Lyme Disease and Virus

[Jubilee]

Dear Doctor, I am disabled with Lyme Disease and have been for 5 years. I am concerned about the complications of acquiring HSV Type 2 from my boyfriend. We have been dating for 9 months and in a sexual relationship for the last 5 months. I waited until I was on antibiotic treatment for the Lyme Disease before having sexual relations with him as I understand that can reduce the chance of sexual transmission of Lyme. Last month, my boyfriend divulged to me he has genital herpes. Sexual relations ceased for a month as I researched and then ultimately forgave him for this late self disclosure. He went to the doctor and was put on acyclovir 400 mg twice a day to reduce shedding of the virus. His blood test revealed HSV Type 2 Ab IgG (Index) 9.89. His infection had cleared by the time he had this blood test. He told me that it had been 5 years since his last outbreak. He contracted the infection 30 years ago. When he breaks out it is one spot about the size of a dime on the shaft of his penis and it lasts for a few days. I also had a blood test, mine came back neg HSV Type 2 index 0.230 and positive for HSV Type 1 Index 20.8. So he hasn’t given me the Type 2 infection. Friction will never be an issue, we have tried condoms and well I will use them as a last resort. He will stay on acyclovir while in relationship with me and I take it as well at the first sign of a cold sore on my lips and would be willing to take it every day as well. What do you think doc? Reducing risk of transmission is the issue here. Also, how high is the risk to me of increasing my viral load and complicating an already debilitating disease. I am not ending the relationship so I need to know risks to me in my health situation and what do you think of the strategies we are using to reduce transmission and are there any more we can employ. Oh one last piece of the puzzle, he was married for 20 years before being widowed and has told me that in all that time – his wife did not get the infection. Of course I know now that you can have it without a breakout. However, she went through 2 years of debilitating cancer treatment before she died. It seems that if she had an infection it would have made it self known in a breakout sometime during that 2 year time span. So there you have it. I look forward to your response.

[Terri Warren]

I honestly don’t know much as at all about Lyme disease and it’s impact on HSV acquisition. It can take up to four months from time of acquisition to time of antibody positivity so I’m not sure you can say at this point that you did not get herpes from him. That will always be a moving target for the two of you, the timing of tests, that is.

You taking acyclovir every day is not going to make a difference in acquisition, at least that we know about at this time.

It does seem unlikely that she became infected if she had no symptoms during cancer treatment. Sometimes, that is the first time that people find out they have herpes, when they are undergoing chemotherapy.
The longer people have herpes, the fewer recurrences they normally have and the less shedding that happens. If he is having an outbreak once every five years now, that’s pretty darn good!

Please free to ask me more questions as you think of them.

Terri

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