From:
To:
askdrgian@gmail.com
Subject: herpes testing

Dear Dr. Gian, thank you in advance for your generous efforts and for having this website.

I have a somewhat vast knowledge of STD’s for a person not employed in the medical field. I was a teachers assistant in Health & Sex ed class while being a student for 5 years at the time. That was several years ago but i have tried to stay on top of new medical research and information just to keep myself educated and/or informed. I have done my best to protect myself against std’s. I have had minimal exposure, very few partners, and have been regularly tested since i became sexually active at 18. I am now 27 and have never had any diagnosis out of the ordinary(yeast,bv etc.)..but have always had abnormal pap smears (abnormal cells,dysplasia) even before being sexually active. My primary reason for writing to you is this following situation and i would like for you to recommend the absolute best test available based on the circumstances i will now share with; My boyfriend and i have been together in a committed monogamous relationship for over one year.

When we first began dating we were open and honest about our sexual history. As a protective measure, we both went to an STD clinic together to be tested for the usual package including HIV. We both received a clean bill of health at that time during the first month of our relationship. HOWEVER, to my knowledge a herpes test isnt normally performed in the state health dept clinics during routine testing, unless there is an outbreak of some sort visible on the skin during the time of visit. Even then, only a culture is usually performed as i am being told. A culture i have also been told can be very inconclusive and produce false negative or false positive results.

FINALLY..a few days ago my boyfriend approached me with a serious concern about a rash that had appeared on the base of his penis just below the pubic hair line …to me looked like a skin irritation (i saw it within the first 3 days of its showing up)…the very next day we went to the local state health dept clinic. They performed a culture or “biopsy” as they referred to it as, by scraping some skin and assured us it would be examined with results available in a few days. We have not yet received the results but dont necessarily feel comfortable with the extent of the exam or test that was applied (very rushed, unprofessional visit). NOW, since we have been together this amount of time with no prior incidents of symptoms or outbreak do you in your professional opinion think this is herpes we are dealing with? My body has a tendency to be very sensitive to things such as other peoples sweat etc., i was thinking that even if he had no known previous symptoms after me being sexually involved with him that i would have had a reaction of some form somewhere along the way??? Please bear with me on this…i dont have access to the best of resources personally but i need you to point me in the right direction. We wont have any peace of mind until we manage to have the best most recommended test out there -even if it is positive, we just want to know for sure. AND is it possible if he has it that i may not have fully contracted the actual virus yet?

One more thing, almost 2 years ago i had come down with flu-like symptoms and had enlarged lymph-nodes and of course went to the doctor. I was tested for chlamydia,gc,syph,and HIV, all came back negative but the doctors were a bit confused by my symptoms and ultimately prescribed a medication for a bacteria illness of the viral nature, in which the symptoms totally ceased and i have never felt anything similar or since. As i mentioned i never had a rash or lesion but could the scenario i described have been primary infection with herpes with no visible sores?

LAST but not least, i have done extensive research on different tests for HSV 1 and 2. To name a few Tzanck,POCkit,herpeselect,positive inhibition elisa, PCR, the western blot and the immunoblot, and the type specific serology blood test. We are not wealthy by any means, but we are willing to pay for a top notch test …please inform me which one is the most accurate (closest to 100% accuracy) and HOW and WHERE to obtain the test. Any other thoughts or recommendations from your angle on this matter are greatly appreciated.

Thank you and God Bless.

Hi,

Hmmmm!  Given your knowledge into this area of STD, I would not devalue, like you seem to be doing, your abnormal PAP test showing dysplasia and I would want to know more about that situation. I hope you had a Papilloma check. You seem to be concerned more about your partner rash and want to know about the best test for Herpes in this situation which seems a bit unclear.
How and Where? call 1-866-478-1347 and they will help you that question. If I had that question for myself I would do a Herpes 1&2 Western Blot test after the appropriate time (3-4 months) from exposure.

I hope this helps and God Bless you too.

Dr. Gian

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From:
Sent:
To: askdrgian@gmail.com
Subject: cmv or hiv
 
Hi

 Sir I thank you for your great work .Doc: I i fell in a problem that i do not know how can i getting rid of it And I want to ask you about something I really do not know the HIV status of the person, but her vagina was smelling very bad. And the smell of her mouth is bad and I had unsafe sex with her one time. after that about one week I feel every HIV symptoms . Headache and an rash on the legs and a pain in the muscles and a fatigue and pain of severe joints & pain of the armpits . I feel itch in the anus and I feel stings on the skin 

Then i started in the work of analyses to the AIDS disease after a month of the mistake. And the results were as the coming : hiv antibody = negative p24 antigen = negative then i do it long the first three month about 20 times all negative after three months i did p24 antigen = negative after 4 1/2 months i did PCR RNA <50 negative then i did antibody after six months : negative after that i did PCR RNA = <50 negative antibody after 8 months = negative Dr. i am still worry about symptoms pleas i need your help is that tests is definitive & decisive in 11 months. now i think i did 45 antibody tests for hiv all negative and 2 PCR RNA =<50 negative and 3 P24 antigen = negative 

Then I wonder why they speak about this virus (cmv) and speak at the same time about hiv . is that mean i need sometime to develop antibody for hiv And there was an infection by Staphylococcus bacteria .And i made a culture to the rash that appears on the body. And it was the same bacteria in the result(Staphylococcus )  And i made a test to the blood and there was an infection by Chlamydia. the test was igm/ titer : 12 then after six months I had test it is igm 18 positve. And he appears at me an inflammation in the form of Bthour with purulent top in the hair bulbs 

