Need Help with next steps

[throwaway225]

Hi Terri-Hope all is well.

About 8 months ago I noticed a red spot on the head of my penis the morning after sleeping with a new partner and saw a doctor that day. The NP instantly said I had a friction burn. I was inbetween insurance decided not to do an STD test since the NP was so confident, I wish I had in hindsight. He suggested lotion and the spot cleared up shortly.

About 2-3 weeks ago another singular flat red spot appeared on the right hand side of my penis head about half the size of a dime. I was traveling so had to wait to wait a week to get tested but went to the UT clinic last Monday. The NP claimed he thought “80% nothing” but we’ll check for herpes just in case. At this point the wound/spot was starting to heal but we did a swab test and blood test. Worried, the results came back Wednesday as follows.

Swab Test:
HSV1: Negative
HSV 2: Negative

Blood Test:
HSV 1 IgG: Positive (1.92)
HSV 2 IgG: Equivocal (0.92)
Herpes Simplex IGM: Negative (0.37)

The NP called me claiming “mostly great results.” He said keep an eye on it but should be fine. I’m understandably very rattled by this whole situation so I’m also keeping in touch with a doctor friend who is in his last year of residency for Internal Medicine. He thought I was fine seeing the results claiming the low IGM, most people test positive for HSV IgG 1, and I noticed the first red spot so soon after sleeping with that partner.

Sill rattled I called my primary doctor for a 3rd opinion. He thinks I have genital HSV 1 since I had a negative blood test for HSV 1 and 2 from 2018. He never saw the wound but seemed confident.

Freaking out at this point, I see a dermatologist that Thursday. She reads the results, looks at the wound under a microscope (which is mostly healed at this point but a showing a little) and thinks I am fine. She said it didn’t look like herpes and thinks I got HSV 1 orally sometime between 2018 to now.

What should I do? Is Western Bolt the best next step?

TY in advance

[Terri Warren]

The western blot is the next step.
First of all, the IgM should never have been done – the CDC recommended that and so do I, given the high rate of false positives (not your issue though).
Your HSV 1 is a low positive and it may or may not be accurate
The spot you describe sounds nothing at all like a herpes lesion.
Even if you are truly positive, we cannot know where the location is – oral or genital. have you ever had a cold sore on your lip or in your nose?
I think you’ve been getting a lot of poor herpes information!
If you want to know for sure about your herpes status, yes, the blot is your answer.

Terri

[throwaway225]

Terri –

I contacted UW and they said they are sending a kit to me but I would have to schedule a video conference with you to schedule the exam. How do we schedule this video conference? Also a few quick questions.

-I have started taking Valacylovir as a precaution, If I start seeing someone is the risk of transmission low if I keep using the anti viral + a condom?

-I enjoy giving blood as a community service. Should I/can I still give blood with the results listed above?

-I saw the closer to 1.3 the better chance of a false positive. Does a 1.9 have a good chance of being a false positive as well?

Thanks Terri and I look forward to speaking over conference soon.

[Terri Warren]

I think you should consider the impact of antiviral medication on the western blot – it may yield a false negative if taken for a longer period of time right after new infection
If you do have herpes, you can certainly give blood
a 1.9 has a very good chance of being a false positive yes – probably 80%
If you want to make an appointment with me, just follow the link to “get a western blot”

Terri

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