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HSV2 male and RA female discordant couple's dilemma

Hi
I was diagnosed with genital herpes type2(HSV2) half month ago. My girlfriend is a rheumatoid arthritis patient diagnosed 4 months ago. She is taking immunosuppressive drugs (Methotrexate,MTX) every week as routine use, and the doctor told her she will probably need it in the rest of her life.
Q1 Will her immunocompromised situation make her easier to get infected? If so, how easy will that be? Like normal discordant couples sleep together without sex and share inanimate things for 100% safe but for her there is a risk?
Q2 Will her immunocompromised situation make her suffer more severe? If so, how bad will that be? Several articles indicate that hsv2 may lead to life-threatened diseases for immunocompromised people. Are there any potential side effects of combined use of mtx and antivirus drugs?
Q3 Almost all the hsv organizations believe that hsv does not affect male and female’s fertilities, but there are several researches (there truly are, I’m not lying and I’m so scared) based on infertility males suggest that hsv can be found in semen, significantly reduce sperm numbers and motility, destroy sperm structures, and therefore, lead to male infertility or even featus anomalies and miscarry. Is that true and what chances are they?
Q4 Given my girlfriend’s special situation, I have to be more risk adverse to making a baby. Since the unpredictable virus shedding, should I try artificial insemination? However, scientists found that hsv does exist in the infected male’s semen, and grace confirmed that there are some cases that women got infected through artificial insemination. What will be your advice if we really want to have our own baby (if I still have fertility) and not let my girlfriend catch this virus? If she get pregnant and hsv at the same time, I know there is a huge risk for both her and the baby,I might ruined her life and our baby. Should we stay together or just let the herpes part us? it's a 6 years serious relationship,we love each other.
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55646 tn?1263660809
First, I want to ask you how you were diagnosed with genital herpes.  Blood test, swab test?  Have you had symptoms?  If you had a blood test, can you tell me the numbers associated with the positive test?  Are you outside of the US?  Has your girlfriend been tested for HSV 2?  

Before I go on to answer all of your questions, I would appreciate it if you could answer these few questions.  Thanks

Terri
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Avatar universal
Nov 9: dangerous sex, with condom but there was a lot of virginal secretion. ( I’m so worried that I may also catch HIV&HBV cause the girl is a commercial sex worker, she has tattoo and smoke, it seems that she doesn’t care much about her body)

Nov 16: a horrible headache, I cannot fall asleep the whole night

Nov 20: four separate rashes came out in my pubic area, and one hard rash appeared in my jaw ( at the same time, I’m worried about this maybe autoinoculation, is it due to hsv?).

Nov 23: I felt so weird then go to the hospital. The doc said they were folliculitis, but I still got a blood check on HIV and syphilis, both negative but I know there is window period.

Nov 28: several blisters grew out around one of rashes in my pubic area( but there were no blisters around the other 3 rashes and the one in my jaw, now the blisters and the rash they grew around were disappeared, but the other 3 and the one in my jaw are still there, but smaller and no feelings, are they caused by hsv?)

Nov 29: went to hospital again, the doc checked my symptoms and surely said it’s genital herpes, they used a swab to get the fluid in the blisters to check( I don’t know it’s a culture check or PCR) and blood check at the same time. Turned out fluid check was positive for HSV2 and Negative for HSV1, blood check was positive for HSV1 IGM, HSV1 IGG and HSV2 IGG but negative for HSV2 IGM (They didn't and cannot provide the value and reference value, just positive or negative. I’m in china, they say the reagent they used for hsv blood checking is out of date and not accurate, I’m sure it’s not Herpeselect or other tests used in US).

Afterwards, I had low fever last for a few days, inguinal lymph nodes enlarged and painful, I really hope it’s not genital herpes but it seems it really is. I haven’t had sex with my girlfriend for 2 years and she’s in UK right now, I think the chance that she also has it is quite low.
Right now I’m worrying about everything on every day, I may also catch HIV, HBV&HPV, the HIV lead to death, HBV is infectious and harms my body, HPV causes cancer…My girlfriend has RA then immunocompromised, we may not able to have our kids, if we try, she may be infected and suffer more than normal people in her rest of her life. I ruined every beautiful things and hurt everyone I love. So hopeless…I love my girlfriend, I cannot explain why I did such a stupid thing that day.  
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Avatar universal
I know I ask too many things, but I really need some professional opinions here to help me figure out what is the right thing to do given my situation. I really don't want to break up with my girlfriend but if I hurt her(emotionally already), I'd rather to die.
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Avatar universal
Is there any possible way that we can have a healthy baby together without transmission of hsv to both mother and baby? The most materials only focus on infected female, I know if the mother got hsv2 before conception,baby's risk is very low.How about the mother being infected and conceived at the same time? Some research say the virus is always in semen,does that mean to get pregnant, the uninfected female must to be infected no matter what preventions we do like suppressive therapy, artificial insemination? Really really appreciate and look forward to your advice. Thanks a lot~
Helpful - 0
55646 tn?1263660809
Thank you for your complete explanation of your situation.  
I think you are in a difficult situation for sure.  Have you talked to your girlfriend about what has happened here?   I definitely think you need to tell her exactly what has gone on here.  It would not be fair to her to have sex with her without telling her you now have herpes, right?  You might want to wait until she comes home and do it in person, though.

