Subject:  Herpes (12/19/01)

Q.      Great site! Very informative and honest. I think that this is a great place for folks to get much needed information and I plan to pass it along. I have a question about oral herpes. I have heard that you can pass the infection to yourself, but wonder how this could be so when you already have the virus and therefore already have antibodies against it. Also, how hard is it to pass oral herpes to your partners genitals?

May I make one suggestion? As a certified childbirth educator I would like to see some information about passing HIV through breastmilk. It has never been shown to do so. Also the use of AZT during pregnancy and the risk of transmitting HIV to the fetus. I think it is a problem that needs to be addressed as there is so little accurate information out there.

A.      Thanks for the compliment and the questions.  First, regarding transmission via breast milk, unfortunately, it has been shown to happen.  In a study done two years ago by the National Institute of Allergy and Infectious Diseases (NIAID), they found that out of 672 HIV negative infants being breast fed by HIV positive women, 47 (7%) became positive as a result.  They also found that the risk to the infant is highest during the first few months of life.  Other studies have estimated the risk to the baby at about 14%, so HIV positive mothers are encouraged to not breast feed their children if other options are available.

          In regards to the use of AZT during pregnancy, if a mother has a natural childbirth without taking any medications, the risk of transmission to her baby is about 20%, and the risk increases with a longer delivery time.  While there is a danger of taking AZT during pregnancy due to its possible toxicity, it drops the likelihood of transmission during birth from 20% to 8%.  If AZT and other antiviral medications are taken during the pregnancy, during the labor and given to the baby for a period of time following birth and the baby is delivered by C-section, the risk of transmission drops to about 2%.  So, in this situation, I think we have to look at it as the lesser of two evils.  While there may be complications as a result of the drugs, those complications are not common; however, having an HIV positive baby will cause a great deal of complications to the infant.  Infants born with HIV progress to AIDS at an alarmingly faster rate than adults do and may not respond as well to treatment.

Now, the herpes question.  I’m not quite sure what you mean by infecting yourself.  To the best of my knowledge, you cannot re-infect yourself with any disease.  Herpes is a virus, and it’s one that your body will not generally eliminate.  Having antibodies to the virus will not prevent you from getting infected because that means you are already infected and will be for the rest of your life.  I believe it is possible to spread sores to new locations if you pick at them; however, that’s not a new infection.  As for transmission of oral herpes to your partner’s genitals, it is possible, but not likely.  It also depends on what type of herpes you have on your mouth.  Herpes Simplex Virus (HSV) is separated into two types of the virus, HSV-1 and HSV-2.  HSV-1 is “oral herpes” where HSV-2 is “genital herpes” although you may have sores from either virus on your mouth or genitals.  If you have oral manifestations of HSV-2 and you perform oral sex on your partner, the likelihood of transmission would be greater.  Genital HSV-1 is also less severe than genital HSV-2.  It is advisable to refrain from performing oral sex on your partner while you have a current herpes outbreak, since that is when you are most infectious; however, even without a current outbreak, there is still a chance, albeit slim, that transmission could occur.


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