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Dr Chip, A clarification for me on HSV-2 testing. My doctor…

Dr Chip,A clarification for me...
Dr Chip,A clarification for me on HSV-2 testing. My doctor said there was a high false positive rate because it looks like something else in the body, and they don’t recommend testing for it unless you have lesions. Do you know if the false negative rate is high? Or is a negative test conclusive and high rate of accuracy? My doctor wasn’t sure about the false negatives. Any research on that? Is a negative antibody test conclusive that they don’t have genital herpes?
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Answered in 13 minutes by:
8/3/2018
Dr. Chip
Dr. Chip, Doctor (MD)
Category: Health
Satisfied Customers: 38,324
Experience: Over 20 yrs of Family Practice
Verified

I disagree somewhat with that

It takes at least two to four weeks for someone exposed to HSV2 to seroconvert and have positive antibodies so an early test can be falsely negative so testing someone under two weeks after possible exposure wouldn't be sensible

But many people may have HSV2 and not have lesions for months to years so a positive test can be possible without any lesions

So I would test someone who's had multiple previous partners even if they never had lesions

Overall the false positives and negatives are fairly rare

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Customer reply replied 10 days ago
Ok, so a negative test is pretty conclusive? I’ve had four tests (inadvertently as they were part of a grouping of other std tests)...and were all negative, so that’s gotta be pretty much a a guarantee that I don’t have genital herpes?
Customer reply replied 10 days ago
Sometimes I get an irritation to the tip of my foreskin that can become red and eventually can crack my skin on occasion, but I think that’s balanitis? I wanted to make sure that wasn’t anything like herpes
Customer reply replied 10 days ago
that usually happens after not showering for a few days, and/or sometimes after flying, oddly enough.

With four negative tests it's conclusive you don't have herpes

And what you describe isn't herpes

Probably more of a dermatitis than balanitis

Sorry--had to be away from the computer

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Customer reply replied 10 days ago
Oh, don't apologize, you have a life too! This was a health professional at a reputable STD clinic that I go to for testing for routine maintenance or the occasional hyper vigilance :). Maybe it is just their protocol for such measures. The differing of opinions is difficult for me to comprehend and gives me anxiety at times, because it's seemingly contradictory at times.
Customer reply replied 10 days ago
They stated that people who are exposed to HSV-2 get a lesion within 10-12 days...and it's really obvious, painful and blistering as you have previously explained
Customer reply replied 10 days ago
The anxiety trigger, if you will, for me was the high false positive rate and that they weren't sure about the false negative rates...so then my guarantee that I don't have herpes because the tests were negative was seemingly thrown out the window...

They can get an outbreak that soon but as I said some people don't get their first for months or even years

The false negatives are usually because the test was done too soon

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Customer reply replied 10 days ago
I see, so if it was done in the proper time allotment- there wouldn't be false negatives?

No there wouldn't be

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Customer reply replied 10 days ago
You know that scenario I described when the stripper kissed myself and a few friends...that was three months prior to the last test, but you and a few others have confirmed that you couldn't get genital herpes that way..and someone described that because it doesn't travel through the blood, which made sense..so I shouldn't have to worry about getting it from kissing? regardless if they performed oral sex on someone that day or not...I guess that would be a stretch

You simply couldn't have gotten it with that scenario

And even so, a negative test three months later would be conclusively negative

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Customer reply replied 10 days ago
The confusion/anxiety was in their response, which was saying that they recommend four months and explained something about people who build antibodies slowly? Those would probably be special circumstances of someone with HIV, chemo, etc... I guess i'm just not sure why they stand by it if other doctors, such as yourself understand the seroconversion to be much faster than that
Customer reply replied 10 days ago
zero risk for genital herpes from kissing someone, regardless of if she performed oral sex recently or otherwise, just flat out doesn't happen that way, end of story?

The seroconversion on average doesn't take more than two months

Of course, there are always some exceptions to the rule but not in your case

And zero risk for genital herpes in your scenario

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Customer reply replied 10 days ago
ok, cool, thank you for that..
Customer reply replied 10 days ago
the dermatitis..just a quick question on that
Customer reply replied 10 days ago
It happens when i go camping, or don't shower for a few days...and sometimes even after flying or a decent night of drinking. It seems as if when I do the latter (fly, drink) I don't stop urine as readily and I can get a little leakage, which seems to cause the issue for me if I don't properly drain..
Customer reply replied 10 days ago
occasionally get be painful to retract foreskin
Customer reply replied 10 days ago
if the skin becomes rough and cracks a little- seem to notice more in winter with more dryness and when urine/wetness irritates...normal?

Pretty normal for dermatitis in that area--you can just use a moisturizer like Eucerin lotion for it

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Customer reply replied 10 days ago
Awesome, I'll consider that
Customer reply replied 10 days ago
In your opinion, are people just covering their butts by saying 4 months for that test? Say, maybe it happened to one person or something, but rarely happens, so because of that they just extended the timeline?

Covering their butts really

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Customer reply replied 10 days ago
that doctor is an epidemiologists who said that and does work for the company selling the test kits...and said they recommend that people test at 5-6 weeks, which is what their website says, yet says that to me over the phone.

Just covering his backside

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Customer reply replied 10 days ago
He did say it was more on the are side and only for people who make antibodies slowly...I can only imagine that would only be in cases of HIV, Chemo, etc... wouldn't you? if there was a scenario
Customer reply replied 10 days ago
honestly, that's what I thought, we all do that from time to time, especially if you're representing a larger company or a broad spectrum
Customer reply replied 10 days ago
which they were

Yes--damaged immune systems with HIV, chemo, etc can be slow to respond

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Customer reply replied 10 days ago
Even with that, 12 weeks should be plenty of time for anyone to respond as you mentioned

More than enough time

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Customer reply replied 10 days ago
Thank you for your time as always.
Customer reply replied 10 days ago
sorry, one last thing
Customer reply replied 10 days ago
Even if someone hadn't had a breakout of genital herpes, it would still show up positive on the test as them having it without any prior visible symptoms?

Yes--if they had been infected with the virus it would show positive of the test even if they'd never had a breakout

Dr. Chip
Dr. Chip, Doctor (MD)
Category: Health
Satisfied Customers: 38,324
Experience: Over 20 yrs of Family Practice
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Customer reply replied 10 days ago
Thanks man, have a great one!
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