I hope the attention to this : 

i tested Syphilis Herpes And the hepatitis = negative And the symptoms are still continuous up till now And I felt shiver in the and when I distrain on my skin by my shirt at the facility that shows red lines under the skin The groan of a bleeding under the skin and an rash on the body and I feel sting in the thighsAnd i made a culture to the semen Now after 11and 1/2 months of this mistake By chance I had test for (cmv) Cytomegalovirus that test was igg positive = 454. and igm = negative then I used treatment It was Zovirax And I do same test for CMV after 2 weeks it came back igg 725 positive and igm negative . now I I use a treatment it is Valtrex 

And i want inform you i was use the masturbation or hand sex every day and when i cum i stop along 2 hours every day maybe 2 years ago. I think this is my problem the (cmv) Cytomegalovirus and Chlamydia is entering in the blood because I use the masturbation every day a long 2 years ago and when i cum i stop along 2 hours before that infection And I have now a pain in the prostate a long 10 months And the last test for hiv was after 11 months it was hiv igg+igm it came back negative 

Always physical tired along 12 months 

My question: 

1- – is this (cmv) Cytomegalovirus always with person who has hiv . Because I am a reading that in one of the sites I do not remember where specifically? Then i reading on one of the sites of a groan they must preserve your health well if I infect by this virus (cmv) so that they do not become sick with the AIDS . what does it mean ??? 

And i reading on the web if somebody infection by this virus (cmv) then it gives false negative for hiv test. 

2- is the muscles uprising or a shiver From the infection symptoms by hiv . Because i feel something is moving inside my body some time in legs and foot and hand and head 

3- now i think i did 45 antibody tests for hiv all negative . 2 PCR RNA =<50 negative . 3 P24 antigen = negative and hiv igg+ igm = negative 

Dr. i am still worry about symptoms pleas i need your help is that tests is definitive & decisive in 11 month for hiv 

And I need your advice about that (cmv) and Chlamydia and your advice about the cure 

Thank u Doc : I hope you answer 

Pleas send copy of your answer to my e-mail : 

Hi 

Question N.1 

I encourage to view the Movie on this blog  ”Sex in the City” and to reflect on HIV transmission and Herpes infections.  However per se the Cytomegalovirus, or CMV, is a very common and usually benign virus found universally throughout all geographic locations and socioeconomic groups, and infects between 50% and 85% of adults in the United States by 40 years of age.  CMV is also the virus most frequently transmitted to a developing child before birth. CMV infection is more widespread in developing countries and in areas of lower socioeconomic conditions. and  CMV is a member of the Herpes virus group, which includes Herpes Simplex virus types 1 and 2,  Varicella-Zoster virus (which causes chickenpox), and Epstein-Barr virus (which causes infectious mononucleosis). These viruses share a characteristic ability to remain dormant within the body over a long period. Initial CMV infection, which may have few symptoms, is always followed by a prolonged, unapparent infection during which the virus resides in cells without causing detectable damage or clinical illness. Severe impairment of the body’s immune system by medication or disease consistently reactivates the virus from the latent or dormant state.For most healthy persons who acquire CMV after birth there are few symptoms and no long-term health consequences. Some persons with symptoms experience a mono-like syndrome with prolonged fever, and a mild hepatitis. Once a person becomes infected, the virus remains alive, but usually dormant within that person’s body for life. Recurrent disease rarely occurs unless the person’s immune system is suppressed due to therapeutic drugs or disease. Therefore, for the vast majority of people, CMV infection is not a serious problem and I wonder if your treatment with Zovirax is really indicated However, CMV infection is important to certain high-risk groups. Major areas of concern are (1) the risk of infection to the unborn baby during pregnancy, (2) the risk of infection to people who work with children, and (3) the risk of infection to the Immuno compromised person, such as organ transplant recipients and persons infected with human immunodeficiency virus (HIV) in which the CMV infection is particularly virulent.

 Question n.2.
I do not think your symptoms are related to a possible HIV infection
 

Question N.3
After you 45 tests for HIV all negative I would close the case on HIV and move on with life. From other indications on your email it seems to me that you are a person of means. I would ask you to use those means to contribute to some HIV Prevention initiative in your area. 

Thank you 

Dr. Gian 

 
 
 

 

  
 
 

 

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From:
Sent:
To:
askdrgian@gmail.com
Subject: please help

a few years back right after loosing my virginity i ended up getting something from my second partner.. now i dont remember what it was but im old enough and wanting to marry now i need to find out if its treatable in anyway im pretty sure the gynocoligyst told me it was un treatable and will come in something like “break outs” its name was very confusing and i cant remember it although i know it either starts with a m or the letter m stood out in it.. i was thinking maybe when i saw a list trichomoniasis…? i cant remember. but i can explain it i dont have any irratation but i get bumps around the out side area of my vagina and the lip area… there almost like a pimple looking type of bump they got a sort of white head but if you try to squeeze them blood comes out nothing else. there pain ful and cause itching. i hope this is all understandable

thanks for your time and i hope you are able to help me!!

Hi,

“m” could stand for Molluscum Contagiosum. Click  our email Archives and you will find more info on this viral disease.

Dr. Gian

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