Symptoms and Results Help Needed

[1ConcernedGuy]

Hello,
Appreciate this forum.

About 6 weeks ago I had unprotected sex with a woman and used a new (to me) lube. Within a day of the encounter I had burning around my lips (the lube got on my lips during oral) and groin but no sores, redness, breakouts, ulcers etc. That burning lasted about 10 days. I also started irritation/itch/pain at the tip of my urethra that has persisted to this day six+ weeks later. Was tested for all stds 5 days after the encounter and everything came back negative. Asked the testing doc at urgent care if everything would start showing on tests so soon and was wrongly told yes. She also said the pain at the tip of my urethra is not a normal symptom of Herpes. Then visited a urologist a week later for the persistent urethra pain and had another urine screen done coming back negative. No diagnosis was provided, I was told I’m fine. I had the stdcheck.com/LabCorp full panel done Monday (about 6 weeks post encounter) and was given Equivocal-positive result at .91, range of .9-1.09 for Equivocal. Igg test, hsv2. I have had aggressive sex with another partner I am 100% positive is (was :/) negative since the initial worrisome encounter assuming that I was clear. This led to redness and rawness around the head of my penis and dry skin peeling along with the continued urethra pain. There has never been any sores/plaques to speak of…just lots of irritation. I did agree to a follow-up with the STDcheck.com doc at the additional fee to be prescribed meds and review the “positive” diagnosis tomorrow.

Questions:
-Based on what I’ve seen on the forum, this doesnt seem to present like Herpes..do you agree?
-Is there any value to retesting at AnyLabtestnow to see what they come up with? $50 seems reasonable to me for a reconfirm IF they don’t use LabCorp/Quest.
-What is the weekly increasing % of accurate result as we near the important 12 week mark? I am ok paying to test weekly/biweekly to monitor the increase in my result, if any.Thanks

[1ConcernedGuy]

Edit….my test was with Quest, not LabCorp.

[1ConcernedGuy]

Edit #2. I did get tested again at AnyLabtestnow, it went to Quest again, and came back negative. Still have the urethra very irritated and regular little pangs of pain throughout groin. Otherwise, no symptoms.

[Terri Warren]

I doubt that your symptoms are due to herpes, but given that 80% of those infected with HSV 2 don’t know they are infected, is it possible that a partner was positive and doesn’t know it? I’m wondering if the lubricant that was used is irritating to you – if it irritated your mouth, it is certainly possible that it irritated your urethra, right?

Terri

[1ConcernedGuy]

Thank you, Terri. There is certainly a good chance she did not know. She insists she has no symptoms and never has. Allergic reactions to lube definitely are possible based on what I read and align well. The .91 result continues to cause intense anxiety. One other thing, I have had frequent painful urination for over two years and been well examined/tested with no Diagnosis. Personal research has led me to believe I have urethral syndrome as symptoms line up exactly and pain generally stays localized at the tip.

I have set a time with you via Eclinic and the WB kit is in the mail. To close out this thread and hopefully help others with similar situations who are worried could you answer the following:

-Is long term painful urination common with HSV2?

-As the redness and irritation were pretty uniform around the tip and the dry skin was brief and uniform along the shaft, does that align with any cases you have seen? Or do you usually see more random “spots” of outbreak? Does “shedding” ever look like light skin peeling from a sunburn without there having been sores? The peeling lasted maybe a day.

-Older archived posts from the docs you have worked with seemed to suggest if there were no lesions/outbreak by ~14 days after encounter the likelihood of infection was low. Do you agree with this? When lesions are in the urethra, is there any way to truly know?

-With a .91 Equivocal 44 days after the encounter and a negative restest 46 days after what would you say my odds are of being truly positive? At some points you mentioned only one Equivocal ever being positive on WB…how far after the encounters were those WBs done? 16 weeks?

-If I dodge this bullet, can the WB be done regularly? The stress of an “Equivocal” or low positive is not something I wish on anyone and pauses life. I’d rather go for the gold standard test first and skip this time of uncertainty especially if I now have a tendency to trip the Equivocal marker.

Thank you.

[Terri Warren]

-Is long term painful urination common with HSV2?
No.

