question

[northern2.0]

I had unprotected sex on one occasion with a female who I don’t know well. 10 days later I noticed a small cluster of blisters/pimple-like objects just above my penis more in the pubic hair area. After some changes in appearance they went away a week or so later. No pain and no itching or anything, maybe slight tingling at times but not much if any. I noticed possible very mild fever symptoms a few days after I noticed the skin legion.

41 days after the sexual contact a fever blister appeared on my upper lip and is still present nearly a week later. I believe I’ve had them before but not completely sure cause it’s been a very long time, probably when I was younger and didn’t think much of it. This one seems more prominent though. A day later I got tested and results came back over the phone positive for herpes. I asked which kind and she said both 1 & 2.

The test was taken 42 days (6 weeks) after sexual contact so approximately 20-25 days after the legion disappeared. The fever blister/cold sore appeared about 3 weeks after the genital legion had disappeared.

I do not yet know what type of lab or test was conducted. I have asked to be referred to a dermatologist for further diagnosis/treatment etc.

My questions:

1) Do you think I contracted HSV 2? I’m confident I did not have it prior to that sexual contact.

2) Should I see a dermatologist for further treatment or a different type of health care provider?

3) They prescribed me acyclovir. Should I begin taking this now or wait or don’t take it at all? Should I take Vitamin D or something like that instead?

4) Why would I get a fever blister in that time frame when I haven’t had one in years if ever? There was no oral sex whatsoever.

5) Any other insights or advice would be highly appreciated.

Thank you very much for your time and advice.

[Terri Warren]

How are you confident that you did not have this prior? Did you have a negative HSV 2 antibody test prior? That is the only way you would actually know.
A dermatologist would work, yes,
I think it would be unwise to take acyclovir at this point, while you are trying to figure out what if anything you have. The medicine can impact the antibody test.
The fever blister that you describe occurred well out of the range of the normal presentation for new infection (1 to 10 days). I have no idea why your HSV 1 infection might recur now but if you have had them before, you don’t get the same type a second time from someone else.

I would advise that you get the test results for your HSV 1 and 2 test. What you want to see is that it was an IgG antibody test, not IgM and that the type 1 and type 2 results are separate, not in the same test. And you want to see if both values are greater than 3.5. If they are under 3.5, they require confirmation with another test, preferably western bot

Terri

[northern2.0]

Results:

HSV1IGG: 60.10 H index 0.00 – 0.90
HSV2IGG: 9.46 H index 0.00 – 0.90

HSV1:

Negative <0.91
Equivocal 0.91 – 1.09
Positive >1.09

HSV2:

Negative <0.91
Equivocal 0.91 – 1.09
Positive >1.09

Questions:

1) What do the values 60.10 and 9.46 at the top mean?

2) Do you see anything unusual about the results or indexes?

3) It says Equivocal may suggest early infection, do those
Equivocal numbers suggest that?

4) The results for each appear to be exactly the same, does that mean they were done in the same test and not separate? The results are on the same lab result together but it doesn’t specify whether they were done together or separate.

5) Should I wait for a certain period of time and take another test in the future?

6) Any other advice or insight regarding these results would be extremely helpful. I don’t understand them.

To answer your question no I have never had a test performed before, but I’ve never had a reason to believe I may have anything. I figured I would have an inclination somehow by myself or a partner. Thank you in advance for your help in deciphering all this.

[northern2.0]

I figured out what the values on the top are, I assume you will tell me I’m positive. I misinterpreted how to read the results. I think those high numbers just made me think they meant something else. I guess my questions are now as follows:

1) Why would those values be so high and does that mean I’ve had this longer than previously described?

2) I’m assuming another test in the future is unnecessary?

3) Any other advice or comments?

[Terri Warren]

Yes, these values indicate that you have both HSV 1 and HSV 2 infections. These are not so high – they are pretty normal values for someone who is infected.
Another test is not necessary, no, unless you absolutely want to rule out a false positive, then you could have a western blot, but these are pretty high values, particularly the HSV 1.
I would assume that you are positive and practice safer sex with partners and consider taking daily antiviral therapy when having sex with someone who is uninfected with HSV 2. I would also certainly encourage you to disclose your HSV status to future sex partners.
Your have one more question on this subscription.

Terri

[northern2.0]

How would I go about doing the Western Blot? Based on the information in my initial post should I wait for a certain period of time? Also I’ve read those IGG antibodies don’t show up that quickly, is it likely I had this prior to the contact I mentioned in the first post or is that impossible to speculate?

[Terri Warren]

Since the test was taken 42 days after the contact, it is not possible to know if you had this before the sexual encounter or not. It would be completely reasonable to have these values 6 weeks after initial infection or you could have had them for years – no way to know.

The western blot should be done 16 weeks after the encounter for greatest accuracy. Our clinic can arrange for that testing to be drawn at a lab near you and sent to the University of Washington.

Terri

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