Western Blot Test Request

[PFDtossaway]

Good day Terri,

Thank you for all that you do with this forum.

I recently had protected vaginal intercourse with a high risk partner (November 10th). During this intercourse I ensured the condom was fully unravelled and covering as much of the penis as possible. I also ensured there was very little/if any contact with unprotected skin at the base but who knows.

Shortly after this event, I noticed a small pea sized lump near my anus, which left sub-dermal. I assumed a blocked pore or something of that manner. I did not squeeze it. After a few days (4-5) it seemed to disappear however a small sore was present in its place. As it was hard to see, I didn’t notice if it was a blister or ulcer. This sore remained for about a week or so then healed and disappeared. Worried this could be syphilis, I took a STI panel including HSV-1&2 (igg) 10 days after the encounter. All came back negative.

About 3 months before the aforementioned PIV encounter, I did receive unprotected anal-oral sex.

About two weeks after the protected PIV encounter I started to experience sciatic-type symptoms in my left leg. Everything from low back pain to aching leg pain and tingling foot.
This sciatic type pain has lasted over four weeks and is on-going.

My questions;

1. If this is GHSV-1 from the unprotected oral-anal encounter, would all these symptoms show up 3 months after infection and seemingly be the initial outbreak?

2. If this is HSV-2 from the protected PIV encounter, would the initial outbreak show up on my anus when there was no anal contact whatsoever? I have read that the first outbreak typically shows up at site of infection (where the virus entered the body). True?

3. Would an initial outbreak cause sciatic type symptoms for 4+ weeks continuously?

Lastly, I plan to retest(igg) at week 8 post encounter, but would like to request a Western Blot at 12 weeks which would be Feb 2nd or later. I live north of the Washington/BC boarder and can drive down to UW for the blood draw

[PFDtossaway]

I should clarify that I am male.

[Terri Warren]

1. If this is GHSV-1 from the unprotected oral-anal encounter, would all these symptoms show up 3 months after infection and seemingly be the initial outbreak?
That seems very unlikely to me but not impossible. You could have had it years before and this was a recurrence. Do you know through testing that you have HSV 1 infection?

2. If this is HSV-2 from the protected PIV encounter, would the initial outbreak show up on my anus when there was no anal contact whatsoever? I have read that the first outbreak typically shows up at site of infection (where the virus entered the body). True?
Ture

3. Would an initial outbreak cause sciatic type symptoms for 4+ weeks continuously?
Probably not, no , quite unlikely

Terri

[PFDtossaway]

Thank you for the prompt response Terri. Very much appreciated

All HSV testing (igg) I have had throughout the years (approx 6 tests) have come back negative and I have never had any noticeable symptoms, until now. As we know, I could be in the 30% of missed infections via igg testing.

Would it be unusual for a herpes outbreak to present initially as a single hard sub-dermal pea size lump, then manifest into a small sore 5 days later? This certainly did not feel like the classic squishy soft blister.

I will reach out to you for a consultation so we can arrange a WB test at UW to confirm. Can you please let me know the best way to do this? I am in Canada and will not be proceeding through my PCP or insurance provider.

Again, thank you very much for the quick response, especially during the holidays.

[Terri Warren]

The test could have missed 30% of HSV 1 infections, not HSV 2. That misses 8%.
Yes, that presentation does not sound classically like herpes.
First, you need to call UW at 206-685-6066 and ask how to get the kit shipped to you in Canada. There is a way, I know.
Next, we need to have a video conference, but I am going to be out of the country for a month starting January 14 and I don’t know what kind of internet we will have – we’ll be in a fairly remote part of Asia – but I’ll be opening up dates when I know the status of that.

Terri

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