Can this be Herpes?

[Ibank99]

Hi Terri,

I have been in a monogamous relationship for over 7 years.  On June 20th, I made a huge mistake and saw a CSW.  During the encounter, I received uncovered oral and covered sex.  Prior to putting on the condom, the CSW rubbed her genitals over mine for approx. 30 seconds.  After she put on the condom we had sex for about one minute.  After completion, she continued for a few seconds and when she got off of me, the condom was no longer on me but she found it on her thigh so I am confident that the condom fell off when she got off of me.  The following Tuesday night while grooming I noticed what appeared to be a cyst.  I then panicked and started to search the web for clues.  I figured there had to be a connection between my encounter and the bump which was at the base of my penis.  After 6 weeks, I decided to see a dermatologist who stated the bump was a common cyst caused by an ingrown hair.  One other item worth noting is that although I dont believe I ever had a primary outbreak, I do recall a hemoroidal incident not to long after my encounter.  From what I have read, it would be very unusual to have a primary outbreak in the anus but I will leave that to you the expert.  

In mid Aug my girlfriend broke out with a rash on her inner thigh, which included a swolen lymphnode in her groin and she complained of some leg pain.  We had sex two days before this rash broke out.  From what I have read, the inner thigh is a very unlikely location for a primary outbreak but I will leave that to you to confirm.  

After dealing with high anxiety I decided to get tested for HSV 1 & HSV 2.  I was tested at 82 days which was just two days prior to 12 weeks.  My results were IGG Herpeselct AB HSV 1 = .33 and HSV 2 = .32 (Both Negative).  Since my test I have noticed cuts by the skin fold of my inner thigh and groin, but I bet I did it to myself by frantically checking myself.  Do you believe I need to be concerned and do you recommend that I retest at 16 weeks?

[Terri Warren, RN, Adult Nurse Practitioner]

I can never be absolutely sure of anything.  To the best of my medical knowledge, you don't have HSV 2

This is my final post on this thread.

Terri

[Ibank99]

Thanks for the response Terri.  Sorry, but I am just trying to get more certainty.  I made an enormous mistake in my life that I will never make again and just trying to make clear in my own mind that this is behind me and I am in the clear.  Being that I tested at 14.5 weeks, do you think I can absolutely believe that HSV 2 for me is not a possibility?  This will be my last question, I promise.

[Terri Warren, RN, Adult Nurse Practitioner]

I suggest people stop testing at 4 months, or I should say, they don't need to test after 4 months.

Yes, this is a classic negative.  I'm thinking, with both your scores (HSV 1 and 2), there was something a little different about that whole testing batch the first time.

Terri

[Ibank99]

Thanks Terri.  Do these results now seem more in line with a true negative with an IGG 2 at .08?  Also, should I consider a retest at 6 months or any other time to be sure?  I have read that 93% test positive by 90 days when no hsv 1 is detected, but there is still another 7% that doesn't.  When generally do you feel that all would test positive by?  

[Terri Warren, RN, Adult Nurse Practitioner]

I think you should consider these results conclusive.  I doubt that another week would make any difference at all in your results.  That's terrific news.  And glad to hear about your partner hiking shortly before the rash appeared, that makes a lot more sense now.  

Terri

[Ibank99]

Hi Terri, after a painful waiting period, I just got my results back.  The test was done on day 102 which was 14.5 weeks post exposure.  

HSV 1 IGG Herpeselect AB = .15 (Negative)
HSV 2 IGG Herpeselect AB =.08 (Negative)

Being that I received these results prior to 16 weeks, do you see any reason for me to retest again?  or should I consider these findings conclusive?

[Ibank99]

Thanks Terri, given the location of the rash and the fact that she went hiking in the mountains in Vermont a few days earlier, I am hoping it was something else.  The anxiety is killing me but then I think of the odds and have to think I will be part of the 85%.  Chances of me getting it from a one time encounter, the chances of her getting it so soon after, the rash location and my negative test result at 12 weeks makes me feel a little more confident but the anxiety is still overwhelming.  I will post my results as soon as I receive them.  

[Terri Warren, RN, Adult Nurse Practitioner]

I would say perhaps 15% of the time, the test goes on to become positive and 85% of the time, it stays negative.  
Again, I believe you will stay negative.  Your original risk was really low, but my concern is the rash that you describe on your partner's thigh and the way you describe it.  If you hadn't put that in your post, I would not be worried, and perhaps the rash is something else completely.  
You posted here for my advice, and I probably should have just suggested you retest routinely.  I hope your test stays negative.  

Terri

[Ibank99]

Hi Terri, I appreciate your guidance and retested yesterday.  A couple of questions for you, you mention that my negative results are higher than most and you mention that you have seen a few increase over time, given that my HSV 1 and 2 values were close to eachother, should that give me comfort that my values are probably correctly negative?  And since you mention my results are higher than most and you have seen a few increse over time, can you give me an estimated percentage of times that you have see high negatives like mine become positive?  I am having a really hard time with dealing with anxiety over this and trying to find some comfort.  Based on what I have read, I would think my chances of being infected are approximately 1 in about 1,000 and the likelyhood of my parner catching it from me after such a short period are probably less than 1 in 100 and given my negative at 12 weeks I would think my chances of being infected are incredibly low.  It will take about 5 days for me to get my results and will advise when I do.  Thanks in advance for answering my questions.

[Terri Warren, RN, Adult Nurse Practitioner]

Yes, I believe that a negative is a negative.  And your test will likely hold as negative, we've just seen a few of those higher negatives move up when more time has passed.  Yes, test this week, 15 weeks is close enough!  I just want another test so we can rule out a concern about the thigh rash in your partner, OK?

Terri

[Ibank99]

Thanks for the response Terri.  If I were to get retested at 15 weeks which would be this week, would you consider that conclusive?  I have read posts of yours where you state a negative is a negative and that any value less than .9 is the same?  Where would hsv2 negative results generally range?  Now I am a bit more concerned as I thought a .29 was a good negative.  Sorry my original post was inaccurate.  My actual hsv 2 was .29, not the .32 I mistakenly stated above.

[Terri Warren, RN, Adult Nurse Practitioner]

I'm so sorry about this post, something odd happened to posts form the 24th.  

Your risk is low for this encounter.  And you are correct that it would be unusual for a thigh to be the first location of an infection.  I actually think it is not at all likely that you have acquired HSV genitally

Having said all of that, I would recommend that you get retested at 16 weeks, just to be certain as your negative results are a little higher than I might like to see.  They are definitely negative, but negatives in this range are far less common than negatives in general, at least in the 5 years we have done ELISA testing in our clinic.  I'm not trying to scare you and again, I think you are likely not infected, but I do recommend that you retest, yes.

Terri