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Connection b/w herpes, pneumonia, HIV?
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The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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Connection b/w herpes, pneumonia, HIV?

30 year old male, no prior drug use or sex with men/sex workers.  No health problems till returned from trip abroad this summer and have felt much anxiety since.  On 06/19 and 06/21 had unprotected oral/vaginal sex w girl from North America.  On 07/03 after returning from trip had unprotected oral/vaginal sex w a steady partner I had had for past 5 months since Feb.  On 07/07, came down w bad "cold", fatigued, sore throat/raspy voice (thought was exhausted from trip).  Didn't go to docs as got over it, raspy voice lingered little while longer.  Got back into regular routine of things/work, then 1 month later on 08/04 felt fatigued again, had low-grade fever, and sore/lesion on head of penis.  Because fever lasted for few days, went to docs.  Culture negative for HSV-2 but positive for HSV-1.  Possibly from receiving oral sex from girl on trip, who later told me has had history of cold sores/fever blisters though claims not to have had any for past few years and says no boyfriend has gotten herpes from her.  Lesion cleared up and not had another outbreak in the months since first one.  Doc said I might not ever have another outbreak and didn't rec daily pill.  Also did HIV 1/2 EIA Antibody Screen w/ Reflexes which came back negative/nonreactive.  So from very last sexual encounter (either 6/21 or very last being 7/03), this was done around 5 weeks/35 days later.  Have read threads re accuracy of HIV tests done after certain amount of time, so was hopeful about negative result.  However 1 thing that DIFFERS & has caused great concern over past few months is fact that at same time got diagnosed with HSV-1, got diagnosed w walking pneumonia.  Never had this before and didn't even know had this time. Went in for followup 2 weeks later and was all clear.  W/ regard to all the above, is there a connection between my HSV-1, pneumonia, and although came back negative possibly HIV?
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300980_tn?1194933000
So the facts.  Sexual exposure to two partner, unprotected and now with HSV-1 genital herpes.

Comments/Issues.
1.  Cannot say who gave the infection to you.  More than half of adults have oral HSV-1, whether they know it or not.  That one partner has a history of cold sores does not mean that she is the source of your infection.
2.  What to do about it?  HSV-1 genital herpes has fewer recurrences and less asymptomatic shedding than genital herpes due to HSV-2.  Except for unusual circumstances, most providers would not recommend chronic suppressive therapy in this situation.  
3.  What is the value of the HIV test done at about 5 weeks after the last sexual encounter? At five weeks 85-90% of persons who will develop HIV antibodies would have done so.  This makes it unlike you acquired HIV but if you are anxious a 12 week test will be more definitive.
4.  Could your HSV or low probability of HIV be related to your walking pneumonia/laryngitis.  NO.  HSV is not associated with pneumonia in normal hosts and for HIV, the disease needs to be advanced and causing meaningful immune suppression to increase risk of unusual pneumonia.  Even then, laryngitis related to the infection would be virtually unheard of.

Hope this is helpful.   Don't worry.  EWH
5 Comments
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Avatar_n_tn
Thanks for responding.  Final questions if I may,

Herpes: possible acquired from girl on trip (the "timeline" fits from when had oral sex and symptoms/very first outbreak ever)?  possible have had it longer than realized though no prior outbreak, and either the wearing my body down from work/travel or the pneuomonia "triggered" my reaction b/c my body couldn't suppress it any longer?  fact that herpes (and pneumonia) is 1 of many symptoms of HIV is not lost on me, and wonder if finally came out because may be immunosuppressed from HIV though no antidobies detected yet.  If no HIV though, any time I get sick now in the future likely that I'll have an outbreak?

Pneumonia: never smoked, am young/physically fit and active, and fact that came down with this lung disease very discomforting, though it eradicated after 10 days of antibiotics.  how could an otherwise healthy individual come down with this opportunistic infection 1 month after trip, if not caused by seroconversion illness or early HIV?  specifically, what you say about pneumonia being rare in normal hosts & rare for HSV to cause pneumonia is what I refer to.  perhaps the "cold" I couldn't fight on 07/03 turned into pneumonia on 08/04 because of early HIV or HSV causing the pneumonia?

HIV: though my 2 partners this year are generally as you refer low-risk, 1 of them has had a promiscuous past and I never got definitive info. on her STD testing history. i realize the test 5 weeks after last possible exposure not 100%.  your information is helpful to me and gives me more understanding than any independent research i could do.  this is my last question.
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Avatar_n_tn
Hello doctor, I got another blood test/same type as the 1st time, for HIV and it came back negative/non-reactive.  This was done 14 weeks after the 1st test, so a total of 19 weeks after my last possible exposure to anything.  With this updated information, could you tell me why I came down with both pneumonia and my 1st HSV-1 genital outbreak at exactly the same time (see questions above)?  How rare is it for a healthy 30 year old to come down with an opportunistic infection such as pneumonia?  Is there a possible relation between pneumonia, herpes, and either maybe-or-definitely-not HIV?  Will I have an HSV outbreak every time I get real sick?  I'm just looking for cold hard facts and not here for merely reassurances.  Thank you.
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Avatar_n_tn
Please see above 11/13/07 and/or 11/26/07 posting.
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79258_tn?1190634010
Re: facts vs. reassurances, you surely must have noticed that this isn't the site to turn to for warm fuzzies. It's all facts.

Anyway, I'm obviously not the doctor... but you don't have HIV. Your negative test after 14 weeks was more than enough, so your negative result at 19 weeks isn't even an issue.

Dr. Hook already answered your other questions: "Could your HSV or low probability of HIV be related to your walking pneumonia/laryngitis.  NO.  HSV is not associated with pneumonia in normal hosts and for HIV, the disease needs to be advanced and causing meaningful immune suppression to increase risk of unusual pneumonia."

Pneumonia isn't weird or rare. It might be the first time you've had it, but there's a first time for everything. You seem extremely anxious about this. If you can't let this go, consider counseling and/or meds.
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H. Hunter Handsfield, M.D.Blank
University of Washington
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Edward W Hook, MDBlank
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