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HSV2 and Immune system suppressing drugs
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HSV2 and Immune system suppressing drugs

I was just diagnosed with HSV2. I knew I had a risk of getting it because my ex-husband had it. For four years, he did a good job of paying attention to if he was having an outbreak, and I never got it. Then one day he got mad at me, decided he didn't care anymore if I got it because he already had it (he told me this after I called him and told him I got it), and so he had sex with me knowing he had sores. I didn't know it. And it was the last time we'd had sex before I asked him for a divorce. This was almost a year ago. I never had a symptom/break out, I didn't know I had it. I'd been tested probably about two weeks before that last encounter and it was clean. I stopped thinking about it. I now have a boyfriend, and we've been intimate, and unprotected. I got my last blood screen back the day after we'd had sex for the first time, if it would've come back one day sooner... yes I know it was irresponsible to not use protection, please don't lecture me. Our biggest problem is that my boyfriend has rheumatoid arthritis, and he is on immune system suppressing drugs. I've read so many different things that say it's not a big deal, to it could be life threatening for him. He is trying to decide if it's worth the risk to stay with me. Yes, we've both read the statistics about the transmission rates, and my doctor put me on Valtrex even though I've never had an outbreak. He is getting tested, but I think it's too early for it to show up. We had sex on Saturday, and I got my test results on Monday. I am trying to deal with having it, and I'm also having to deal with the guilt of not knowing if I could have passed him something that for me is annoying, but for him could be deadly. Does anyone know anything about what could happen to him if he gets it?
Tags: Immune System Suppressing Drug
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Avatar_m_tn
My wife has HSV2 and we both had it before we married although she was probably my source. That made things a lot easier. It has been a long time and like you I had issues dating. However people were willing to look past it even with the limited information that we available back when, there was pretty much just scaremongering.it will come down to how informed your partners are and how calmly and rationally you educate them.
20 Comments Post a Comment
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3149845_tn?1386354841
Hi, i think it would be a good idea to post this in the paid expert forum and ask a doctor for advise. There are 2 doctors here and both very experienced in these issues one is doctor HHH. I believe there is a small fee but the info will well be worth their expertise. Post it in the std expert forum.
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Avatar_m_tn
I agree we have no comment in the arthritis related issue.

What was the testing you had done and what were the results??
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Avatar_f_tn
PCR blood test. My doctor always checked because my ex had it. It came back positive this time. When I was pregnant he put me on valtrex two weeks before my due date, just in case I got it in between my last test and giving birth.
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Avatar_m_tn
PCR blood test?? I have heard and seen doctors do this, but as HSV is not blood borne it is not a particularly useful test at all. I do believe there are rare occasions with initial infections where it may be found in the blood, but you are the first person I have ever heard of to test positive in this way.

I would seek another professional opinion, but really you have nothing to lose in following up with an IgG antibody test for HSV2.
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Avatar_f_tn
I sort of freaked out when he told me the results (since I knew I'd had unprotected sex just a couple of days before) and asked if they could be wrong. He told me that the PCR test is the most accurate.

I did find that someone posted a similar question already in the paid forums, it was a reverse situation- the man had HSV2 and his girlfriend had RA. The answer was:

"The risk of HSV transmission to your partner probably is quite low, regardless of her rheumatoid arthritis or the treatment for it.  I am unaware of any evidence that either RA or immunosuppressive therapy increases the risk of acquiring HSV if exposed, although immunosuppression might increase the risk of more severe symptoms once transmission occurs.

Just as the frequency of symptomatic outbreaks declines with time, so does asymptomatic viral shedding.  However, there are no useful data to predict how frequently you might be having asymptomatic shedding at this time and it makes sense to take precautions to protect your partner.  An important step in that is for her to be tested for HSV-2.  (This assumes your genital herpes is due to HSV-2, which is highly likely.)  As a sexually active adult, there is a 20-25% chance she already has it (if you live in the US) - in which case, there probably is no significant risk of a new infection.

If her blood test is negative, showing she is susceptible, then you can consider the various options:  avoidance of sex if/when you have symptoms, condoms, and antiviral therapy.  But as noted above, the risk of transmission might be quite low - but there is no practical way to know for sure."

