Question
I am HIV positive and suffering from recurrent herpes simplex.
31 May 2012. Related: All topics, Complications and coinfections, Sexual health.
I am HIV positive and suffering from recurrent herpes simplex. What can be the reason? I am on Atripla treatment.
Answer
Thank-you for your question. It’s not unusual for people with HIV to also be infected with herpes. Herpes outbreaks are linked to the immune system so your CD4 count affects how likely you are to have a herpes attack. When the CD4 is low attacks are common, but as the CD4 increases they become less likely. So if you recently started treatment it’s likely that you will have fewer attacks as your CD4 increases. But some people on treatment do still get herpes attacks, and this can be helped with prophylaxis (preventative) treatment.
It’s difficult for me to give you a personal answer without a bit more information. It would be useful to know your most recent CD4 count. It would also be useful to know more about your herpes occurrences- how often they occur and whether you take any treatment for them.
Herpes infections are usually treated with aciclovir (Zovirax). The body processes aciclovir in the same way as tenofovir, one of the three drugs in Atripla. Because herpes treatment and tenofovir are both processed in the kidneys they can react with each other. This doesn’t mean they can’t be used together but your doctor might want to monitor this more closely, or adjust the dose.
Aciclovir can be taken to treat serious attacks of genital or anal ulcers. Aciclovir can also be taken on a regular basis to prevent recurrent attacks of herpes. In the UK aciclovir is recommended on a regular basis if you have two or more herpes attacks in a year. You may want to consider this if you are experiencing frequent, severe or long-lasting herpes attacks. This would involve taking aciclovir every day or every two days.
Hi Femi, without knowiing your CD4 and viral load when you started treatment it is difficult to comment. However, you need to wait until your viral load results become undetectable in the next test. It usually takes several months for treatment to reduce viral load this low.
Also, genital herpes can increase the risk of HIV transmission so you can’t have sex with your partner if you have any lesions or ulcers from herpes.
Please ask your doctor to explain this.
Please also encourage our wife to also be tested for HIV and herpes so that she can benefit from treatment too if this is needed.
am HIV positive and of recent I had very mild genital herpes symptoms and I have started taking drugs, can I have sex with my partner/wife who is negative without condoms
Hello Refiloe and many thanks for getting in touch.
It sounds you have been through quite a lot recently.
How are you feeling?
From what you describe your doctor has been looking after you quite well.
Have they said when you need to go back for another smear?
I am guessing you will be followed up every 6 months now?
Apologies I can’t answer with certainty but every country has different monitoring guidelines.
In the UK you would be called back for a smear every 6 months – 1 year.
You can definitely have sex again but you need to give yourself some time to heal, as you say.
Has your doctor said how long that might be?
I would again expect this to be at least 2 weeks but also depends how you are feeling and if you get any new symptoms.
You should inform your doctor about anything new you notice and worries you.
Using a condom is good practice for you too – especially now that you are more sensitive.
If you want to remove the condom discuss with your partner and have a sexual health screen (both of you)
That way you can treat everything that might come up and lower the risk of other infections for you.
Please contact us at questions@i-base.org.uk if you would like to discuss this further
Hi l ‘m living with hiv and l have hsv2. l experienced a severe lower back pain.
I was in a relationship using protection with my partner.
I was not taking any vitamins. Now l did a papsmear my results came back abnormal.My doctor removed the cells.
Is it safe for me to have sex once l’m healed?
Hi Lerato,
We are not doctors at i-Base, but we do give up to date info about HIV treatment to people who are positive, and to their friends and families.
However, it’s a good idea to have a sexual health check with your doctor if you think you have herpes. You can ask for a check for other sexually transmitted infections too.