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hsv 1 -ve after 7 weeks exposure but + after 12 weeks?

I was exposed to someone recently sexually and orally who has hsv 1. Next few days I got a red bleeding patch on head of my penis with a few red bumps and swollen testicles. i decided to get tested for hsv and other STDs. All negative except my Hsv 1/2 IGM came back 1.99 which was positive. I got tested at another facility two days later and they did specific HSV IGG + IGMs which came back negative. The same day i took another test from another lab which did non type specific IGG and IGM where my IGM came back positive with a score of 1.64 which was also positive.
I started antiviral Valcivir for 21 days 500mg morning and evening after which the red rash and bumps cleared up after 2-3 days.
I have taken a few IGG hsv 1 tests since then. All of them have come back negative. Latest was about 7 weeks post exposure which was also negative.

Now just wondering what to make of all of this. Has the antiviral interfered with my igg tests? Has anyone been negative for hsv 1 at 7 weeks and then positive after 12 weeks? When should i retest for this? How likely is it that i have been infected with HSV 1?
1 Responses
207091 tn?1337709493
COMMUNITY LEADER
So a few things -

The IgM is terribly unreliable, and shouldn't have been done on you in the first place. The CDC and all herpes experts recommend not using this test. Ignore it entirely. It's as likely to give you a false result as it is an accurate one.

Did anyone culture your sores? The best way to diagnose herpes is with a type specific culture, or preferably, a PCR swab, which is more sensitive.

Have you been taking the antiviral since you first got symptoms? If you have, it could be interfering with your testing. The best thing you can do is to stop the antiviral, wait about 12 weeks and test again. The valcyclovir could have sort of taken over for your immune system, preventing antibodies from developing.

If you get another sore, get it cultured. Insist on a type specific culture or PCR swab.

When you say you were exposed orally - did that person give you oral sex? If they didn't, you can't get genital hsv1 from them.

Herpes doesn't bleed, so I can't say that what you had was herpes, or if you have it. Herpes doesn't usually cause swollen testicles, either. Gonorrhea, chlamydia and syphilis can, though. Have your testicles gone down in size?

A primary outbreak of herpes - where you have neither hsv1 or 2 - wouldn't likely clear up in 2-3 days, even with antivirals.

I don't want to give you false hope - you could have herpes. I don't know. I'm saying that the symptoms don't sound like it. You could have herpes and something else, as well. What other STDs were you tested for?

12 Comments
Hello thank you for your response.

So the sores were not cultured or swabbed as by the time i started antiviral it cleared in 2-3 days.

I started taking antivirals on day 13 post exposure and and I took for 21 days. I also started taking doxycycline on day 6 post exposure and i took for 14 days.
My last IGG test was taken 18 days after I stopped the antiviral.

My testicles became normal size i think after about 10 to 15 days post exposure again more in line with when i started the antiviral therapy and a week post the start of the antibiotics.

Yes we both gave each other oral and we had protected sex and briefly unprotected sex lasting maybe a minute or two.

Regarding other STDs i was tested for Chlamydia Gonorrhoea Syphillis and HIV. i was negative for all except chlamydia which came back positive for IGG indicating it was an old infection not a recent one according to my Doctor. I also asked my partner to test for everything and she was tested and came out negative for Hepatitis A,B, C, Chlamydia and HIV and Gonorrhoea and HSV2 but positive for HSV1. We both got HIV retesting done about 7 weeks later and she and I are both HIV negative. A NAT qualitative HIV-1  was also done at about 30 days post the incident for both of us which came negative. She also says she was vaccinated for HPV 6 years back gardasil at the age of 25.

Hope this clarifies your questions. She will be getting HIV tests done again at about 90 days from exposure which was before me which is in another 3 weeks. I will get mine in another 5 weeks which will be 12 weeks post the incident. I have not had a physical relationship for previous 4 months although she was seeing someone else two weeks prior to meeting me. He got tested also for everything recently after this all came out and he was negative for hsv2, hsv 1, hepatitis a,b,c and HIV screening. Chlymadia & Gonorrhoea we dont know.
The blood tests for chlamydia aren't the most reliable way to determine a if you have, or had it. A urine test or urethral swab are better, but I assume that's why you're taking the doxy?

With regards to herpes, the doxy won't affect it at all, but the Valtrex might have. It's all still early for testing, though, and even if you hadn't taken the Valtrex, it still wouldn't be conclusive. It can take up to 12-16 weeks to develop antibodies, though many do much sooner. Since you took the Valtrex, it may take you a bit longer.

Your partner could have taken a 4th Gen DUO HIV test and it would have been accurate at 28 days post exposure. If she only has 3 weeks until 90 days is up, she can go ahead and test now with a regular antibody test - any antibody test will be fine. It's not going to make a difference. If her test is negative, you don't need to retest.

I don't think your symptoms were herpes related. Even with Valtrex, clearing in 2-3 days is really, really fast, especially for a primary outbreak. Test again at 16 weeks from the exposure and count it good if it's negative.




Thanks. So basically it took 2 days for the red patch to subside and then another 3 days for it to completely disappear. The blisters cold sores in the mouth persisted for around 21 days though. Perhaps because hsv 1 is more suited for the mouth perhaps that was why it disappeared so fast. Anyhow i will retest in 12 and 16 weeks just because the anxiety is killi ng! Thanks so much for the quick response.
Oh you didn't mention the mouth sores before. I'm assuming you kissed her, so it would make sense that if this is herpes, you got it orally and genitally at the same time.

Did you have sores all over your mouth? On your tongue? What did they look like?

I had two blisters in the inside of the lips and they felt like sores. One on top and one on the bottom. Took almost 3 weeks to clear.
That could be herpes. It's still fairly mild for a primary.

Unfortunately, right now, the only thing you can do is wait and test later. I know that's a sucky answer. :(
Not at all. Thank you. Last question - how many cases have you seen where people seroconverted late as in post 8 to 9 weeks? Just want to understand in more real numbers rather than percentages. Because I understand it's roughly 30 percent who convert late but how many cases clinically have you seen with late seroconversion?
I've seen it, but not at all frequently. It happens more in people who already have hsv1 than who don't. I've never seen anyone convincingly not develop them past 12 weeks, though, who hadn't taken an antiviral from the start.
So I started antiviral on day 13 or 14 and took for 21 days. What would you say my chances are then?
I think they're pretty good, since you had a couple of weeks to start building antibodies, and you were only on them for a few weeks. I think if you test at 16 weeks, you'll be fine.

Hi glove.
What happened with your results. Hope all is well.
Hello Geminii. I tested at 9 weeks and was negative. Now will do one at 12 weeks. If that is negative, I think I can put this behind me.
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