I wasn't worried about if it made it easier to pass it to him, I was/am worried about how serious it could be if he gets it. There are some serious things I've found, like meningoencephalitis... it's usually caused by HSV1, but in some cases HSV2. I am in love with this man. Four days ago we were planning our future together... but if this could be something that serious for him, he said he would have to determine if staying with me is worth the risk of leaving his children without a father. This is the hardest thing I've ever gone through. For most people it's just a nuisance, for him it could be far worse. I hate this. I hate my ex for knowingly giving it to me.
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3149845_tn?1386354841
Fleetwood is correct about the pcr blood test. Its a more precise test than a culture but is from a swab of a sore or scrapping not blood. You really need to confirm this. Fleetwoods very sharp to ask you for test verification.!!
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Avatar_f_tn
Wouldn't it be more likely to come back negative if it wasn't accurate?
I made an appointment though anyway- my doc will be pretty annoyed that I'm asking him to re-test, but if by some miracle I don't have it (given my ex's confession) it would be obviously good to know.
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Avatar_m_tn
The issues I'm raising for you and other readers are about diagnosis method, not necessarily whether you do or don't have the virus.

HSV is not blood borne and an infection will not necessarily be detected in the blood. Hence a negative PCR blood test for HSV is not evidence of a lack of infection. You can be infected and more often than not have a negative PCR blood test. Thus you may have been infected longer than just prior to a positive test using this method.

It is difficult to consider why you'd have HSV DNA in your blood if you indeed were not infected so it is reasonable to conclude that you are. Hence a retest is probably not required. If it were me though, I'd want to see the results of the IgG antibodies for HSV1 and HSV2, this is the retest you should consider.
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Avatar_f_tn
Thank you for the advice and information. I hate that a relationship that has zero problems is very likely to be over because my ex was a jerk. I know I'm grasping at straws with the re-test... I'm just very sad right now. Telling my boyfriend was the hardest thing I've ever done, and the thought of having to ever tell someone else if he and I break up, and I ever want to have another relationship with someone is very difficult for me to deal with.

I've read so many things on here where people comment "if that person loves you they'll stay with you, it's just an inconvenience" and all the other things they say to help you feel better about it. But he does love me- it's not just an inconvenience for him though. Meningoencephalitis could kill him. His suppressed immune system makes this a whole different ball game than most people have to consider when it comes to staying in a relationship with someone that has herpes.
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Avatar_m_tn
I just don't feel there is enough of a relationship between herpes and your partners condition. I always thought those conditions were related to an over active immune system attacking the body and not a suppressed one. Encephalitis can kill anyone although kills just about no one and it usually comes from viruses that are already in the body.

Still it is this partner's choice and his life and the fact that you put his health above your happiness speaks volumes for the person you are. Many men will gladly couple with you regardless of any condition you have.
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Avatar_f_tn
His immune system is over-active, hence the rheumatoid arthritis. It's the drugs he takes for that, they suppress his immune system to stop it from attacking his joints. If he gets a cold, it's significantly worse for him than most people.
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Avatar_f_tn
So, my doctor said my body suppresses the virus very well, that my viral count doesn't even register, and with the fact that I've not had an outbreak in the entire year since I've gotten it, he said I would've never known.

He said because the virus is inactive my boyfriend doesn't really have much to worry about, but he said he'd keep me on the suppressor to keep it inactive. But I thought it could shed whenever- even with a suppressor... I'm confused. And I'm sort of surprised at how casual my doctor is about it. He actually said "I won't say it's impossible for you to give it to him, but it's as close 0% as it can be. He has nothing to worry about." He said condoms would even really be unnecessary. In part because they don't really help all that much when it comes to herpes, but mostly because of how well the virus is being suppressed by my body, plus the addition of the suppressor. He said even with the immune system suppressing drugs, the chance that it could be something serious for him, in the remotest chance that he gets it, he could take the same suppressor and it won't be any more serious for him than most people.

Is it weird that my doctor is so confident about this? And so casual really? I've read some things that say with the suppressor the chance of passing it is less than 1%. I've read other things that say it only cuts the risk by about 50% (which, I suppose if the rate of chance is 4%-2%, that would be 2%-1%...). Is it really THAT easy to manage? I guess my ex and I went 4 years with him not taking anything and just paying attention... I only got it because he did it on purpose.

