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Hopkins Ask the Doc: Herpes and Hepatitis C

Johns Hopkins News
A weekly column presenting answers to your health questions by experts at America's foremost health institution.

October 29, 1997, Baltimore

The question: I am entering into a relationship with a woman who has genital and oral herpes. What can I do to make sure I am safe from becoming infected? She was diagnosed 2 years ago around the same time that she found out that her partner had Hepatitis C. Is it likely that she has Hepatitis C as well, and would she have any noticeable symptoms?

Paul G. Auwaerter, M.D., responds:Herpes virus infections are typically divided into type I [HSVI--oral] and type II [HSVII--genital]. By adulthood, between 80 and 95 percent of Americans will have been exposed to oral herpes infection. HSVI becomes latent and may reactivate periodically, causing what are commonly referred to as fever blisters or cold sores. There is no effective way to prevent spread of infection short of avoiding any human contact, since most humans eventually become infected.

HSVII is spread most typically by sexual contact. Risk can be reduced through the use of condoms. Men and women who have been infected may intermittently shed virus without any symptoms. This is how genital herpes has become so widespread. Although herpes vaccines are in development, there is currently no foolproof way to avoid HSVII except by avoiding sexual contact.

Rarely, HSVI can cause genital ulceration, and HSVII can cause oral ulceration.

It's unknown whether or not sexual transmission is an important means of spreading Hepatitis C [HCV]. This virus appears to be most commonly spread through the sharing of needles in IV drug abuse. Spreading by sexual contact probably can occur [probably less than 15 percent of cases at most], although most evidence points to high risk or promiscuous sexual behavior as the most important factor in cases where infection by sexual contact is believed to have occurred. The Centers for Disease Control does not have any formal recommendations for couples in monogamous relationships for avoidance of HCV. Use of condoms probably is of help, but actual documentation of this is lacking. Exact rates of transmission appear low, e.g., there are a number of couples who have been followed for years where one partner is HCV positive, the other negative, without the negative partner showing any evidence of infection.

Paul G. Auwaerter, M.D., is an assistant professor in The Johns Hopkins University School of Medicine, with appointments in the divisions of internal medicine and infectious diseases. His research interests include virology and immunology, as well as the study of community-acquired pneumonia.

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All information is intended for your general knowledge only and is not a substitute for medical advice or treatment for specific medical conditions. You should seek prompt medical care for any specific health issues and consult your physician before starting a new fitness regimen.

Copyright The Johns Hopkins University, 1997. All rights reserved.

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©1996-1998 Inteli-Health, Inc. All rights reserved. All information is intended for your general knowledge only and is not a substitute for medical advice or treatment for specific medical conditions. You should seek prompt medical care for any specific health issues and consult your physician before starting a new fitness regimen. Use of this online service is subject to the disclaimer and the terms and conditions .