You can take daily medicine to reduce the risk of infecting her, but it is not perfect and will not protect her completely.  Also, using condoms will not protect her completely.  

However, the one thing about this is that you tested HSV 2 IgG positive, which could be from this infection, but could also be from an infection you've had for a while.  You took the test almost three weeks after the contact so it is also possible that you contracted it from the sex worker.  Without an index value, I can't really help you much with that.  I'm just thinking that the odds of getting herpes from a one time encounter using a condom are pretty low, but not impossible.

My advice would be to tell her when she gets home that you were recently diagnosed with genital HSV 2 infection.  You can't be certain if it is new or old infection (which will bring up the sex worker conversation), but since it might be old, she should also be tested.  

She can certainly have children, but if you have intercourse, there is a chance she will get herpes, though a lower chance if you take daily medicine.  You could do artificial insemination, yes.  But this is her whole life and your whole life, are you really thinking you could never have sex again?  That seems unrealistic to me.  

Terri
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Avatar universal
Many thanks for your reply. I will tell her the truth before anything happens and respect her decision. But I think I'm also responsible to tell her what exactly the risk is she will taking if we stay together, that's why I really want to know the potential complications between RA and herpes and the possibility to have a baby without transmission. If you have any comments on this, that will be great. Thanks again.
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Avatar universal
Terri, very appreciate your patience and time. Your opinion is extremely important to us so I'm still seeking your more specific advice.
1 What will happend if my girlfriend get infected given she is taking MTX and will probably take MTX in the rest of her life? What's the potential interactions of RA and herpes and the drugs used for ra and herpes?

2 Since research confirms that HSV does exist in semen, which means to be conceived, my girlfriend has to be exposured to HSV even by artificial insemination, what the transmission risk is if we go for artificial insemination or the normal intercourse? One study in 1989 indicates that two women used a HSV infected male's semen samples for artifial insemination and one of them got infected.

I will fully respect my girlfriend's decision, but before I tell her the simple fact the I've got herps, I also bear the responsibility for telling her what the life will be as exactly as i can  if we insist staying together. We love each other very much. If having a baby or just live together is life-threatening for her, we may have to make a very hard decision.
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55646 tn?1263660809
1.  The person who is immunosuppressed will be more vulnerable to catching herpes and may have more recurrences if they are infected.  Daily medication for you can reduce the risk of transmission and if she acquires it, daily medicine for her will reduce the frequency of outbreaks.  I am not aware of any interactions between antivirals and her medicine, but she should check with her doctor about that to be sure.

2.  The research strongly suggests that semen is not a good carrier of virus.  Transmission through aritificial insemination is very rare.

I would not describe herpes in any way as being life threatening to her.

Terri
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Avatar universal
Thank you very much for your reply. Still a few questions to ask hope you don't mind.
1 By more vulnerable to catching herpes, you mean during sexual contact or even normal daily life? I know there is nearly no transmission risk if people live together, sleep together without sex and share inanimate items.Does this still hold for people like my girlfirend who is a RA patient and immunocompromised due to MTX?

2 I found an article named 'The impact of HSV for Inflammatory arthropathy patients', the author suggests HSV could lead to a serious very severe and grave deseases for RA patients ( cause they take immunosuppressive drugs), I'm so scared and have no idea. Have you heard any real cases like this or any related academic theories? Is the impact of HSV on RA patients just very rare and theoratically possible or it's common and true in RA patients?

Dear Terri, thank you very much truly. I'm not doubting your professionality or challenging you. They are just a few research and articles I found, and the opinions they presented make me scared and miserable. Hope you could share your opinion. I provide the link below, hope you could take a look.

http://www.google.com.hk/url?sa=t&rct=j&q=HSV%20for%20Inflammatory%20arthropathy%20doc&source=web&cd=1&ved=0CDAQFjAA&url=%68%74%74%70%3a%2f%2f%6c%65%6e%75%73%2e%69%65%2f%68%73%65%2f%62%69%74%73%74%72%65%61%6d%2f%31%30%31%34%37%2f%32%35%30%32%35%32%2f%32%2f%54%68%65%69%6d%70%61%63%74%6f%66%48%53%56%2e%64%6f%63&ei=slmuUpK4EsiyiQf71oCYDg&usg=AFQjCNGusQ4Kgp8EU0IHy_GzaKJ5Ubmjqg&bvm=bv.57967247,d.cGU&cad=rjt
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55646 tn?1263660809
1.  During sexual contact.  Yes, even immunocompromised people don't get herpes through household activities
2.  I don't think this article is saying anything different than what I am saying.  If she gets herpes and she is on methotrexate, she can have more frequent outbreaks that are harder to control than someone who is not.

Terri
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