Herpes testing / acyclovir effect

[Dd8]

Dear Terri

I had protected sex with a sex worker 7,5 weeks ago.
Ten days after I had a strange “feeling” in my penis. I did not care for a few days but as nothing improved A week later I Got tested for all STDs. Everything came back negative except a bacterial infection (klebsiella penumoiae) ; not a very common infection according to my doc. So he wondered if there was not anything besides this infection. I took antibiotics for 10 days. As I had severe back pain and nerve-like feeling in the lower left part (mainly testicle) I continued seeking for STD especially syphillis and herpes as the first time test was very early (3 weeks post exposure).
in my country the protocol is to have HSV1-2 non specific IGM and IGG tests.
My results are (post exposure) :

3 weeks : IGM : 0,3 / IGG : 0,0
5,5 weeks : IGM : 0,4 / IGG : 0,1
6,5 weeks : IGM : 0,3 / IGG : 0,0

All other stds negative at 6 weeks. At this point as my left side pain did not go away I did a stupid thing : I took acyclovir for 5 days. (After the 6,5 weeks).

I know I have to wait 12 weeks to have a satisfying accuracy but my questions are :

– i know you do not consider IGM tests as real indicators ; but to my understanding mainly due to false positives. Is there a real concern with false negatives ?
– I was planning to have an intermediate testing at 8,5 weeks…can the 5-days treatment interfer with this ? And at 12 weeks ?

Thanks

[Dd8]

Another question : I take Xanax ( low dosage : 0,25 mg once or twice a day max) ; can this interfer with the seroconversion process ?

[Terri Warren]

I’m not aware of problems with false negatives for the IgM test, no, but because there are problems with the test in general, I can’t honestly say how reliable it is. But as you seem to know, the reliable test is the type specific IgG. The grouped IgG as you describe is not helpful unless completely negative. Even then as with the IgM, I’m not sure how reliable it is.

Five days of acyclovir will not interfere with the IgG test, no. You can certainly test as you go along at 8.5 and 12 weeks but the most reliable test will be at 16 weeks. So I’m a little confused here – do you have a baseline IgG test at all? If not, and it turns out positive, you will not be able to know if you just got infected or have been infected for years, right?

Xanex will not interfere with testing no.

May I ask what country you are living in?

Terri

[Dd8]

I live in france. I will ask later for a specific igg test / it is probably available but not that “usual”.
Thanks for your answer on acyclovir and xanax
I do not have baseline for IGG, but all the non-specific tests have been negative and equal to 0 (once to 0,1 but I think it does not mean anything but 0 / see above). I think – as IGG are supposed to stay for years – that if I had had previous infection (either to HSV1 or 2) the resukts would have been positive (but i would not be able to know if it would have been HSV1 or 2, old or recent infection).
I think we use “grouped” HSV1/2 tests here as HSV1 is not that common as in the US.

[Terri Warren]

Well, I completely missed the IgG in your note . Sorry about that! Yes, great that it is negative at this point so you do have a baseline at 3 weeks which is great. I have seen grouped IgG be positive and then type specific be negative, but that is not the case in your situation.

So in summary, if your grouped IgG stays negative, I don’t think you have anything to worry about. If it become positive, you will not be able to know if it is HSV 1 or HSV 2 and THEN you can find the type specific testing

So sorry I missed the IgG results after the IgM result.

Terri

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