This site (and the expertise you provide on it) are truly a god-send.
MEDICAL PROFESSIONAL
It worries me that the test may ahve not been done properly. I would get the Western Blot. It does cost over $100 but it is the gold standard and will resolve this once and for all. Sorry your having to go through this. EWH
Dear Dr. Hook,
I decided I could not wait until later in the week and just got back from having a BioKit test. According to the nurse, the test was indeterminate. She said that the negative was bright red (consistent with a negative test result???) but that there was also some faint marking on the positive. Do you have any insight into what this means or why this might be the case? Should I take this (along with the low HerpesSelect results) as evidence of infection or as evidence of not having HSV2? The nurse could not answer my questions. Also, should I take steps to try and get a western blot test? I understand that it is expensive but am in dire need of some clarity.
I deeply appreciate your help. Thank you once again.
I decided I could not wait until later in the week and just got back from having a BioKit test. According to the nurse, the test was indeterminate. She said that the negative was bright red (consistent with a negative test result???) but that there was also some faint marking on the positive. Do you have any insight into what this means or why this might be the case? Should I take this (along with the low HerpesSelect results) as evidence of infection or as evidence of not having HSV2? The nurse could not answer my questions. Also, should I take steps to try and get a western blot test? I understand that it is expensive but am in dire need of some clarity.
I deeply appreciate your help. Thank you once again.
MEDICAL PROFESSIONAL
If you indeed turn out to have HSV-2, that does not mean your symptoms are due to the infection. The symptoms you describe as well as their duration (present for more than 10 weeks) are not suggestive of HSV.
Please let us know wha tthe Biokit results show. EWH
Please let us know wha tthe Biokit results show. EWH
Thank you once again for your reply. I have one final set of questions and then I will end the thread (I am planning on getting the Biokit test - and hopefully a definitive answer regarding all of this - later this week). Assuming I am positive for HSV2, what could explain the timing of my symptoms. As I said, I have only had sex with one woman over the last five years but I have never had any symptoms before 10 weeks ago. Can HSV2 really linger this long before causing symptoms like the ones I have described? Is it possible that I have had outbreaks so subtle that I did not notice them? In particular, is it possible to have urethral or internal outbreaks that cause no pain, discharge or burning? If this is truly the first outbreak, does this mean that I will start having them frequently despite a long history of avoiding them?
Sorry to pester you with so many questions. I know, however, that the answers you give help so many people beyond myself. I have learned a great deal from the advice you have given others so I hope that others can learn from my questions. Thank you so much Dr. Hook for everything.
Sorry to pester you with so many questions. I know, however, that the answers you give help so many people beyond myself. I have learned a great deal from the advice you have given others so I hope that others can learn from my questions. Thank you so much Dr. Hook for everything.
MEDICAL PROFESSIONAL
1. Since many skin conditions are self limited, an apparent response to acyclovir would not necessarily be diagnostic. As far as the Sureview is concerns, there is no reason to wait until you finish the acyclovir to test. I would go on and have the test. If it is negative you can stop the acyclovir and have no reason to worry about transmitting infection to your GF.
2. I think you've answered this question. I would at the very least, use condoms until all is sorted out. EWH
2. I think you've answered this question. I would at the very least, use condoms until all is sorted out. EWH
Dear Doctor,
Thank you so much for your very helpful reply. I have two follow up questions that I hope you do not mind answering. First, if the Acyclovir helps resolve my symptoms, would this be evidence for having HSV2 (even after 10 weeks of having them)? Would it be wise to wait until I finish the Acyclovir before taking the Surevue test? I was able to find a place to do a Surevue test but it is fairly expensive. I will, however, have the test if you believe it is absolutely necessary to sort everything out.
Second, should I avoid having sex with my girlfriend (with a condom) until these symptoms stop? It looks like she has not contracted HSV2 despite having unprotected sex in the past and I would hate to risk transmitting it to her now.
Thank you again for the service you provide here.
Thank you so much for your very helpful reply. I have two follow up questions that I hope you do not mind answering. First, if the Acyclovir helps resolve my symptoms, would this be evidence for having HSV2 (even after 10 weeks of having them)? Would it be wise to wait until I finish the Acyclovir before taking the Surevue test? I was able to find a place to do a Surevue test but it is fairly expensive. I will, however, have the test if you believe it is absolutely necessary to sort everything out.
Second, should I avoid having sex with my girlfriend (with a condom) until these symptoms stop? It looks like she has not contracted HSV2 despite having unprotected sex in the past and I would hate to risk transmitting it to her now.
Thank you again for the service you provide here.
MEDICAL PROFESSIONAL
Welcome to the Forum. I'll try to help. You may or may not have herpes but either way, the discomfort you describe is not compatible with herpes. Herpes would not have lasted so long and would have been associated with lesions.
As for your blood test results. Published studies indicate that persons with HerpeSelect values between 2.0 an 2.5 have 50/50 chance of having HSV-2, the remainder being false positive results. In your case, the odds that this is a false positive may be somewhat higher. On the other hand, over 80% of Americans with HSV-2 do not know it. Thus I do think it is your interest to try to get more information on whether or not you have herpes. The best way to do this is either be getting a Surevue test or a Western blot assay performed at the University of Washington. If the Surevue is negative or if the Western blot is either indeterminate or negative, you do not have HSV-2.
It is difficult to say what your symptoms might be due to. One possibility is a problem called the Chronic Pelvic Pain Syndrome (CPPS). CPPS is probably not a single problem but a "catch-all" that is still being sorted out. You can learn more about this possibility by reading the excellent description on Wikipedia.
I hope this comment is helpful. EWH
As for your blood test results. Published studies indicate that persons with HerpeSelect values between 2.0 an 2.5 have 50/50 chance of having HSV-2, the remainder being false positive results. In your case, the odds that this is a false positive may be somewhat higher. On the other hand, over 80% of Americans with HSV-2 do not know it. Thus I do think it is your interest to try to get more information on whether or not you have herpes. The best way to do this is either be getting a Surevue test or a Western blot assay performed at the University of Washington. If the Surevue is negative or if the Western blot is either indeterminate or negative, you do not have HSV-2.
It is difficult to say what your symptoms might be due to. One possibility is a problem called the Chronic Pelvic Pain Syndrome (CPPS). CPPS is probably not a single problem but a "catch-all" that is still being sorted out. You can learn more about this possibility by reading the excellent description on Wikipedia.
I hope this comment is helpful. EWH
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
