Brief Answer: Kindly elaborate few points Detailed Answer: Hello, Welcome and thanks for posting your query to the forum. I can understand your concern for your friend's results regarding HSV 1 & 2. Though you have tried to provide the best possible details but I request you to provide me certain more details. - Have your friend experienced any type of skin lesions like any fluid filled vesicles around mouth or at penile site any time after the act or in past. - Have your friend had used protection in form of condoms at the time of fellatio. Hope to hear son from your side. Regards, Dr Sanjay Kumar Kanodia (MD- Dermatology & Sexually Transmitted Diseases)

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Brief Answer: Less chances of HSV-2; wait for 2 weeks Detailed Answer: Hello young fellow, Thanks a lot for adding informations so that now I can help you best regarding your friend's situation. Before I directly come on your query, let me explain you simply about certain important things regarding herpes - To tell you medically - Herpes lesions manifest itself as small vesicles (fluid filled blisters) which remains for just a day or two and then forms ulcers which are quite painful. These ulcers then heal in next 5-7 days. To begin with also these vesicles are quite painful and itchy with discomfort and once the vesicles burst in a day or two then the ulcers which are formed are quite painful for next 4-5 days. So the symptoms can never go unnoticed. It is typically seen as "fluid filled multiple vesicles present closely in a grouped manner" which you can see on net as a ready reference. There are two types of herpes – one is on lips which is caused by HSV-1 and the other is on genital area caused by HSV-2. Accordingly, there are antibodies for these i.e IgM denoting recent infection (less than few weeks to months) and Ig G denoting past infection (more than few months). Many a times, we see that IgG is positive in cases where there is no clinical evidence of disease is present and shows that there had been subclinical episode was present. In herpes there is incubation period (period from exposure to the clinical appearance of herpes vesicles) is 2-7 days. It may be delayed for weeks also. It is a sole fact that the herpes antibodies must come positive within days after the clinical appearance of herpes lesions/ vesicles. There are certain cases where the incubation period or we say the appearance of lesion may get delayed to few weeks. In these cases the IgM antibody or the test result may not show positive status accordingly for few weeks. So getting all these important information we can make out certain important points: - Your friend do have HSV-1 infection which is also depicted by the positive Ig G status. It is a infection which was present before the infection and there is no correlation of HSV-1 and its reports with the latest unprotected exposure. Therefore you need not to correlate the positive Ig G report of HSV-1 with the last incidence. - At present your after 12 days of exposure your friend do not have HSV-2 infection as depicted by HSV-2 IgM : Negative / HSV-2 IgG : Negative. It is a very good sign that even after 12 days of exposure your friend did not manifested any clinical sign of herpes because in most of the cases of genital herpes we find the eruptions within a week period. Therefore the chances of getting infection is on least of the side. - To be 100 % sure we have to wait for around another 2 weeks of period because we consider the safer limit to be around 4 weeks period where the infection may get delayed. But as I said above in my clinical experience if the test is negative at 12 days then the chances of getting the infection is on least of side. There is no need to go for further testing. The only part is wait and watch for any eruption in next 2 weeks which in my experience is less likely. I hope these informations will help you. I will be glad to answer any further of your queries. Regards, Dr Sanjay Kumar Kanodia (MD- Dermatology & Sexually Transmitted Diseases)

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Brief Answer: Majority of hereps cases presents within 7 day Detailed Answer: Dear young fellow, Thanks for your regards and further follow up. Regarding your further queries: As I said previously, there are least of chances of occurrence of genital herpes (HSV-2). In most of the cases of genital herpes we observe that the eruptions occur within 7 days of exposure. If the eruptions do not appear within 7-14 days then the chances of eruption of herpes are on least of side. You can also get that the eruptions and the ulcers of genital herpes are so frankly present that we can not miss it. So the eruptions never can go unnoticed and are always frankly present if at all the infection is caught clinically. So in the present case you should not be worried about the possibility of herpes. The 4 weeks of period is taken theoretically as safer limit as in very few percentage of cases may manifest itself in around 4 weeks. But as I said in my own clinical experience I have seen cases to present within 7 days ( majority) to maximum 14 days (in very few percentage of patients) and never after 14 days. So accordingly on my own clinical experience I have suggested that the chances of herpes is least likely in present condition. I hope these informations will help you. I will be glad to answer any further of your queries or if not then can close the query and rate the answer. Regards, Dr Sanjay Kumar Kanodia (MD- Dermatology & Sexually Transmitted Diseases)

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