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Q. Herpes 1 and 2 IgG are on the higher side. Is it a matter of concern?

Answered by
Dr. Sushil Kakkar
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Nov 05, 2017 and last reviewed on: Sep 16, 2022

Hello doctor,

I accidentally touched the vaginal fluid of a sex worker two and a half months ago. I had cracked skin on my finger. It was a deep crack, but not a bleeding crack. So, I consulted a local doctor there. He gave me PEP medicines for 30 days. It was Teno-EM and Lamivir. Five weeks later, I did an HIV 1, 2, and P24 combo test. It was negative. I repeated the same test in the ninth week. It was also negative. Please advise how conclusive these tests are. Should I go for any other conclusive test? I am in the 10th week after exposure.

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#

Hello,

Welcome to icliniq.com.

I have noted your concern.

There was actually no need for PEP (post-exposure prophylaxis). The HIV (human immunodeficiency virus) virus does not enter through cracks, especially if it is more than a few hours old and is not freshly bleeding.

Nevertheless, your HIV screening tests are conclusive, and you do not need any further tests. The window period of the combo test (P24 antigen and HIV antibody test) is two to three weeks, and this screening test is reliable beyond this window after exposure.

Regards.

Thank you doctor,

I had a bath with her and inserted that cracked finger into her vagina. Also, I had unprotected oral sex with her. In my ninth week, HIV 1, 2, and P24 combo tests are negative. So, can it be considered conclusive, or do I have to go for any other test? Also, I request you to please go through my STD reports for the ninth week and advise. What is herpes 1 and 2 IgG? It is on the higher side. Is it a matter of concern?

#

Hello,

Welcome back to icliniq.com.

Unprotected oral sex, though it carries a lesser risk of HIV as compared to unprotected vaginal or anal sex, is not entirely safe.

You may do a 12-week HIV antibody test because though the combo test is reliable, it should be followed by a 12-week test for a conclusive result.

You have a herpes simplex virus (HSV) infection (oral or genital). IgG positive means that you have an old infection with HSV.

Do you have any history of cold sores or genital ulcers? Have you had other sexual partners in the past?

Regards.

Thank you doctor,

I will go for the test after the 12th week. I do not have any record of cold sores or genital ulcers. Also, I do not have any other partner. Very long ago, I once had unprotected sex with a colleague. Apart from that, I never had any unprotected sex except with my wife. Is this increased IgG a matter of concern? Is it curable? Should I take any medication? Is it infectious? Please advise.

#

Hello,

Welcome to icliniq.com.

The treatment for herpes is only required during a clinical episode of cold sores or genital sores and not otherwise.

Yes, genital herpes simplex virus can be passed on through sexual contact, and oro-labial herpes (cause of cold sores) can be passed through kissing. Therefore ideally, your wife should also test for HSV to see if she already has the virus or not.

Herpes simplex infection (oral or genital) can be clinically silent and may remain asymptomatic for months or years, and in a majority of the patients, it is detected for the first time only on lab testing. In those who have a clinical episode, it may present with either oral or labial sores (herpetic gingivostomatitis) or painful genital sores.

Regards.

Thank you doctor,

I am more worried now. I have not had unprotected sex with my wife since my exposure. Still, does she have to get tested? Cannot I start some medication instead?

#

Hello,

Welcome back to icliniq.com.

HSV can be passed on despite protected sex. Since you have HSV, your wife should also get tested for the same.

There is no need to take any medications unless you have a clinical episode of genital or oral herpes.

The IgG will stay positive for a lifetime. It is just a marker of past infection. Treating for herpes would not affect the IgG. It would still be detected.

Regards.

Hi doctor,

I had a test after 91 days, as we discussed over the phone. I am attaching my reports. Please look into it and advise. I did liver, kidney, VDRL, HSV 1/2, HIV 1/2, and P24 combo tests. As I took the PEP course for 30 days, is there a possibility that it could delay the HIV Infection? Do I have to wait for six months for a conclusive result? My HSV1+2 IgG is on the higher side. Should I take any medicine for this? Sometimes, I feel mild itching on my penis. What could be the reason? My primary concern is HIV. Can we consider the result final and conclusive? My 72-day HIV index value was 0.09, and the current index value is 0.1, which means there is an increase of 0.01. Why is there an increase? I hope it will not keep increasing to make my result positive after a few months.

#

Hi,

Welcome back to icliniq.com.

Your tests are fine (attachment removed to protect patient identity). If suppose you were infected with HIV and PEP had not worked, then most likely you would have tested positive at this point as seroconversion usually occurs one to three weeks after PEP is finished.

HSV type 1/2 IgG is just an indication of past Infection. It would always stay positive. No medication is required unless you have a clinical episode. Since you have a previous history of cold sores, you would need treatment only in case you develop a bout of cold sores in the future and not otherwise.

The index value is not an absolute value. It is always relative to the reference range (<0.9, 0.9-1.1, and >1.1) mentioned in the test. It does not matter whether it is in the upper or lower limit. We should look at where it falls as compared to the reference range.

