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Re: Infection via broken skin
Mar 24, 2005

Re: Infection via broken skin

I would like to thank you for your reply dated Feb 9, 2005. I have done a STD test and the results are as follows:

HIV Non- Reactive (hoo-woo) Anti HCV Non-Reactive Candida Antibody Negative Chlamydia IgG Antibody Equivocal (0.92) HSV I IgG Antibody Mild Positive (3.12) HSV II IgG Antibody Low Positive (1.54)

I wonder whether my HIV result is reliable because of the presence of Chlamydia and HSV antibody. My test was done more than 3 months after my last exposure. I would greatly appreciate if you could kindly enlighten me on the following:

(1) What does Equivocal result mean? My doctor advised me to treat it as negative and no further test is required as I do not have any symptoms relating to Chlamydia.

(2) HSV I & II testing. I was also advised that due to the potential cross reactivity, the result of HSV II may not be conclusive. My doctors view was that I was exposed to HSV I but not necessarily HSV II since I have never had any associated symptoms. He advised me not to worry too much about it. Please advise what should I do, is there any other more specific test available?

(3) If I am exposed to both types and my wife is not infected, how to protect her from being infected. It seems to me that it is an impossible task as I have to refrain from kissing or having close physical contact with her for life.

(4) If unfortunately she is infected by me, would there be any risk of superinfection (like HIV) if we engage in kissing or unprotected sex ?

(5) Can I continue to donate blood?

(6) Where can I look for reliable sources of information on HSV. Is there any website like the body.com on HSV ?

I am sorry to have to bother you again. I am now under a different kind of stress, i.e. HSV instead of HIV.

I have today donated $2,000 to your Foundation as a token my appreciation for your help during the past months and as a support for the cause of your Foundation. As I wish to remain anonymous, please do not send the acknowledgement letter.

Thank you.

Good health and Good luck.

Broken skin and heart.

(Note: The donation is made via wire transfer from DBS bank (Singapore). It will take 3 working days to reach your Foundation).

.

Response from Dr. Frascino

Hello Broken Skin and Heart,

Welcome back to the Forum!

First off, congratulations on your negative HIV tests. WOO-HOO! I was delighted you finally got tested and received this excellent news!

Now on to your current questions:

0. Yes, your HIV test results are indeed reliable despite your equivocal chlamydia and mild/low positive HSV-1 and HSV-2 antibody tests.

1. Equivocal means that the test can't determine if you are truly positive or definitively negative. It's the gray zone in a test trying to differentiate black from white. There are many reasons why a specific test might be equivocal. Regarding chlamydia, your doctor is probably correct. However, it's also worth noting that chlamydia can be cured with a single dose of oral antibiotics. Consequently, if there is any doubt, I would err on the side of treatment.

2. Yes, there is some cross reactivity between HSV-1 and HSV-2 IgG antibodies. From your test results, I agree you most likely have been exposed to HSV-1 sometime in the past and have some cross reacting antibodies showing up on your HSV-2 testing. I do not believe any additional testing is warranted, nor do I believe you are HSV-2 infected.

3. According to the U.S. Centers for Disease Control and Prevention, HSV infection is very common. Almost 90 percent of Americans are HSV-1 infected, mostly through non-sexual contact, by the way. Approximately one out of every five Americans above the age of 12 is infected with HSV-2. As far as protecting your wife, we recommend that if you have early signs of a herpes outbreak or visible sores, you refrain from sex (intercourse and oral) until the signs are gone and/or the sores are completely healed. Using latex condoms also offers some protections, as HSV cannot pass through intact latex. If you were having recurrent bouts of genital herpes (and I realize you are not, by the way), oral anti-Herpes medications can help prevent transmission. In your case, without ever having had signs or symptoms of active herpes infection, I see no reason to refrain from kissing or having close physical contact with your wife.

4. No.

5. Yes, you can continue to donate blood if you have a positive herpes antibody test. This is not a problem.

6. There are a variety of sources from which to get additional information, including:

a. National Institutes for Allergy and Infectious Diseases. www.niaid.nih.gov/factsheets/stdherp.htm

b. National Herpes Resources Center. www.ashastd.org/hrc/index.html

c. Centers for Disease Control and Prevention. www.cdc.gov

d. American College of Obstetrics and Gynecologists. www.acog.org.

And for our readers who might be looking for a site that addresses HIV and HSV coinfection, I suggest http://hivinsite.ucsf.edu/InSite?page=kb-05-03-02#S1X

At this point I should point out, my friend, that it seems to me your current HSV stress is as equally unwarranted as was your HIV stress from last month! Chances are you are merely like 9 out of 10 of us and have blood work that indicates you had HSV-1 exposure in the past. Without symptoms, no special precautions are needed. OK?

Finally, thank you for your very generous contribution. Your compassion and desire has touched my heart and will touch the lives of many who are struggling desperately with the challenges of living with HIV/AIDS. Personally, on their behalf, please accept my heartfelt appreciation. Generally with donations of this size, in addition to sending a personalized thank-you letter, I include a token gift of appreciation from the Foundation; however, of course, we will certainly respect your wishes to remain absolutely anonymous and not send any communications to you. Please note that The Robert James Frascino AIDS Foundation is a 501(c)(3) California not-for-profit organization, whose sole mission is to provide crucial services for men, women, and children living with HIV/AIDS and to raise awareness of the HIV/AIDS epidemic through advocacy and education. In the year 2004, the virus killed 3 million people one person every 10 seconds. Over 40 million people are currently infected, five million of those infections occurring last year alone. In the midst of war, a troubled economy, and the massive redirection of resources, I am especially thankful to you for recognizing the ongoing tragedy of the World AIDS crisis and the critical efforts necessary to combat the pandemic. Your gift of $2000.00 will immeasurably impact the lives of people infected and affected by HIV/AIDS. Once again, I thank you for your extreme generosity. May the higher powers bless you with health, peace and contentment.

Dr. Bob



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