Is this HSV2 primary infection?

[Oas59]

Hi, I have benefitted from your help and advice in the past, but some of us never learn. I’m a gay male and I massaged a man, eventually rubbing my penis on his butt cheeks. I also rubbed in between and may have touched his anus with my penis. Part of the time I had a condom, but not all of the time. He had no visible signs of infection…clear. I don’t know his status but assume the worst at this point. I was negative for HSV2 going into this. I also fingered him with intact hands. Three days after I got a bump on my inner thigh that is red, slightly raised, but has not blistered or popped. I’m hoping its a hair follicle, which I tried to pop but it only bled. The area where the bump is located was covered by pajama pants at the time, and not where I’d expect a primary outbreak.I was straddling his thighs and rubbing his back. Urgent Care said they could not swab unless it was an open lesion. I have been taking Valcyclovir because I have HSV1, and don’t want to expose someone in case I do something dumb in a weak moment, orally. I’m now 8 days since this encounter. I would have expected something on my penis, which was the point of contact, from a primary outbreak. If there was contact with his anus it could not have been more than a total of 10-15 seconds, in a couple of fleeting brushes. The bump doesn’t seem to be changing, about 3mm, no watery blister, and a small tight healing area where I tried to open it two days ago. Has my Valcyclovir thwarted a normal first outbreak, or is this possibly just a follicle. It’s in and area where thighs can rub together, about three inches from the crotch, toward the back of the thigh. Do you have an opinion? Very nervous here, and feeling so foolish once again. Thank you, Terri

[Terri Warren]

I don’t feel that your encounter represented any real risk of the acquisition of HSV two. I suspect that the red bump is nothing more than a ingrown hair or some other sort of irritation. It does not sound like HSV-2 to me
Terri

[Oas59]

Thank you so much for your reply! My concern is the coincidental timing of this, and it is still there after a week, although getting smaller, but still not weepy so that it can be swabbed. It just doesn’t look like something I’ve had before. Perhaps my scratching it open with a sharp instrument caused this. My worry was that the valacyclovir caused a muted first symptom HSV2. I do feel better at hearing your opinion from the information I’ve given you! You are an invaluable resource!

[Terri Warren]

For the record, anything can be swab tested. We do clinical trials for people have no symptoms and swab their genitals every day and we recover virus. I suspect that scratching it with a sharp instrument is a really good clue to the fact that it is something else. It is also possible that if you got a new infection and we’re taking acyclovir that the symptoms would be muted

Terri

[Oas59]

So, as a follow up, would you recommend getting a swab test at this point? I stopped the valacyclovir almost a week ago, by the way. Should I just wait to see if anything else happens? Would the valcylovir cause a primary outbreak in a different area than the contact? I hope to put this to rest…so much anxiety. Thanks again, Terri

[Oas59]

Sorry, I keep thinking of details trying to be thorough, but want to say that there IS a small scab on this area, especially since I opened it last week. It just seems to be long healing, maybe because I’m not disturbing it. I also have developed what seems to be normal jock itch in the legs creases, but I’ve had that before. Nerves are getting the best of me, I’m afraid.

Last question…do people with GHSV2 routinely shed from the anus as well as the genitals, even if it wasn’t acquired there? (I may owe for more questions.) Once again, thank you.

[Terri Warren]

The Valtrex would not cause anything except reduction of outbreaks and viral shedding. It think it is likely too late to swab this area now.
Yes, people with genital herpes often shed from the anus as well as the genitalia. If you get any other lesions or unusual skin presentations, be sure to have it swab tested right away

Terri

[Oas59]

Hi Terri, I did have the bump swabbed the day after my last question, just over a week after it appeared. It was still a red bump with a small, flat scab. I asked the doctor to rub or scuff it since it was dry. He also took blood for the LabCorp Herpes select test, which I told him probably wasn’t useful at that time. He laughed and said I was telling him how to do his job, after I’d apologized and told him why I have some prior knowledge. He isn’t my regular GP, is very young and I don’t think has much experience in this realm. My results are:

PCR swab: No DNA detected for HSV1 or HSV2

Herpes select: HSV1 46.50
HSV 1 and 2 IgM screen: negative both
HSV 2 specific antibodies <.90

This result I expected. Do you have any opinion, especially on the swab test? Perhaps no sample was collected? I realize it may be weeks before I can really put this to rest with further testing.

Just as an aside, do you think there will ever be a cure, an effective vaccine, or even a home test that could tell when a person is shedding virus? Thank you for all you do. There seems to be very few people out there with extensive, even basic knowledge on this subject…nothing that approaches your experience.

[Terri Warren]

I don’t understand your question about no sample is collected. If they did a swab test, sample was collected and no DNA was detected. So far you’re negative for HSV two. I don’t think there will be a home test to know if you’re shedding but there could be and I think there will be a cure and an effective vaccine.

Terri

[Oas59]

Just to clarify my question, a swab was done, although the scab was dry, so a sample was collected or attempted, if anything was picked up. The test results came back as ” no DNA was detected for HSV1 or 2. I wondered if that is a possible test result, or could it be because an inadequate/insufficient sample was taken…could this swab have been done incorrectly. I don’t have much faith in what this young doctor was doing, but maybe that’s unfair of me. I insisted on the swab..it’s why I went. Perhaps I’m trying too hard to determine an early outcome in hopes that I’m negative. I need to let this go or at least play out in due time. Very stressful. I will also have a blood test done again after waiting the appropriate amount of time. Thank you, Terri

[Oas59]

I always think of something else I intended to ask. I know that I was negative before this incident. Does the blood/antibody test that was done so early, two to three weeks out, have any value at all? if I understand correctly, probably not.

[Terri Warren]

No DNA detected IS a test result, yes, absolutely.
If there was an inadequate sample, the report would have said so.
If a blood antibody test is done too soon after a new infection, it could be falsely negative. It takes time to make antibodies, some people take longer than others. If you follow this up say in 6 to 8 weeks with another IgG test and it is boldly positive then I think that does represent a new infection. Remember that the IgG test can have false positives so I would be really careful about continuing to use that test.

Terri

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