Hi doctor,

Thanks for the reply. I understand that I should stop worrying about HIV and that no further tests are required. Can I be unprotected with my partner? If I get any health issues, Can I get regular treatment without explaining this incident? I read on the internet sources that after the PEP course, the window period is six months, and so I am a bit scared. Kindly advise.

#

Hi,

Welcome back to icliniq.com.

Yes, you can resume a healthy physical relationship with your partner. Please forget about HIV from this particular incident, and there is no need for a repeat test at six months.

Though you keep on getting tested, the result is not going to change.

Thank you.

Hi doctor,

I got a skin problem on my neck. It is itching and spreading all over the neck. I have attached the picture. Please have a look and advise what it is. Also, help me with some medicine. I got my HIV test done again after 118 days of exposure and 88 days after PEP, which came back negative. The report is attached. I am not able to kill my anxiety, and still thinking about it. Please advise me to go over it. My tension gets increases whenever I get any health issues.

#

Hi,

Welcome back to icliniq.com.

I have viewed the image (attachment removed to protect patient identity).

It is a sunlight-induced eruption on the back of your neck. It has nothing to do with HIV. I suggest you apply-

1. A topical potent steroid, Halobetasol propionate 0.05 % (Halovate cream), twice daily for two to four weeks.

2. In addition to this, you may take a tablet of Levocetirizine 5 mg (Teczine 5mg) once a day, in the evening, for symptomatic relief from itching.

Consult your specialist doctor, discuss with him or her and take the treatment with consent.

I have viewed the test report. It is absolutely fine. Your screening test is negative. Some of the literature does mention a 12-week screening test after completing PEP as confirmatory, so even that has been taken care of by your latest test at 88 days (after PEP). So now, there should be no doubt that you have HIV.

Thank you.

Hi doctor,

Please see the attached pics of my index fingers, I got the treatment done many times (allopathy/homeopathy), but I am not able to get rid of this skin problem. After medicine, it goes off, but after some time, it comes back again, now it is more than two years, this problem is still there.

I feel itching in that particular area, and sometimes the skin gets cracked as well. If I eat with my hands, then it feels like burning in my fingers. Right now, I have this in both my hands' index fingers, but I get the same patches in other fingers as well.

Please advise what this problem is and help me with some permanent solutions and precautions to be taken to avoid the recurrence.

Thanks

#

Hi,

Welcome back to icliniq.com.

I understand your concern.

I have viewed the images (attachments removed to protect patient identity).

You have hand eczema. I suggest you apply-

1. Cosalic ointment and Dipsalic-F ointment (mixed 1:1) twice daily for two to four weeks.

2. Use a moisturizer example- Moisturex cream, twice daily before applying the medicines.

It can recur. Soaps and dry/cold weather in winter can induce a flare-up.

Continue with the moisturizer even after these patches resolve, as that will prevent or reduce the chances of flare.

What all medicines have you used previously?

Regards

Hi doctor,

I use e-rikshaw from metro to office, last Wednesday I took an e-rikshaw, and after traveling about 700 to 800 meters, I felt a prick in my buttock, I checked on the seat but did not find anything, in the evening at home I checked my underpants no sign off blood found, I feel a little pain in buttock while I am seated. As I have a phobia of HIV, I thought of asking you, is it a matter of concern or just ignore it? Please advise.

#

Hi,

Welcome back to icliniq.com.

I understand your concern.

I do not think there is anything to worry about.

Firstly, the HIV virus does not survive outside the body for any length of time.

Secondly, even if it was a nail that you felt did not puncture deep enough; otherwise, you would have noticed a blood stain.

Thirdly, a nail is solid, unlike injection needles which are hollow and therefore carry less of a risk than hollow needles.

Take care.

Hi doctor,

For the last few months, I have had a pre-ejaculation problem. I can not stay for a minute. I am done in 8 to 10 in and out. Kindly advise some solution for it.

#

Hi,

Welcome back to icliniq.com.

I understand your concern.

You can try Lignocaine 2% gel application on glans 30 to 45 minutes before intercourse.

Take care

Hi doctor,

Thanks for the reply. Is this going to treat the problem, or do I have to use it every time before the intercourse? If yes, in that I would rather go for the treatment. Please suggest a better treatment for this solution as it is hampering my personal life.

#

Hi,

Welcome back to icliniq.com.

I understand your concern.

This is most likely a temporary problem, so lignocaine gel is worth a try. However, if you wish, you may take 1 Tentex royal tablet twice a day for three to four weeks.

Consult your doctor and take their consent before taking any medication.

Take care.

Hi doctor,

Thanks for the reply. I have been facing this problem for a long. I started taking an ayurvedic tablet a few days ago. Should I stop taking it? How much time will it take to treat the problem if I start taking this Tentex royal tablet? Is this the jelly you suggested to use- Xylocaine 2% Jelly, and can it be used for a longer period without any side effects?

#

Hi,

Welcome back to icliniq.com.

I understand your concern.

The jelly can be used repeatedly for as long as needed.

You may take Tentex royal tablet (Gokshura, Kokilaksha, Vathada, Sunishannaka, and Kumkuma) for three to four weeks to see if it works for you.

Take care.


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