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Urine herpes test

Hello Doctors,

I will tell you my sad story, I am a male 21 years old, I had unprotected oral sex twice with a sex worker in 2012, and a protected sex with another sex worker in 2012 as well, I had 5 HSV IgG tests, the first one was after a week from the protected sex, the second one was at 80 days from the protected sex, third one was at 9 months, the last two tests where at 13 months. all the results were the same, Positive for HSV1 and Negative for HSV2, I am just worried about HSV2.

The thing is, I was happy with my results, until I read about the Urine herpes test PCR, I read a thread in Freedomhealth Clinic forum, Dr Jose answered a question and wrote : "Most people have been exposed to one or both types of herpes at least once in their lives. That is why the blood test for antibody serology is not very useful. The most useful test for detection is a PCR test (urine or swab), even in absence of any symptoms." THIS THREAD WAS ON THIS DATE 04-18-2009

Dr Sean and Dr Jose are in the International HIV forum as well, you must know them, and I called the same clinic ( Freedomhealth clinic) and they said that they still providing this test ( Herpes urine test PCR ), and there are so many threads in their forum discussing about this test.

So what do you think Doctors about this test? is it accurate? should I go for it?

Just to let you know that these are my only exposures I had in my life and it was the first time for me to have sex.

Thanks,
3 Responses
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239123 tn?1267647614
MEDICAL PROFESSIONAL
"So you do not recommend me to do the urine herpes test at all? "  Correct.  It makes no sense.  If anyone recommended this it in your situaiton, I would suspect them of being in for it for the money, not for your health benefit.

I will also add that having genital HSV-1 pretty much doesn't matter anyway.  It irarely causes recurrent outbreaks and is rarely  transmitted sexually.  So what does it matter?  Why are you so freaked out about it?  Read this thread:

http://www.medhelp.org/posts/STDs/Herpes-Confuses-Me/show/1414935

The other information you have provided doesn't change my opinion or advice.

You really need to mellow out about this.  Don't get tested with PCR or anything else.  I will not advise you about having tests that I would not recommend, so that will be all for this thread. No more advice from me.
Helpful - 0
Avatar universal
Hello Doctor Hunter,

Thank you very much, I really feel better after reading your comments.

So you do not recommend me to do the urine herpes test at all?

I want to tell you another thing as well, you said viral shedding can occur anywhere in the anal area, before the protected sex I had that I told you about in my first post, I went to a massage shop like for 5 times ( the first three times I went there I chose the same girl to do the massage for me, and the last two times I chose another girl) and almost each time I went there I was hugging the girls from behind, so my penis and my pubic area was touching the bottom  "a s s" sorry for the language, and each time I went there I had body to body massage as well. Can HSV2 be transmitted in this way "by hugging from behind" ?

And another risk I want to tell you about if you do not mind Doctor Hunter, before the protected sex I had, I also went to a strip club, and a stripper came to me and she put her finger in her Vagina and then she directly put the same finger in my mouth and I tasted it ( she put the same finger in my mouth, the same finger that she put in her vagina). is this a risk for oral HSV2? Because I remember I had a single cold sore in my right lips during that month, although I know that I have HSV1, all the five tests I had say that I am positive for HSV1.  

And just to tell you that these exposures and events were before a month or two months from the protected sex I told you about in my first post.

Sorry about my English, I am not native speaker of English.

I wish you all the best Doctor Hunter.
Helpful - 0
239123 tn?1267647614
MEDICAL PROFESSIONAL
Welcome to the forum.

I won't get into an online debate with differing approaches to HSV diagnosis.  It is true that, in general, experts in the UK have less faith in the antibody tests to diagnose HSV-2 than in North  America.  However, there are serious problems with the PCR alternative.  First, viral shedding can occur anywhere in the genital or anal area; testing urine could miss shedding from, say, the penile shaft.  Second, shedding is intermittent, typically present less than 10% of the time.  So even if negative on several tests, it isn't possible to certain that HSV-2 is absent.  And each PCR test may cost $100 or more.  To some extent, you can get around this by collecting several swabs over a couple of weeks, pooling them, and testing the single pooled sample.  However, it's still not an ideal approach.

But  perhaps most important, the main problem that reduces faith in the HSV-2 antibody is that positive results -- especially weakly positive ones -- are difficult to interpret.  That's not your problem.  You have had several negatve IgG antibody tests and your consistently negative HSV-2 results are very reliables.

On top of all that, HSV-2 is virtually never transmitted by oral sex; and although condoms aren't perfect, the intercourse exposure also was very low risk for HSV-2.  

So the bottom line is that you definitely do not have HSV-2, indeed almnost certainly couldn't have caught it anyway.  You don't need any more testing, by PCR or any other methods.  I would advise you to move along without worry about it.

Best wishes--  HHH, MD
Helpful - 0

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