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STDs (Expert Forum)
shingles at 28
Answered by
University of Washington
Seattle - WA
This forum is for questions and support regarding STD issues such as: Chlamydia, Crabs (pubic lice scabies), Gonorrhea, Hepatitis (viral), Herpes, HPV, Molluscum Contagiosum, PID, Rectal Infections, Syphilis, Trichomoniasis, Warts, Yeast Infection.All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.
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shingles at 28
by kaisbou, Jan 18, 2005 12:00AM
I had a bout of shingles 5 weeks ago just two weeks before my marriage. It now healed without persistent pain but left a darker skin. I had 2 unprotected vaginal sex encounters 3 years and 9 years ago with prostitutes. While reading through the net HIV was stated as a risk factor for shingles. Does this mean that I am infected? What shall I do? I am really very scared and cannot work anymore. Can stress or another disease be the cause? Also on a medical health test for work last summer, I had a ESR of 22 mm/hour which above the normal value? what can you conclude from this info? Please help me as I can't sleep anymore.
Thanks
Thanks
Doctor's Answer
by H. Hunter Handsfield, M.D., Jan 18, 2005 12:00AM
, Jan 18, 2005 12:00AM
You probably know the following facts about shingles, but for other readers who may not: Shingles (medical term herpes zoster) is not sexually transmitted. The virus is named varicella zoster virus (VZV), and varicella is the medical name for chicken pox. VZV infections are permanent--that is, after childhood chicken pox, VZV persists in the body. It can reactivate any time later in life, in the form of shingles. Thus, if your diagnosis is accurate, you definitely did not get it from the sexual encounters you describe 3 yr and 9 mo ago, or from any other sexual exposure.
Shingles is most common in the elderly as immune capacity declines, and persons with advanced HIV infection indeed are at increased risk of shingles. However, outbreaks can occur at any time and one episode generally doesn't mean any immune abnormality. (My son had chicken pox at age 3 and an episode of shingles at age 13.) So if you have had one outbreak, don't worry about it. You don't need to be tested for HIV--unless, of course, you have had other risks, such as sex with other men, injection drug use, etc. However, if you have a second and especially a third episode of shingles within a year or two, the possibility of impaired immunity should be checked out.
An erythrocyte sedimentation rate (ESR) of 22 is only a mild elevation and could be due to any minor infection you happened to have at the time, even a recent cold. But why was the test done? ESR isn't a common test unless a person has an obvious infection, arthritis, unexplained fever, or an autoimmune disease like lupus.
Finally, going back to my statement above, "if the diagnosis is accurate": Where on your body was the shingles? Does your comment about sexual exposure mean it occurred in the genital area? If so, I would want to know for sure that a test for VZV was done--i.e., that you in fact had shingles and not genital herpes. The two conditions can appear identical.
Bottom line: I doubt you have anything to be scared about. But if uncertain, see a health care provider.
Good luck-- HHH, MD
Shingles is most common in the elderly as immune capacity declines, and persons with advanced HIV infection indeed are at increased risk of shingles. However, outbreaks can occur at any time and one episode generally doesn't mean any immune abnormality. (My son had chicken pox at age 3 and an episode of shingles at age 13.) So if you have had one outbreak, don't worry about it. You don't need to be tested for HIV--unless, of course, you have had other risks, such as sex with other men, injection drug use, etc. However, if you have a second and especially a third episode of shingles within a year or two, the possibility of impaired immunity should be checked out.
An erythrocyte sedimentation rate (ESR) of 22 is only a mild elevation and could be due to any minor infection you happened to have at the time, even a recent cold. But why was the test done? ESR isn't a common test unless a person has an obvious infection, arthritis, unexplained fever, or an autoimmune disease like lupus.
Finally, going back to my statement above, "if the diagnosis is accurate": Where on your body was the shingles? Does your comment about sexual exposure mean it occurred in the genital area? If so, I would want to know for sure that a test for VZV was done--i.e., that you in fact had shingles and not genital herpes. The two conditions can appear identical.
Bottom line: I doubt you have anything to be scared about. But if uncertain, see a health care provider.
Good luck-- HHH, MD
Actually I had it on the right side of my chest and back.
my doctor immediately identified it as shingles. Indeed it is my first outbreak and I hope it will be the last. At first I thought it was an allergic reaction to some kind of fish I ate some days before. My worries are about HIV because if you search the net for shingles you get HIV. Can stress cause an outbreak of shingles?
My only risk was as I said unprotected vaginal contact 3 years and 9 years ago with prostitutes (here in europe in a brothel, i.e. they should be regularly tested by the government hopefully!). Can you estimate my risks for these 2 encounters?
thanks again
But my standard response to almost everybody who has anxieties about HIV after questionable sexual exposures is get tested! The negative result will help you sleep better than any reassurance I can give.
HHH, MD
It is really a great service you are giving to worried people.
Forgot to answer your question: ESR was performed as one of several blood tests done when you want to get a job in Germany. I just got the report sent to me at work without any comments. ESR was the only value that was not normal.
How likely is can HIV infection happen in people that did not get any other STD?
Best wishes-- HHH, MD