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Dr. David
Dr. David, Doctor
Category: Health
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Experience:  Ten years practicing as a licensed family physician.
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Does genital herpes become problematic or dangerous if an

Resolved Question:

Does genital herpes become problematic or dangerous if an infected person must undergo breast cancer chemotherapy, and cannot take Neulasta to boost the white cell count? My husband has herpes, and I have never gotten it after 14 years. I'm 56 years old. Two years ago I had breast cancer: 1 cm., mostly-invasive, ductile carcinoma, e.r. positive, her2 negative, grade 3, negative lymph nodes.During chemo I had a severe allergic reaction to Neulasta and couldn't continue taking it, hence my white blood cell count was problematic throughout the treatment. After treatment,my wbc climbed to around 4.5 (Spring 2008); now it has been 3.2 for 6 months, although my neutrafils are in the normal range. As far as I know I don't have cancer now. But I'm afraid to have sex with my husband without a condom (I'm post-menopause), because I'm afraid that now I might be more susceptible to getting herpes, and that if I were to ever need chemo again, herpes infection would be dangerous, given my wbc concerns. True or not?Thanks.
Submitted: 8 years ago.
Category: Health
Expert:  Dr. David replied 8 years ago.

I would like to help you with your question about genital herpes.

The herpes virus is quite common and easily spread. Most people have at least one strain of the virus somewhere in their body.

However, not everyone has symptoms of herpes. It is quite possible that you already have the herpes virus but you are not have any symptoms or outbreaks.

It is also possible that you are not particularly susceptible to the virus. Genital herpes is most easily transmitted when an infected person has an outbreak of fluid-filled blisters. If you can avoid contact with these blisters, then you can minimize the risk of contracting the infection if you do not have the virus already.

Some people who are infected with the herpes virus will have an outbreak of genital herpes when their immune system function is low or when they are under stress.

But other people who are infected with the virus will never have an outbreak, no matter what. And I suspect that you may be in this latter category.

In either case, I do not imagine that the herpes virus would be any more dangerous to you in your current condition than it would be otherwise.

I hope this helps. Please let me know if you need more information.

Customer: replied 8 years ago.
Dr. David, Thank you for your response. I was blood-tested (before the breast cancer dx) and I did not have herpes at that time, even though I had been exposed for about 10 years.Since the brca dx, lumpectomy, chemo & radiation I have always used a condom,due to the post-tx drop in wbc. So I probably still don't have herpes. My question is really hypothetical, so I can make a decision about whether or not I can stop using condoms. If I got herpes, and ever had to have chemo again (without the ability to take Neulasta to prevent neutrapenia), would a herpes outbreak be dangerous? Would it give me a more severe or pervasive infection, would it require postponement of a needed chemo infusion? I'm sorry if this wasn't clear the first time. With any luck, I'll never have to deal with this, but I'm weighing a decision about using condoms. Thanks.
Expert:  Dr. David replied 8 years ago.

OK, I think I am starting to understand your concerns. I apologize for not addressing these issues more directly in my previous post.

If I am understanding your question correctly, it sounds like you are concerned that if you become infected with the herpes virus that it might cause some dangerous complication later on down the line if you should ever need chemo again. So you are weighing the odds in making the decision to use condoms or not to prevent possible infection.

Indeed, the immunosuppression that occurs during chemotherapy is sufficient to reactivate a dormant herpes infection. Because of this, physicians often prescribe the drug Acyclovir to those with known genital herpes infections during chemotherapy.

So hypothetically if you did have genital herpes and you did have chemo again, then the chemo might provoke a prolonged herpes outbreak. However, the drug Acyclovir could be used to prevent or reduce this possibility. It seems an unlikely situation that the herpes outbreak would be so severe as to prevent a needed chemo infusion, but I suppose it could be a possibility.

Furthermore, your reduced WBC count may make you somewhat more susceptible to acquiring a new herpes infection. It is difficult to quote an exact figure on how much more susceptible you have become however.

Overall I would have to bet against your fears being justified.

I hope that this answers your question more thoroughly. Please let me know if you need more information.

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