› Forums › Herpes Questions › HSV-2 and risk for HPV, HIV and other questions
- This topic has 9 replies, 2 voices, and was last updated 7 years, 3 months ago by Terri Warren.
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November 1, 2015 at 4:30 pm #10379Concerned & CuriousSpectator
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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November 1, 2015 at 4:40 pm #10381Concerned & CuriousSpectator
Just paid for my next round of questions, so that I can post everything in the one go:
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?
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?
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.
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.
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!!
Apologies for the lengthy questions, and thank you so very much for your invaluable time and effort!
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November 2, 2015 at 5:23 pm #10395Terri WarrenKeymaster
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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November 2, 2015 at 5:29 pm #10396Terri WarrenKeymaster
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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November 2, 2015 at 6:36 pm #10401Concerned & CuriousSpectator
Thank you for your prompt reply, Terri! And do let me know if I need to pay again.
So, just to clarify, him having both asymptomatic HSV-1/2 and HPV (assuming he has the latter) would not make it any easier/efficient than normal for HPV to be transmitted, and because I did not have HSV-2 at the time of exposure, I was also at no greater risk than normal from acquiring HPV from him (but am now, when lesions are present)?
And in case I ever test positive for HPV in the future, my body’s normal ability to clear the virus will be the same as if I did not have HSV-2?
Fyi, I am around 40yo, so have tested for HPV a few times in the past. I never thought to get Gardisil given my age, but I think I will now anyway, but want to wait for my next HPV test first and give my body time to adjust to HSV-2 before subjecting it to more things!
Yes, high-risk HPV is obviously the greatest risk factor for developing cervical cancer (HSV-2 alone has no bearing), but an HPV *and* HSV-2 co-infection is apparently linked to an elevated risk, according to at least one study (unless I misinterpreted it).
Regarding the increased risk for HIV, Dr Handsfield usually only quotes a 2x risk (not 4x), but then I saw the 4x risk in a different reply, where he differentiated between a recent and established HSV-2 infection, so I was curious. I will certainly be even more careful now, but just wanted to know how my risk has changed as a result of HSV-2. As an added precaution, I think I’d better arm myself with Magnum condoms, since they’re thicker and longer than normal ones!!
The bumps on my pubic bone were definitely not there before. They were the last to appear during my primary outbreak. A sanitary pad may have irritated the skin, causing them to erupt. Not sure. Anyway, squeezing them seems to have made most of them finally go, except for one, which is now semi-healing, but it’s already been one month! Arghhh, I hate our every bump/pimple in my genital area could now be herpes!! Lol
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November 2, 2015 at 6:45 pm #10402Concerned & CuriousSpectator
On the bright side, that doctor was misinformed, so I no longer feel like I missed the boat. Phew! Also, it’s very good to know that HSV-2 does not impair the immune system. Furthermore, I am now essentially protected against HSV-1. One small blessing to come out of this?! Lol
Anyway, many thanks for your answers! This forum has been extremely helpful and it’s truly an excellent service that you provide, both here and on MedHelp. :))
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November 3, 2015 at 11:01 pm #10424Concerned & CuriousSpectator
Help, I am now having abnormal vaginal bleeding as well, which is terrifying!!
I NEVER have abnormal vaginal bleeding, all Pap smears have been normal to date, and no HPV has ever been detected previously. I have not started menopause (only around 40yo), have regular but short-cycle periods, and am not on birth control.
After my encounter with the guy who gave me HSV-2 (and I fear possibly HPV) just over a month ago, I took emergency contraception immediately (2x Microgynon 30, then 2x again 12 hours later). That was about a week after my last normal period.
I got my first post-emergency contraception (EC) period more or less on time, with no spotting in between. Felt like a regular period. Then, about a week later, I got my period again, but this time heavier than normal with blood clots, which I thought was due to the timing of the EC.
This second post-EC period ended after the normal time, but I continued to spot brown until today, when a fair amount of red blood came out with stretchy mucous after I peed! I don’t know what’s going on and am terrified.
Fyi, I otherwise feel fine. No prodrome, no new visible bumps or blisters, even the stubborn ones have basically gone, so why am I bleeding again?? Is this due to HSV-2, HPV or both?
I am not on any meds at present and have been drinking nightly herbal teas, including liquorice root and St. John’s wort, but am not on birth control, so I don’t understand. Do you have any idea? Totally freaking out after calmly accepting my fate for weeks, and just want my body to go back to normal. 🙁
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November 3, 2015 at 11:17 pm #10425Concerned & CuriousSpectator
P.S. Which I thought my body had until the fresh vaginal bleeding today, which is only two weeks after my second post-EC period. So, in summary, unknowingly infected and took EC on Sep 30, one period on time (Oct 13), a period again one week after the other had finished (Oct 23), then new bleeding two weeks after that (Nov 4).
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November 4, 2015 at 5:20 pm #10441Concerned & CuriousSpectator
Update: Phew!! Saw my doctor, who examined me. Said everything looks normal inside, including my cervix, and that I am having a third period in a month! However, this has never happened to me before after taking EC. Could HSV-2 be making me more “sensitive” to the effects of EC?
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November 5, 2015 at 4:48 pm #10468Terri WarrenKeymaster
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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