-As the redness and irritation were pretty uniform around the tip and the dry skin was brief and uniform along the shaft, does that align with any cases you have seen? Or do you usually see more random “spots” of outbreak? Does “shedding” ever look like light skin peeling from a sunburn without there having been sores? The peeling lasted maybe a day.

No, none of these sound like herpes. The skin peeling is far more consistent with a yeast (fungal) infection

-Older archived posts from the docs you have worked with seemed to suggest if there were no lesions/outbreak by ~14 days after encounter the likelihood of infection was low. Do you agree with this? When lesions are in the urethra, is there any way to truly know?

I don’t really agree with that because 80% of those infected don’t know they are infected. I would say IF someone is going to have symptoms with a first infection, it would happen within 2-10 days, possibly 14 days.

-With a .91 Equivocal 44 days after the encounter and a negative restest 46 days after what would you say my odds are of being truly positive? At some points you mentioned only one Equivocal ever being positive on WB…how far after the encounters were those WBs done? 16 weeks?

I think the odds are quite low. The western blot you ask about was done at 12 weeks after a concerning encounter.

-If I dodge this bullet, can the WB be done regularly? The stress of an “Equivocal” or low positive is not something I wish on anyone and pauses life. I’d rather go for the gold standard test first and skip this time of uncertainty especially if I now have a tendency to trip the Equivocal marker.

The western blot can be done by anyone, anytime, yes. And those people who test equivocal or low positive will always do that on the IgG test

Terri

[1ConcernedGuy]

Hi Terri,
Now that I am down this road and know every story detail could potentially help someone else who is worried I wanted to ask additional questions.   Again, I appreciate your efforts being a voice of calm, reason, and continued help.

I understand I may just be prone to tripping markers and have likely passed the usefulness of the IGG test now. That said, all HSV2 data points with two new ones (53 and 65 day results) since last post follow:

-IGG Test 4 days after encounter, NEGATIVE (I realize this is not a helpful data point, lab unknown)
-IGG Test 42 days after encounter, .91 EQUIVOCAL(Quest via STDcheck.com, paperwork and phone call to their counselor said I am positive and to see a doc)
-IGG (re)Test 44 days after encounter, NEGATIVE (Quest via Anylabtestnow)
-IGG Test 53 days after encounter, NEGATIVE @ .80 (local lab via Arcpoint)
-IGG Test 65 days after encounter, EQUIVOCAL @ .90 (Quest via Stdcheck.com, again told I’m positive)
-My WB specimen was delivered to your lab recently and I await results. 

Question 1-With the concerning vaginal encounter lasting ~15 minutes unprotected, and ASSUMING she is confirmed positive, where would you put my risk (% if possible) of having become infected? 

Question 2-With regards to the above consistent barely Equivocal results, where would you put my risk (% if possible) of being truly positive at 65 days out?
 
Question 3 -Is staying in this particular range for so long a good or bad sign?  Should it be going down if not infected?

Question 4-If negative, how accurate (% if possible) will the WB results be at 65 days post encounter? 

Question 5 – How often, in your experience, have you seen it ultimately take beyond 12 weeks (and up to 6 months) post exposure to test positive on the IGG AND the WB?

Thank you.

[Terri Warren]

Question 1-With the concerning vaginal encounter lasting ~15 minutes unprotected, and ASSUMING she is confirmed positive, where would you put my risk (% if possible) of having become infected?

probably around 1%

Question 2-With regards to the above consistent barely Equivocal results, where would you put my risk (% if possible) of being truly positive at 65 days out?

around 1%

Question 3 -Is staying in this particular range for so long a good or bad sign? Should it be going down if not infected?

It’s a good sign!

Question 4-If negative, how accurate (% if possible) will the WB results be at 65 days post encounter?

well, that’s hard to say. If positive of course you can rely upon it but negative, I would say maybe 70% reliability

Question 5 – How often, in your experience, have you seen it ultimately take beyond 12 weeks (and up to 6 months) post-exposure to test positive on the IGG AND the WB?

I’ve not seen that in people who have not taken antiviral medicine for longer than 2 weeks. I’ve had a handful of people in my life who don’t seroconvert by the blot but have positive swab tests

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