Remicade & HSV

[frankie123]

I have Crohn's disease and recently received two infusions of Remicade.  I recently tested positive for HSV 2 with a Western Blot test.  The test was for screening only. I have never had any symptoms.  HSV 2 is listed an adverse effect of Remicade.  Does that mean it is possible that I might have acquired the virus from the infusion?

I read about one case in which a patient who had received Remicade was NOT given a test for Lyme disease because Remicade is known to cause a false positive result.  Is it possible that Remicade, which is a (chimeric) IgG (1K monoclonal) antibody, produced a false positive result by raising the level of IgG antibodies in my blood?  

[gracefromHHP]

Like I said - the best thing to do is to call the lab and ask them to look again at your Wb and why. They are really nice folks there -  206.987.2088   is their number.  

grace

[frankie123]

Sounds like you are both familiar with the chimeric monoclonal antibody Remicade, so you might be interested in this article about how antibody therapy and other factors can interfere with lab results.  It is from the College of American Pathologists website:

http://www.cap.org/apps/portlets/contentViewer/show.do?printFriendly=true&contentReference=cap_today%2Ffeature_stories%2FAntiAnimalAntibody.html

[northshore07]

Remicade affects the body’s immune system and thus makes you less able to fight infections.  Given this side effect of Remicade, your body’s immune system may be somewhat compromised and an occurrence of herpes may results.  Remicade does not give you herpes (you have to have sex to get herpes or other STDs), you already acquired the virus at some point.  I believe it simply means that Remicade could make your body more vulnerable, due to the potential for your immune system to be less functional than usual, and an outbreak could occur.  There are a lot of people who learn they have HSV2 and didn’t even know they had it.  Not all people have outbreaks or if they do, they are so minor and often mistaken for something else.  I do see that Herpes Simplex is listed as an adverse side effect.  Note that the name Herpes Simplex includes both HSV and HSV2.  I hope this helps.

[frankie123]

See:  http://www.fda.gov/cder/foi/label/1998/inflcen082498lb.pdf

page 9

[gracefromHHP]

I've read thru quite a bit of the 40 pages of info on remicade and I saw no mention of hsv issues.  Where did you see hsv2 as an adverse effect?  Anyways no medication causes you to be infected with herpes - it can increase your likelihood of being infected with it but it won't cause you to develop it - you have to be infected with the virus or come in contact with someone infected with the virus to get it from them.

Until proven otherwise since it sounds like you've never been tested for herpes before - assume you have hsv2.  I'd give the fine folks at the U of washington a call and talk to them and ask them to look at your WB again too just to err on the side of caution. Let them know why you are so concerned about all this so they can help you figure out if it's a false positive or not. Reading the WB is a fine art which is why it's only done at 1 lab in the country currently.  

grace