You would think this is all good news, but my boyfriend is still not sure he can deal with it. Makes me very sad. I'm afraid if he can't deal with it, no one will ever be able to deal with it. I know it's the stigma more than the actual problem itself.
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Avatar_m_tn
I still feel it is worthwhile getting an IgG antibody blood test for HSV1 and HSV2.

Your doctor is being a little optimistic here, but not overly so. Given you are aware of your infection and will avoid outbreaks, there is a 5% per annum chance of infecting your partner, a male. You can halve this with condoms, although this is less given it is female to male, but suppressives are very likely to halve the risk. Hence you could be talking about 1 to 2% chance per annum; antivirals being the key.

Shedding is unrelated to outbreak frequency, this has been proven in research. Every couple is different though in their ability to transmit and receive.
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Avatar_f_tn
And he dumped me :(
I guess it ultimately didn't matter that I was super good to him, that he was crazy about me.... he just couldn't deal with it.

Will anyone ever be able to deal with it? If a guy who was already thinking marriage because he was that crazy about me can't handle it... what if no one ever thinks I'm worth it? How do you guys deal with this?
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Avatar_m_tn
My wife has HSV2 and we both had it before we married although she was probably my source. That made things a lot easier. It has been a long time and like you I had issues dating. However people were willing to look past it even with the limited information that we available back when, there was pretty much just scaremongering.it will come down to how informed your partners are and how calmly and rationally you educate them.
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Avatar_f_tn
Thank  you everyone who offered support and advice, I appreciate it. Still crossing my fingers that my test was a false-positive. Statistically a 5% chance... I know it's not much, but I just cannot deal with this. I am having panic attacks and extreme depression right now. I am not handling this well.
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Avatar_f_tn
Hi,
You've been very helpful with your knowledge of this subject, so I'm hoping you could give me your insight on something. I keep seeing that the level of the number in an igg test determines if I have hsv2- but that just because the number is positive, if it's low enough it means I don't have it? I see some posts where people say they're only +1.1 or something, and that means they don't have it. I am still waiting for my results, but I want to be able to understand the numbers. I thought that if it showed up at all that means you have it. Like even a +0.1 would mean I have it.
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Avatar_m_tn
Blood testing works on the principle of having a little well that is coated with an antigen that has been designed to attract just the relevant HSV1 or HSV2 antibodies. Your blood though has a lot of antibodies and other stuff that can stick to the antigen and cause a 'noise' reading.

A low positive can mean one of two things. Either a lot of stuff in your blood apart from the right antibodies as stuck to the antigen in the well and hence a false positive or the level of antibodies is rising owing to a recent infection. A subsequent test in both cases can provide more clarity.
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101028_tn?1348750963
just to clear up a few things.

in general, pcr blood testing is of little value. in newly acquired infections, herpes can be detected via pcr in the blood.  in recurrences, occasionally it can be detected. your provider should update their herpes blood testing knowledge since they are setting themselves up for massive malpractice suits if they are ordering pcr blood testing for herpes routinely :(  they should be limiting their use of pcr testing to lesion cultures, not blood tests.

at this point, you should seek out a type specific herpes igg blood test to confirm your status.   since you've never had active symptoms, I recommend waiting at least 4 months since you've last had sex with any partner and seek out a herpes WB blood test if at all possible.  that will help with false positive issues.

as for future partners, of course they will accept you!! it's unfortunate that your ex bf evidently didn't do enough reading to realize that his risk of contracting hsv2 from you if you were on suppressive therapy and you used condoms was less than 1%/year.  if he's having unprotected sex with partners without full std testing, he's putting his health at a far greater risk than he is having sex with you knowing you have hsv2 ( potentially )!!!

grace
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Avatar_f_tn
I gave him all the info, I gave him all the stats. I even told him he has a 12.5% chance that I will kill him with food poisoning from under-cooked chicken, compared to having only a 1% chance I'd ever give this to him. He just couldn't handle the idea that he has even the slightest chance he'd get it. I even tried to explain that he has a greater chance of getting it from someone else- someone who doesn't know they have it, or someone who isn't honest enough to tell him.
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