In a far off country and inconclusive results

[Randybobandy]

I am currently living in a 3rd world country that has a very poor medical system. Hopefully you can help provide some clarity where local doctors have been unable. I have a Partner who has been my sole sexual partner, and I hers, for the last 8 months.

Symptomes:

I first noticed a pimple like sore on the topside of my shaft about 1 inch from the base (in May). It seemed like an ingrown hair or very deep pimple. It was hard if squeezed and contained white puss.
About 2-3 weekes later i noticed some other sores apear about 1 inch away on the left side where my shaft, testicles and pubic region meet. There were 2 sores about half an inch apart. They were different than the first, more like infected hair folicules with half CM diameters, they never blistered or oozed or hurt but scabbed over and remaind for about a month. Just as they were starting to heal I got a sudden powerfull itch in the same spot, which i scratched. I then looked at the area and there were two more sores that formed, these ones hurt and oozed (july 10th). After about 1 week they began to heal and a 3rd wave of sores appeared, these ones looked a lot more like typical herpes with blisters (i didnt scratch this time). They were also accompanied by swolen nodes in my pubic area, sorness in my thigh, a slight pain in my lower back just left of my spine and tingly/ichyness in the area. (it seemed very much like what I had read herpies would be like) At this time the deep pimple on my shaft, which had still not gone away, also had another pimple appear on top of it. Again turing into a hard lump.

Tests:
I was tested for HSV2 one month before having sex with my partner: IgG 0.07, IgM 0.57 (she was not tested)

During my breakout i was tested for HSV2 again: IgG 0.75, IgM 3.30.

I went back 1 week later to also get HSV 1 included.
HSV1: IgG 2.72, IgM 0.37 // HSV2: IgG 0.61, IgM 2.19

My partner was also tested at this time (to her knowledge she has never had a breakout).
HSV1: IgG 1.07, IgM 0.39 // HSV2: IgG 1.40, IgM 1.24

The doctor has diagnosed me with HSV1&2 and her with HSV2. I guess the most likely senario is that i have had HSV1 unknowingly for a while already and this is now an initial breakout of HSV2 which I got from her. But, while I know my symptoms sound like herepes, with such low positives and no symptomes for her, it seems pretty inconclusive.

As I mentiond above I dont really trust the doctors or testing in this country. (To give an example, my partner specifically requested IgG testing and not IgM. She was called by the doctor and told she was positive for HSV2 IgG. Only when she went to get a physical copy of the results did we notice that they had in reality only given her IgM tests, when we informed them of their error they said we would have to repay to get the proper IgG test. We changed clinics but unfortunatly scams are par for the course here.)

My question is, with what tests would we ideally now proced with un confirming our diagnosis, or do you think that it has been properly diagnosed?

[Terri Warren]

Well, if what you posted is the correct result, you are positive for HSV 1 and negative for HSV 2 (.61) and she is positive for both, though just barely. I am assuming the cutoff values are the same as with the tests we use here in the US. Am I reading this correctly?

You aren’t really describing typical herpes lesions but it is possible that she truly does have HSV 2 and you just acquired it and have yet to have a chance to develop antibody. You could try retesting in a few months and see if your HSV 2 index value has increased. But her positive HSV 2 is only 1.4 and there is an 85% chance this is a false positive (again, if you are using the same index value as is used here.

She needs a western blot to confirm her HSV 2 status but it sounds like that isn’t a possibility for you two right now.

Terri

[Randybobandy]

The test cutoff values are as below, not sure if the same as US:
Negative: < 0.8
Boarderline: 0.8 – 1.1
Positive: > 1.1

That would put my partner at boarder line for HSV1 and low positive for HSV2. Giving her about a 15% chance of having HSV1 or/or 2, as you mentioned.

Is it indicative of anything that my IgG value was so low 9 months ago (0.07) and the 2 recent tests are (while still negative) much higher (0.75 & 0.61). Or is that normal fluciation?

As for my symptomes. I think that the deep pimple and the other lesions might be unrelated. Not sure if that chages your suspision. However, the later 2 outbreaks I experienced were blisters and accompanied by swolen lymph nodes, tingling, and some sponal pain, which is what has me worried. Do the blisters always burst with herpes? Because for my final outbreak, the blisters were clear, but disapeared without bursting. And I think the second to last outbreak was also blisters but I popped my by itching them before I saw what it looked lke.

Is it possible that this is a case of HSV1 that I have had for a while and its just now is flairing up for the first time? Or does it not really work that way?

So if we are unable to get a WB test, would both of us retaking the IgG in a few months be the best course of action?

[Terri Warren]

You could certainly retake the IgG test, yes and see if your values in particular have changes. You do have a higher than usual negative, but that may or may not have any meaning – hard to say without a follow up test. Herpes does present with blisters so it is possible that they symptoms that you describe are related to herpes. Without a swab test it is really not possible to say but I can say that it is concerning. However, most often herpes blisters do break in the normal situation.

Terri

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