Put this to bed for me please

[triple0zero]

I had 3 (receiving oral only) encounters with the same female over 2 months with the last being in mid Jan 2019. I went to get tested (no symptoms) 5 weeks after the last encounter and got the “all clear” for everything tested BUT HSV2.

The results were HSV2 IGG 1.00 (equivocal) and (labcorp) conducted a supplemental assy. which yielded “negative”. I was concerned about the inaccuracies (~8%;HSV2 IGG) & timing of the test and waited to retest.

22 weeks after the most recent January encounter I retested for both HSV1 & HSV2 with type specific IGG lab work (Quest).

This time around the results were HSV1 Negative at <.90 & HSV2 Equivocal at 1.04. So given these results, and the nature of the sexual activity I tend to believe this is not Herpes related.

About 2 week ago I noticed this small, painless, non-itchy raised bump on my shaft. After much reading and comparing pictures I think that it may be Molluscum contagiosum. I scheduled a visit with a dermatologist to start possible treatment.

1)I have read that after 12 weeks post potential exposure, the HSV2 test will be as accurate as possible and only a WB can provide additional assurance. True?

2)Does this bump sound like it is a result of HSV2?

3)Do we know transmission rates of males receiving HSV2 via oral encounters? (I’ve read this is the least likely scenario to acquire HSV2. HSV1 is another story – Negative IGG according to the most recent labwork).

4) If the bump is still present by this weekend should I request a PCR swab being that it will have been present for nearly 3 weeks at that point?

5) I understand it is ALWAYS recommended to test/re-test after atleast 12 weeks from a sexual encounter for maximum accuracy within the parameters of IGG testing. Is there a range where one may wait too long for the most accurate results? IE: Are my equivocal results the best its going to be if I do not pursue a WB?

6) Do we know what other conditions can cause elevated/equivocal/loq pos IGG results?

[Terri Warren]

1)I have read that after 12 weeks post potential exposure, the HSV2 test will be as accurate as possible and only a WB can provide additional assurance. True?
True

2)Does this bump sound like it is a result of HSV2?
A single bump that is not painful sounds unlikely to HSV 2. Is it flesh-colored and does it have a dimple in the middle? That sounds more like molluscum, if anything

3)Do we know transmission rates of males receiving HSV2 via oral encounters? (I’ve read this is the least likely scenario to acquire HSV2. HSV1 is another story – Negative IGG according to the most recent labwork).

At least 95% of HSV 2 is genital so getting HSV 2 by receiving oral sex is incredibly unlikely

4) If the bump is still present by this weekend should I request a PCR swab being that it will have been present for nearly 3 weeks at that point?
If it remains the same for three weeks, this isn’t HSV 2

5) I understand it is ALWAYS recommended to test/re-test after atleast 12 weeks from a sexual encounter for maximum accuracy within the parameters of IGG testing. Is there a range where one may wait too long for the most accurate results? IE: Are my equivocal results the best its going to be if I do not pursue a WB?

No, no “too long” parameter

6) Do we know what other conditions can cause elevated/equivocal/loq pos IGG results?
We don’t, but low false positive and equivocal unrelated to HSV 2 are not that uncommon, to be honest. Wish we had a better test that was easily obtained.

Terri

[triple0zero]

2) A single bump that is not painful sounds unlikely to HSV 2. Is it flesh-colored and does it have a dimple in the middle? That sounds more like molluscum, if anything

Reply: Yes, I would describe it as “fleshy” and I have seen a persistent dimple. However; my research tells me that molluscum is extremely contagious/spreads quickly. I have not popped or messed with the bump since I discovered it (other than generic washing/rinsing in shower) and it dosnt look to have spread. At one point it did look glossy. The bump isn’t very raised (like a wart) but still noticeable. Today is day 14 and is hasn’t ruptured/drained or become an ulcer (as far as I know).

Again, it is not painful, itchy or sensitive to touch. The closest pictures I can find/comparable are ingrown hairs – but I haven’t shaved down there for awhile before I found it.

[Terri Warren]

It doesn’t always spread rapidly. Molluscum doesn’t generally go away on it’s own – you could break it open and squeeze out the cheesy substance inside of it, if there is some (which would indicate molluscum). Clean it well with alcohol after doing this.

Terri

[triple0zero]

Just to confirm, there was a white head at one point – I did not notice it drain but the contents seemed to disappear and the bump is becoming more and more mild in appearance. Today is day 15 (plus or minus 1 or 2 days). Still no painful sensation, itching, tingles or tenderness.

1) With my encounters being stricty oral (receiving) – an equivocal + negative supplemental assy @ 5 weeks AND an additional equivocal at 22 weeks, what percentage would you feel this is and underlying negative.

2)Does mild discomfort/pinch pain in the urethra opening post orgasim (lasting many months) sound herpectic? Have any idea what that may be?

[Terri Warren]

1) With my encounters being stricty oral (receiving) – an equivocal + negative supplemental assy @ 5 weeks AND an additional equivocal at 22 weeks, what percentage would you feel this is and underlying negative.

I assume we are talking about HSV 2 only and the answer is that if you have never had intercourse (your encounters are strictly oral, as you said above), then HSV 2 is not a real risk for you.

2)Does mild discomfort/pinch pain in the urethra opening post orgasim (lasting many months) sound herpectic? Have any idea what that may be?

No, I think a prostate evaluation might be something to consider.

Terri

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