95 percent sure I got herpes from fingering a women

[gilligan227]

Here is my story and questions.

I am married male who sometimes went to massage place and had mutual masturbation, I had always thought safe and I believe did also.

I got tested for studs back in oct. 2010 all clean.

Nov 23 I had mutual masturbation experience will massage women.

Approx one week later noticed discomfort on index and small bump, but no fluid.  I did not pay attention until discomfort turned to slight pain and then researched whitlow, but sounded like whitlow was very painful so I dismissed it.  But I was watching form signs just in case.  After 3 weeks and no blister but pain still there I thought maybe a have a splinter, so I used a pin to see if anything there.  Finger then felt like imnormal cut from the pin.  6 weeks later then I noticed small blister on middle finger, but painless.  After 6 weeks i went to dermatologist, he said this blister did not look like herpes and no fluid to culture.  I then got paranoid and got tested, i also started  to take  for
Possible infection from index finger.

Results after 6 weeks hsv1 equivocal, hsv 2 negative, I was concerned why did hsv 1 go from neg to eqivocalso got tested again after. 7 weeks, this time both neg, still concerned because I was on Bactrim that week for index finger, I got tested after 8 weeks, this time hsv 1 neg but hsv 2 positive at 1.12, so I thought must be new
injection and antibodies growing, went to doctor he ran another test after approx 9 weeks from exposure, this time hsv 2 now 1.46 positive.  He are now waiting for results from PCR DNA test.

Questions:

Based upon test results, im assuming I have recent infection of herpes, no other sexual encounter execept my wife who I know doesn't cheat and if she did would had to get infected exact same period as my exposure, what else could be cause of these test results

I am also concerned I autoinnoculated my genitals by masturbation and drainage after urinating, how possible is this.

Can whitlow be transmitted To my kids

[gilligan227]

Thanks just a note the PCR DNA test I took was blood test not a culture, do have any info on this Type of test.

[Edward W Hook, MD]

The accuracy of the PCR does not vary by time.  It is used to detect virus from infected sites.  It is 3-5 times more sensitve than culture.

To say that a test can indicate that a person is "exposed" to HSV is incorrect.  Either you have it or you don't.  If you have it, you develop a true positve antibody test.  If you don't your test is either negative or falsely positive.  I have already told you that there is typically no meaningful difference between a value of 1.12 and 1.46.    If you are developing antibodies a repeat test should give a much higher value.   You can repeat the test an see if it goes up above 3.5, you can have your octor request a Western blot from the University of Washington or you can just move on.  EWH  

[gilligan227]

Thanks Dr., your prediction was correct just got PCR results, it was negative, however my mind still not ease, the doctor said antibody increase from hsv 2 neg at 7 weeks, to 1.12 at 8 weeks, to 1.46 at 9 weeks is probably due to being "exposed" to virus and recommended i do antibdoy test again now at 10 weeks.  So i have a couple of questions:

how accurate is PCR test at approx 9 weeks?

what does being "exposed mean", do i have HSV 2, could i transmit it to others (from finger, or from genitals if i autoinnocatulated genitals shortly after exposure from masturbating), assuming antibody count increases more but under 3.5, what are next steps?

[Edward W Hook, MD]

Welcome to our Forum.  I suspect that you do not have a herpetic whitlow and that the blood tests you describe are falsely positive.  I will explain and make some suggestions.

You are correct that herpetic whitlow can occur following an exposure of the sort you describe but the problem is VERY rare and does not occur on two fingers, even adjacent fingers, in the way you describe.  Typically herpetic whitlow is quite uncomfortable, just as you expect.  In addition, you were examined by a trained specialist (your dermatologist) who felt this was not likely to be herpes.

As for your blood tests, when HSV type specific blood tests yield "positive results" with values of less than 3.5, they are more often falsely positive than indicative of a true infection.  The values you report are very low and are in the range where greater than 75% of such results are false positive.   Furthermore, there is no meaningful difference in a value of 1.12 and 1.46.  If you had been developing anti-herpes antibodies, I would have expected your values to have increased more.

I predict that your PCR will be negative.  In addition, if you want to be completely sure that you do not have HSV you could repeat your blood test,  If the value is not now greater than 3.5, this too is evidence that this is not HSV.

I hope you find my comments helpful.  EWH