I have some concerns regarding the accuracy of tests for STD's. I have read on various sites of the prevalence of false negatives etc. from various tests due to their sensitivity not being 100%.
My exposure was unprotected oral (I am male). I realise that HIV testing is very accurate with few, if any false negatives, but have been suffering with continuous sores since this exposure and have been wondering about herpes and syphilis.
1. I had type specific herpes testing done 6 months post exposure, both negative. How accurate are these tests? I realise that they miss quite a few infections. (All these tests were done through TDL)
2. Syphilis IgM IgG @ 6 months as well, how accurate are these tests and would taking antibiotics early post exposure have affected the production of antibodies?
3. Is it possible where the only exposure was oral to the penis from female csw to develop lesions / symptoms around the anus (opening)? I was thinking herpes but I understand that, even if there were initial lesions missed on the penis, recurrence would be in the same dermatome S2 or S3 that does not involve the anus, is this correct? The sores do not seem to go. Do you think there can be any STD cause since the only risk was oral to the penis?
I have had testing for chlamydia, gonorrhoea and mycoplasma / ureaplasma. I understand that these pcr tests are very good and also HIV ab/ag @ 4 months post exposure which should also be OK.
I would be most grateful for your insight to put my mind at rest.
I do apologise - we had some glitches with the Forum when we upgraded the system which meant that we were unable to see that posts had been made - so sorry.
Anyway, you asked:-
Quote:
Dear Sean / Jose
I have some concerns regarding the accuracy of tests for STD's. I have read on various sites of the prevalence of false negatives etc. from various tests due to their sensitivity not being 100%.
My exposure was unprotected oral (I am male). I realise that HIV testing is very accurate with few, if any false negatives, but have been suffering with continuous sores since this exposure and have been wondering about herpes and syphilis.
1. I had type specific herpes testing done 6 months post exposure, both negative. How accurate are these tests? These are very accurate and at 6 months I would regard them as comfortably certain - you can of course repeat them but I would suggest that this would be a waste of money and time. I ma confident that the quality control at TDL is very goodI realise that they miss quite a few infections. (All these tests were done through TDL)
2. Syphilis IgM IgG @ 6 months as well, how accurate are these tests and would taking antibiotics early post exposure have affected the production of antibodies? If you had taken high doses of antibiotics very early on then the effect would be to deal with any developing syphilis before you had a chance to develop antibodies - in other words you might have cured it before it was detectable - if the antibiotics had failed then you would subsequently develop antibodies and certainly at six months these would be apparent.
3. Is it possible where the only exposure was oral to the penis from female csw to develop lesions / symptoms around the anus (opening)? I was thinking herpes but I understand that, even if there were initial lesions missed on the penis, recurrence would be in the same dermatome S2 or S3 that does not involve the anus, is this correct? not necessarily - but you have established already that you were not contaminated with herpes so the question is academicThe sores do not seem to go. Do you think there can be any STD cause since the only risk was oral to the penis?no - I think very unlikely.
I have had testing for chlamydia, gonorrhoea and mycoplasma / ureaplasma. I understand that these pcr tests are very good and also HIV ab/ag @ 4 months post exposure which should also be OK.
I would be most grateful for your insight to put my mind at rest.Hopefully this has reassured you - apologies again regarding the delay.
Could I finally just clarify two points regarding herpes from your answer.
1. You said that you would be happy with results of test for antibodies @ 6 months, however, I was concerned because with this likely to be HSV1 if present from an oral exposure, I have read that about 15% of people do not develop detectable antibodies to HSV1 - is this correct.
2. Secondly if it was HSV1 and the blood tests were not , the lesions anally are just inside / around the anal opening. I understand that this is the S5 dermatome area. I was under the impression that recurrences were always in the same dermatomal area as the exposure, i.e an initial exposure on the penis could recur on the buttocks or down the backs of the legs as well. Your answer has confused me slightly, can recurrences (without auto inoculation) be in different dermatomes?.
1. You said that you would be happy with results of test for antibodies @ 6 months, however, I was concerned because with this likely to be HSV1 if present from an oral exposure, I have read that about 15% of people do not develop detectable antibodies to HSV1 - is this correct.
You are worrying far to much about this - undoubtedly some people will have variations in their herpes antibody levels - but the figure of 15% in my mind is way too high. You are clearly not one of life's optimists - the likelihood of you developing anatomically distant herpes lesions from an oral exposure which also miraculously does not yield an expected positive for antibody testing is just enormously unlikely and I do not believe it to be an even remotely sensible scenario.
2. Secondly if it was HSV1 and the blood tests were not , the lesions anally are just inside / around the anal opening. I understand that this is the S5 dermatome area. I was under the impression that recurrences were always in the same dermatomal area as the exposure, i.e an initial exposure on the penis could recur on the buttocks or down the backs of the legs as well. Your answer has confused me slightly, can recurrences (without auto inoculation) be in different dermatomes?.the appearance of herpes simplex 1 can be anywhere on the body-if you have it - and the objective evidence for you is that you do not have it and that you are catastrophising unnecessarily. It can switch dermatomes. Again, I'm afraid I am not convinced by your hypothesis. I do not believe you were contaminated by herpes by the oral episode with a sex worker; or that you have consequential and anatomically remote lesions around your anus; or that you are one of a tiny minority who might show negative on herpes testing.
Many many thanks for your understanding and patience. This will be my last question I promise.
You said that it can switch dermatomes, this seems contrary to the literature and other information sources, it was not something I was aware of, I thought it resided in the nerve ganglia of acquisition? Do most recurrences occur near the site of acquisition?
All this occured soon after the oral exposure hence my linking together. I think I have convinced myself itwasthe cause. Just to finally put my mind at rest, are there any other viruses /conditions that could have been acquired and could be causing these symptoms?
Once again many thanks for your patience and I will not bother you further.
You said that it can switch dermatomes, this seems contrary to the literature and other information sources, it was not something I was aware of, I thought it resided in the nerve ganglia of acquisition? Do most recurrences occur near the site of acquisition?yes - but, herpes simplex 1 = cold sore virus can emerge elsewhere
All this occured soon after the oral exposure hence my linking together. I think I have convinced myself itwasthe cause. Just to finally put my mind at rest, are there any other viruses /conditions that could have been acquired and could be causing these symptoms?I don't think there's anything wrong with you except a pre-occupation with diseases - objectively you don't have anything physically wrong with you.
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