Herpes as symptom for HIV?

[rprommens]

Six weeks ago I got herpes on my lips/nose. It started to spread to the inside of my thighs, my leg, my underarm, my chest, my stomach, my neck and my cheek. Until now I only had herpes on my lips/nose, since childhood. I do not have any herpes on my penis/scrotum. I don’t have any other std-related complaints. I don't have any non-std-related complaints too.
Yesterday I went to see my doctor (again). He didn’t take blood tests or cultures which weren’t necessary so he told me.. He prescribed me Zelitrex for 5 days. He was very concerned about the herpes being spread over my body. He said that herpes normally doesn’t act like that. He strongly advised me to test myself for HIV. I did have unprotected sex on some occasions and I had genital warts about six months ago, so I have reason to worry. I realize that taking the test is the only way to be absolutely sure about HIV which is why I will take the test this Monday. Right now I would like to know if my herpes is likely to be a symptom of HIV, without having any other complaints. I  read that herpes can be a symptom of HIV because of the low resistance that people with HIV can have. But I’m wondering if it’s likely that my herpes is a symptom of HIV if herpes is my only symptom. How likely is it that this herpes outbreak is ‘just’ a (rather serious) herpes outbreak. I’ve read that it’s not entirely impossible that people infect themselves with herpes on other bodyparts, and given the circumstances (very stressful time and low resistance, already had the herpes on my lips/nose), could this be an explanation too? Thank you.

[H. Hunter Handsfield, M.D.]

Although I do not like to openly disagree with the diagnosis of a doctor who has examined someone and I have not, I very much doubt the lesions on your thighs, leg, chest, etc are due to herpes.  Herpes never acts in the way you describe. True disseminated herpes is a devastating disease; you would not be walking around with it for several weeks.  And because it isn't herpes, I see no reason to have any special concern about HIV--but you don't say what your risks for HIV are.  If you are a gay man, an injection drug user, or come from a part of the world where HIV is expecially common--say equatorial Africa--then of course get it checked out.  In the meantime, insist that your doctor test your for herpes and/or request a second opinion, perhaps from a dermatologist.

Good luck--   HHH, MD

[nervous2618]

I will  give you my uneducated answer until doc gets to it, but yes herpes is more prevalent with HIV, but not an indicator.  There are many symptoms of HIV, and I am sure if you had one symptom, you would have more.  Get tested.  It will put your mind at ease.  I did and in 6 days shall have my results.

Were your partners those of a high-risk catagory?  Ya know.....hookers, drug users, etc.  If not, then the odds of you contracting it are low.  

Your doc was right.  Get tested and rule it out.  Don't be too scared though.  Many doctors know little about STD's, so your doc may have just not understood your situation.

Good luck.

[monkeyflower]

I was under the impression that you couldn't get the kind of herpes you currently have on your mouth (HSV1 or 2) anywhere but your face and "boxer short" region. Is it possible you also have shingles, which is another variation of herpes (herpes zoster), but caused by the chicken pox virus? I don't really know if it relates to HIV, but if so I'd think it'd be pretty rare. Lots and lots of people get shingles, and very few of them have HIV (lots and lots of people also have HSV, but very few of them have HIV, either). Are you under any other stress? That can really compromise your immune system. It's a good idea to get tested, but I wouldn't stress out about it too much in the meantime :-)

[rprommens]

Thank you both for your replies.

nervous2618: My partners were bi-sexual so yes I think they were of a high-risk category (if there even is such a thing as high-risk category). My doctor happens to know a lot about STD's, he told me that he works for an STD foundation too. I will get tested.

monkeyflower: I was under the impression that you could get HSV1 on your lips and sometimes in your nose and that you could get HSV2 in your genital area. Now I was told that herpes in your genital area can be HSV1 too and herpes on your lips and in your nose can be HSV2 too. I was also told that some people can have "odd" presentations of the virus and that it can be on many different parts of the body, but I am unable to find any documentation about this. I've also read that while being infected with herpes it's more easy to get infected with HIV too, which makes sense I think. And I've read that when someone's resistance is very low the herpes infection can be more severe, and since an HIV infection can mean that your resistance is very low...

I'm not under any stress now. I was under a lot of stress for a couple of days before I got the herpes on my lips/nose 6 weeks ago, because of an icident. I know from experience during what kind of periods it's likely for me to get the herpes on my lips/nose (new job, new relationship, vacation, and situations that cause a lot of negative stress). I was not surprised that I got the herpes after the incident and it didn't surprise me that the herpes got really bad because of the impact of the incident, but that it would be this bad and spread over my body was not what I had expected.

[rprommens]

ps monkeyflower: I forgot to mention about herpes zoster that my doctor told me about that (I'd already read about it); herpes zoster tends to be on one particulair area on the body. Herpes zoster usually starts with an aching sentation before the vesicles appear, this was not the case for me. Strangely enough my vesicles haven't hurt me at all (they do itch), it's the wounds that are healing (especially on particular locations) that hurt me and these are still itchy too.

[Christie2004]

Your doctor didn't do any type of test, yet stated you have disseminated herpes????  This would indeed be very unusual except in severely immunocompromised patients.

There are many other things that cause itchy rashes, even things that appear to be vesicles.  Of particular interest would be bullous impetigo.  It commonly starts around the mouth and nose and can spread through scratching.  Here is a link:

http://www.emedicine.com/emerg/topic283.htm#target1

There are images in that article, also.  I'd get a blood or culture diagnosis to r/o herpes.  It's never a bad idea to have an HIV test anyway.