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STD Risks for Immunosuppressed
Hi,
I am a 35 year old heterosexual male with a lupus-like autoimmune problem. I have been taking immunosuppressants, most recently Rituxan and Imuran. I also ocassionally take Prednisone during flareups. I haven't been feeling good and haven't had sex since starting immunosupressants two years ago. I am feeling better now and am ready to get back in the sack, but I am probably going to have to stay on the immunosupressants.
I took Rituxan a few months ago, so my b-cells are gone, but they should come back within 6-8 months or so. I don't think any STDs tests for antibodies would work until my b-cells come back. I have read that the b-cells probably don't fully recover even after they come back for a year or two afterwards.
The Rituxan didn't work any better for me than Imuran, so after my b-cells come back, I will go back on Imuran for the forseeable future.
I have HSV-1.
Am I at greater risk than the average person for STDs while I am on Rituxan and/or Imuran and should I take any special precautions? What about my risk specifically for HIV?
I used to have uncovered oral sex and covered genital sex. Is this still ok or should I switch to covered oral sex?
I am a 35 year old heterosexual male with a lupus-like autoimmune problem. I have been taking immunosuppressants, most recently Rituxan and Imuran. I also ocassionally take Prednisone during flareups. I haven't been feeling good and haven't had sex since starting immunosupressants two years ago. I am feeling better now and am ready to get back in the sack, but I am probably going to have to stay on the immunosupressants.
I took Rituxan a few months ago, so my b-cells are gone, but they should come back within 6-8 months or so. I don't think any STDs tests for antibodies would work until my b-cells come back. I have read that the b-cells probably don't fully recover even after they come back for a year or two afterwards.
The Rituxan didn't work any better for me than Imuran, so after my b-cells come back, I will go back on Imuran for the forseeable future.
I have HSV-1.
Am I at greater risk than the average person for STDs while I am on Rituxan and/or Imuran and should I take any special precautions? What about my risk specifically for HIV?
I used to have uncovered oral sex and covered genital sex. Is this still ok or should I switch to covered oral sex?
Thanks. I learned that the immune system does little or nothing to prevent infection of an STD, but determines the severity of disease once infected.
A general question: Unprotected oral sex and protected genital sex are both low risk, but which one is relatively more risky that the other?
A general question: Unprotected oral sex and protected genital sex are both low risk, but which one is relatively more risky that the other?
MEDICAL PROFESSIONAL
I forgot to answer the last question. Condoms for genital sex and unprotected oral sex generally is low risk for all STD and for the reasons above, I doubt your medical condition or drugs make any difference.
MEDICAL PROFESSIONAL
My main reaction is that you should be asking these questions of the provider who cares for your lupus and prescribes the immunosuppressive drugs. S/He probably is more expert than I am in judging any changes in your susceptibility to infection.
However, my understanding is that the drugs you are taking don't really have much effect, if any at all, on suscepbility to infection. Their greater effect is in making infections worse in terms of symptoms, potential for complications, etc. For example, you probably are at no more risk than I am of getting, say, a staph infection of your skin; but you probably are at higher risk for rapid progression or for a complication like sepsis (bloodstream infection).
Certainly there are no data to suggest that immunosuppressed people (e.g., persons with advanced HIV infection) are at any greater risk of catching gonorrhea, chlamydia, herpes, or syphilis if exposed. However, syphilis is more resistant to treatment and herpes recurrences are more frequent and more severe in AIDS patients. Similarly, to my knowledge the risk of HIV is no higher in people on immunosuppressive therapy than in other persons.
But as I said above, you should check with your own provider, and rely on his or her responses if they differ from mine.
Best wishes-- HHH, MD
However, my understanding is that the drugs you are taking don't really have much effect, if any at all, on suscepbility to infection. Their greater effect is in making infections worse in terms of symptoms, potential for complications, etc. For example, you probably are at no more risk than I am of getting, say, a staph infection of your skin; but you probably are at higher risk for rapid progression or for a complication like sepsis (bloodstream infection).
Certainly there are no data to suggest that immunosuppressed people (e.g., persons with advanced HIV infection) are at any greater risk of catching gonorrhea, chlamydia, herpes, or syphilis if exposed. However, syphilis is more resistant to treatment and herpes recurrences are more frequent and more severe in AIDS patients. Similarly, to my knowledge the risk of HIV is no higher in people on immunosuppressive therapy than in other persons.
But as I said above, you should check with your own provider, and rely on his or her responses if they differ from mine.
Best wishes-- HHH, MD
You are reading content posted in the STDs Forum
Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
