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Dear Terri,
I am a ~40yo female who recently tested positive for primary genital HSV-2 (ugh, the “bad” one!) by PCR swab, so no doubts about my diagnosis. However, I have read extensively about HSV ever since and still have a few assorted questions that I can’t seem to find answers to.
As background, I had sex with a male friend who said he had recently tested clean, as had I, but like me, we had both (until then) only tested for the Big Four, not HSV (we have since both tested for HSV-1/2 IgG antibodies, and I was negative for both at the time, so never previously infected, while he was positive for both…).
Anyway, there was a lot of vaginal sex, which was initially protected but ended up 2/3 unprotected (doh!), though limited only to that one night/morning because I came down with symptoms within 1-2 days, which brings me to my questions (can’t fit them all into this initial post):
Q1. Does HSV impair the immune system and its ability to fight off or overcome other viruses and infections, from the common cold/flu to HPV, etc., and does an HSV-2 and HPV co-infection make it easier to pass the latter, as is the case with HSV-2 and HIV?
Based on what my friend later told me, he has been exposed to HPV in the past via a long-term ex, so the latter is of particular concern, even if he has never had symptoms (I am very worried that he could have potentially transmitted both via our single encounter!).
Fyi, I have always tested negative for HPV previously and am most anxious about my next test, which I intend to do in about six months from exposure. Should I have HPV, I am hoping HSV-2 won’t hamper my body’s ability to clear it due to the increased cervical cancer risk of having both.
Q2. Once enough antibodies have been established (presumably in 3-4 months from infection), does genital HSV-2 “protect” a person from both genital *and* oral HSV-1? I know that secondary genital HSV-1 is basically unheard of, but I’m not so sure about oral HSV-1.
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As background, I had sex with a male friend who said he had recently tested clean, as had I, but like me, we had both (until then) only tested for the Big Four, not HSV (we have since both tested for HSV-1/2 IgG antibodies, and I was negative for both at the time, so never previously infected, while he was positive for both…).
Anyway, there was a lot of vaginal sex, which was initially protected but ended up 2/3 unprotected (doh!), though limited only to that one night/morning because I came down with symptoms within 1-2 days, which brings me to my questions (can’t fit them all into this initial post):
Q1. Does HSV impair the immune system and its ability to fight off or overcome other viruses and infections, from the common cold/flu to HPV, etc., and does an HSV-2 and HPV co-infection make it easier to pass the latter, as is the case with HSV-2 and HIV?
No, herpes does not impair the immune system. Not at all. There is some concern that if a person has a reactivation of HSV at the time they get exposed to HPV, they may be more vulnerable to acquiring HPV as there is broken tissue to enter more easily.
Based on what my friend later told me, he has been exposed to HPV in the past via a long-term ex, so the latter is of particular concern, even if he has never had symptoms (I am very worried that he could have potentially transmitted both via our single encounter!).
While that is possible, it is felt that by the time a person has had five sex partners in their lifetime, they likely have been infected with at least one type of HPV so if you do turn out to have HPV and you’ve had five partners, it could have come at any time. You will never know for sure.
Fyi, I have always tested negative for HPV previously and am most anxious about my next test, which I intend to do in about six months from exposure. Should I have HPV, I am hoping HSV-2 won’t hamper my body’s ability to clear it due to the increased cervical cancer risk of having both.
How old are you? Normally, women are not tested for HPV until age 30. There is no increased risk of cervical cancer with HSV, only with HPV and only with certain strains of HPV. Have you been vaccinated for HPV yet?
Q2. Once enough antibodies have been established (presumably in 3-4 months from infection), does genital HSV-2 “protect” a person from both genital *and* oral HSV-1? I know that secondary genital HSV-1 is basically unheard of, but I’m not so sure about oral HSV-1.
People who have HSV 2 first do not subsequently acquire HSV 1 in any location. The opposite is not true.
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Q3. I believe it was Dr Handsfield (on MedHelp) who said that the increased risk for HIV is 4x for those recently infected with HSV-2 and 2x for those with an established HSV-2 infection, but when is it considered “established” in this case? After 3-4 months, 6 months, a year, longer? Does an HPV co-infection further increase that risk?
I”m not sure where that research is coming from. The four times risk is well publicized, however I’ve not read a research study on established vs. new
Q4. Regarding future sex partners of unknown status, if a condom is properly used without incurring any slippage or breakage, is an HSV-2 positive woman at the same very low risk of acquiring HIV from a man (if infected) as if the genders were reversed?
Women are always more at risk of acquiring any STI than men due to being receptive with intercourse. I’m curious – would you have sex with someone who had not been tested for HIV infection? I’m guessing not and especially not now, right?
I have only seen men ask this question (also on MedHelp and answered by Dr Handsfield). I am concerned about the exposed skin at the base of a man’s penis, as I am not sure whether HIV can outwardly pass via microscopic skin breaks/lesions (herpetic or otherwise) in that area.
No, that is not a worry for HIV infection. HIV doesn’t come off of skin like herpes and HPV.Q5. Sex is to be avoided until the skin is fully healed after an outbreak, but what if there are a few stubborn papules that take forever to clear? The lesions that ulcerated on my inner labia/perineum healed pretty quickly, but I had 3-4 “bumps” (not blisters) under the hair on my pubic bone that took ages to go (I even stupidly tried to squeeze them to hurry things up!). All other symptoms had long cleared. Not sure when to consider myself outbreak-free in such a case.
Are you sure those are HSV? Perhaps they are not. Most often lesions heal at pretty much the same rate. And yes, certainly a good idea to avoid sex with any visible lesions, but you do know that is just a guideline and that shedding can occur at other times, right?
Q6. If antivirals are started almost immediately during a primary outbreak, is it possible to potentially limit the number of nerves et al. infected and thus reduce the odds/severity of subsequent outbreaks, whilst preventing the antibody count from ever reaching detectable levels?? A doctor told me this, but I have yet to find anything to back this up, so am curious – and if remotely true, also upset, because I didn’t start antivirals until quite late!!
No. That is not correct. None of that statement is correct.Apologies for the lengthy questions, and thank you so very much for your invaluable time and effort!
Terri
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No I don’t think the herpes has anything to do with all this and I think the EC does. WE have seen this disrupt periods for a while. Hang in there – it will resolve but it can take a while to get your hormones back on track.
Terri
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