Positive IGG for HSV-1 at 6.5 weeks; new genital exposure (from oral) or old?

[upsidedown]

Early 40s male, don’t recall ever having an OB or cold sore. Same for wife of 16 years.
Was w/escort – kissed on lips, received unprotected oral and protected sex; shaved prior to encounter but not since

19 days – onset of tingling, rash/ hot/abrasion feeling on scrotum and where shaft meets it, along with redness; tingling lasted at least a week
26 days – went to health dept – nurse saw redness but said it’s not herpes and no lesions to swab
5.5 wks – derm says it’s dermatitis (I didn’t tell him my fear that it’s HSV); recommends OTC itch relief cream
6.5 wks – Ignored health pros and got IGG blood test; result: 15.9 for HSV-1
7 wks – urologist visit – doesn’t think it’s herpes; showed him my IGG test, he said everyone has HSV1
7 wks – primary care dr thinks it’s fungal, prescribed a powder; says > 80% of people have HSV1 and wouldn’t have recommended taking blood test w/o physical signs
8 wks – Scrotum discomfort continues

Q-Is IGG of 15.9 possible at 6.5 weeks, or is this a sign of a well-established infection? Would a retest in a few weeks help me figure out if it’s new, ie would the level rise?
Q-The scrotum irritation started at 3 wks and has now been going on for 5+ wks w/varying intensity. I look every day and brace myself for blisters/lesions, but there’s never anything there that I can tell. Is it possibly an OB, or would an OB not typically last so long?
Q-Health dept, urologist, derm, PCP all say it’s not herpes; yet I got + blood test and am beside myself with anxiety. To me it is most logical that this is an OB of gHSV1, as I can’t think of another reason why it occurred 3 wks post-encounter. Drs all say everyone has HSV1 and I’ve prob had it for years w/no symptoms. But w/o swabs there’s no way to tell where it is. What do you think?
Q-Which do you think is likelier? I’ve had HSV1 for yrs and didn’t know it, so either my wife never got it from me, or she also has had it for years and didn’t know it. OR I just caught gHSV-1 from oral

Thank you.

[Terri Warren]

1. Yes, an index value of 15.9 would be possible at 65 weeks. A retest will not help you know if this is new or old – only an index value taken right after the encounter would help you to know if this is new or old infection.
2. The scrotum symptoms and progression sound nothing at all like herpes to me. And herpes symptoms don’t last for 5 weeks steadily,nope
3. I would disagree that 80% of the population is HSV 1 positive but more than half the population is HSV 1 positive and without an outbreak one cannot know where it is that is correct. The actual statistic is that 56% of the US Population between 14 and 49 have HSV 1 infection – more over that age.
I think it is far more likely that you’ve had herpes for years – you may have an oral infection acquired at childhood from an adult with a cold sore kissing you – who knows, but the chances that you got it from this encounter are extremely low.

Terri

[upsidedown]

Thank you. I’d greatly appreciate your thoughts: on a few more questions:
1. If 56% of US has HSV-1, and my encounter was with a “high risk” individual, why do you say the chances from this encounter are extremely low?
2. Of the 56% w/HSV-1, what percentage would you guess are asymptomatic?
3. Would it be unusual for my wife and I to both have HSV-1 and both be asymptomatic?
4. After nearly 20 years together, would it be possible that she didn’t have HSV-1 when we met and STILL doesn’t have it?
5. If this really is a new genital HSV-1 infection, what are the odds I could transmit to my wife thru intercourse? Again, she’s either had it asymptomatically or doesn’t have it at all (I assume) because I just contracted it and we haven’t yet had sex again. Historically we have sex a few times a month.
6. Please help me reconcile the ideas that (1) most people w/HSV-1 get it as a child from an adult w/a cold sore, and (2) it would be difficult to transmit HSV-1 to my child because we kiss our children differently? My daughter’s never had an OB that I recall, only very chapped lips from time to time. I’ve kissed her on the lips for years. Should I stop?
7. If I’ve had it for years orally, does that reduce the odds that I could have just contracted it genitally?
8. Should I shave again (base of shaft where it meets scrotum) so I can better examine my skin for lesions or blisters without hair in the way?
9. Can a blister present as a single, very small pimple / whitehead an inch or so above the penis?
10. Recently I got a hemorrhoid, which I’m treating and paying very close to the surrounding area. I’ve also had a surprising amount of clear leakage from my anus. I don’t know if this is related to the hemorrhoid or anxiety, or a separate issue, but could it be related to genital HSV-1?

Thank you again.

[Terri Warren]

1. If 56% of US has HSV-1, and my encounter was with a “high risk” individual, why do you say the chances from this encounter are extremely low?
Because a single encounter, statistically, is just unlikely to result in transmission.
2. Of the 56% w/HSV-1, what percentage would you guess are asymptomatic?
Probably 70%
3. Would it be unusual for my wife and I to both have HSV-1 and both be asymptomatic?
Not all that unusual, no
4. After nearly 20 years together, would it be possible that she didn’t have HSV-1 when we met and STILL doesn’t have it?
Yes, that is possible
5. If this really is a new genital HSV-1 infection, what are the odds I could transmit to my wife thru intercourse? Again, she’s either had it asymptomatically or doesn’t have it at all (I assume) because I just contracted it and we haven’t yet had sex again. Historically we have sex a few times a month.
We don’t have statistics on transmission of HSV 1 through intercourse but it is not high, IF you have this genitally
6. Please help me reconcile the ideas that (1) most people w/HSV-1 get it as a child from an adult w/a cold sore, and (2) it would be difficult to transmit HSV-1 to my child because we kiss our children differently? My daughter’s never had an OB that I recall, only very chapped lips from time to time. I’ve kissed her on the lips for years. Should I stop?
The way we kiss a child is not the way we kiss an adult lover. If you have no cold sore present, it is fine to kiss your child. But in the past, and still with some people in the present, they don’t give a second thought to kissing a child with a cold sore present.
7. If I’ve had it for years orally, does that reduce the odds that I could have just contracted it genitally?
It almost eliminates the chance that you would get it genitally
8. Should I shave again (base of shaft where it meets scrotum) so I can better examine my skin for lesions or blisters without hair in the way?
No, I don’t think that is necessary
9. Can a blister present as a single, very small pimple / whitehead an inch or so above the penis?
That seems unlikely to me
10. Recently I got a hemorrhoid, which I’m treating and paying very close to the surrounding area. I’ve also had a surprising amount of clear leakage from my anus. I don’t know if this is related to the hemorrhoid or anxiety, or a separate issue, but could it be related to genital HSV-1?
I think that is likely related to something else entirely. does not sound herpetic to me

Terri

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