quick question

Can HPV 1 make it eazier to contract :HIV

[Teak]

I really don't see how a non-genital wart would make it easier to transmit HIV. Contact your dermatologist and ask.

[D1955]

I meant HSV1

[Teak]

Now, that is a big difference. The answer is no, what you do need to concern yourself with is HSV2. I thought that you might be talking about HSV1 but there is an HPV 1,2 and 4.

[D1955]

Thanks because all my other std tests came back negative except HSV1

[Teak]

Over three quarters of the population has HSV1, you could have been born with it or you could have got it as easy as from kissing. Stress can bring an outbreak on quicker than anything, along with little things like the common cold. It's nothing to be concerned about. Just don't do a lot smooching when you have an outbreak. Not only can you give it to others, but those little suckers sometimes hurt. :)

[monkeyflower]

Genital or oral HSV1? If you get cold sores, you can assume it's just oral, and you can relax about an increased HIV risk.

If you have HSV1 genitally, you are at a somewhat increased risk, but I'd think not nearly as much as someone who has genital HSV2. Typically genital HSV1 results in much fewer outbreaks/less asymptomatic shedding (which is what increases the risk of HIV).

I definitely would NOT stress out about this, though. I'm quite sure your risks are minimal at best regardless :-)

[strata]

Regardless of whether it's HSV-1 or HSV-2 or located genitally or orally (you can have either type in either location), you'd be at an increased risk for HIV transmission ONLY if you had open sores at the time of exposure...

...and I'm hoping that you wouldn't be having sex with someone, protected or otherwise, during an active outbreak.

[monkeyflower]

No, the risks are increased regardless. That's due to asymptomatic shedding, where you have microscopic breaks in the skin (that's also why you can get herpes even when your partner is not having an obvious outbreak). Genital HSV1 is not as prone to either recurrent outbreaks or asymptomatic shedding, so I'd think it would be a much lower risk. Just how much lower, I don't know, but you could post to Dr. Handsfield on the STD board for more info.

Regardless, it's not something to worry about.

[dumbo]

Not true.  Simply having the virus in your system increases the odds of transmission.  Dr. H has said this before....I wish I could remember what post.  I will try to find them and show you.

[strata]

dumbo & monkeyflower,

If you can refer me to any sources that state that asymptomatic shedding of HSV increases the risk of ACQUIRING HIV, please post them.

I've never read this and have not been able to find any references this evening after I read your posts.

There is definitely a CORRELATION between HIV and HSV-2 (a large portion of the HIV+ community is co-infected with HSV-2, which is also fairly prevalent in the HIV- community), and some studies indicate that co-infection with HIV and HSV-2 can lead to higher viral loads and thus greater predilection for HIV TRANSMISSION, but I can't find anything about asymptomatic HSV and a greater risk of HIV ACQUISITION.

monkeyflower - the statement about 'microscopic breaks in the skin' seems incorrect. While _HSV_ can be transmitted by skin-skin contact and can enter the body through microscopic tears in the mucosal lining or genital skin, HIV is not transmitted by skin-skin contact.

[monkeyflower]

http://www.dph.sf.ca.us/sfcityclinic/stdbasics/herpes.asp

"The open sores of herpes do play a role in the spread of HIV. A person with a herpes sore is three to five times more likely to acquire HIV if exposed to an HIV-positive sex partner. Also, people with HIV and herpes have an increased amount of HIV fluid in their open herpes sores, which increases the risk of transmitting both diseases to a partner during unprotected sex."

But sometimes you don't *know* you have "open sores"...

From http://www.westoverheights.com/freebooktext.html:

"Virus can be given off from the genital skin of both men and women with no sores, through microscopic breaks in the skin. This is called asymptomatic shedding of the virus; giving off the virus from the body with no apparent symptoms. The more sensitive our virus detection methods become, the more viral shedding we can identify. Shedding rates vary, based on location of virus and type of virus. The chart below is a guideline about how often shedding happens in healthy adults.

HSV 2 genital 15-20% of days evaluated

HSV 1 genital 3-5% of days evaluated

HSV 1 oral 18% of days evaluated

HSV 2 oral 1 % of days evaluated

We know that up to 70% of new cases of herpes are transmitted from someone showing no apparent symptoms at the time they infect their partner. Research has shown that asymptomatic shedding occurs more frequently during the first year of having herpes than it does subsequently."

The increase in risk of contracting HIV among folks with HSV appears to be due to breaks in the skin, whether obvious or not. There's lots of info out there on this. Dr. Handsfield has even discussed it in the past on the STD board. :-)

[strata]

I'm still not convinced, and I don't think the information in your last post provides sufficient evidence for your conclusion. "Open sores" are open sores, and asymptomatic shedding is ASYMPTOMATIC, i.e., there are no active sores.

I don't think there's any disagreement that SYMPTOMATIC herpes (i.e., open sores) increase the risk of both HIV transmission and acquisition. Nor is there any disagreement that herpes infection in an HIV+ patient can increase the risk for TRANSMISSION to the uninfected partner.

But I'm still not convinced that asymptomatic shedding in an HSV-2+/HIV- person increases that person's risk for HIV acquisition.

Obviously, I could be wrong. But I can't find any of Dr HHH posts regarding this or other sites that support this idea. If you can provide a link to a thread were he discusses it, I'd greatly appreciate.

[monkeyflower]

Here ya go... I can't figure out how to post a link, so I cut and pasted the info. I was actually the one who asked the question:

me: On a related note, I just read about a clinical trial on the role of suppressive therapy in reducing the chances of contracting HIV. I'm interested in just how having HSV can increase the risk of contracting HIV. Is it through open lesions only (breaks in the skin), or are you at higher risk regardless of outbreaks? What about during asymptomatic shedding? Or is it possibly just a matter of risky behavior, i.e. if you have HSV2, chances are you've had more partners, unprotected sex, etc.? Thanks - as always :-)

HHH: It is much more than just risky behavior. The HSV link with HIV transmission is due to unnoticed (perhaps microscopic) breaks in the skin or mucous membranes, plus the fact that inflammatory cells that come to HSV lesions are loaded with HIV (if the herpes-infected person is HIV+), and are especially susceptible to HIV if exposed.

Suppressive antiviral therapy in herpes is a very personal decision; there are no clear guidelines for health professionals that say "definitely yes" in one situation or "definitely no" in another. Suppressive HSV therapy would reduce your risk of transmitting HSV-2 to partners. It is a reasonably good bet it would also reduce the risk of catching HIV, but that isn't proven; a $30 million research study (funded by NIH plus the Gates Foundation) currently is underway in several countries to answer exactly that question.

Regards-- HHH, MD

[dumbo]

Believe it or don't.  Simply having HSV in your system increases HIV transmission risk.....but if it is already a low risk then a risk even double zero is still zero.

Having HSV can bring certain cells, that HIV needs to "find" in order to infect, can be at surface without the presence of active HSV (i.e. open sores)

I can't find the specific post where I read this from Dr.h but he has said it before.

[strata]

monkeyflower - I stand corrected. Thank you for sharing the post.

dumbo - "Believe it or don't"?!?
I thought it was fairly clear that I wasn't trying to be belligerent; I was simply asking for a reference to support the statements about an HSV+/HIV- person being at greater risk for HIV infection, even during asymptomatic shedding. I didn't think my request was all that unreasonable.

I would never expect anyone on this forum to simply take MY word for something, and I have often provided links to posts by Dr HHH, other medical experts, or medical studies (from NIH, CDC, and elsewhere) to support my opinions.