Blood Test - Impact of Suppressed Immune System

[Suppressedimmunity]

Would the active use of prescriptions used in the treatment of rheumatoid diseases (enbrel, humira, methotrexate, predisone), suppress the creation of anti-bodies and interfere with ability of blood tests to accurately determine a herpes infection?

[Edward W Hook, MD]

I'll chime in by starting off by agreeing with Dr. Handsfield.

You say little about your situation.  If you are worried about herpes but have not had an obvious outbreak, odds are you have not recently acquired the infection.  The effect of the drugs that you are taking is more profound on the cellular side of the immune system than the antibody producing side.  Furthermore, while these drugs are immunosuppressive, they are not profoundly immunosuppressive.  They might make the clinical presentations of herpes more obvious but they would be unlikely to hamper the development of a positive antibody test.  If you have not had an outbreak, my advice would be to believe the tests.  EWH

[H. Hunter Handsfield, M.D.]

Those symptoms don't really suggest genital herpes.  Unless you also had been exposed to someone known to have genital herpes, probalby I would not have recommended HSV antibody testing at all.  Combining the lack of symptoms that suggest herpes plus the likely reliability of the test result, you can be confident you are not infected with HSV-2.

However, the drugs you are taking could well make you more susceptible to chronic fungal or bacterial infections that might explain your symptoms -- which already was obviously on your doctor's mind, given the antifungal therapy.  I suggest you and your rheumatologist (or other primary care provider) continue to follow that path to an ultimate diagnosis.  Or see a dermatologist if that hasn't been done yet.

[Jason564]

Do immune system blood tests indentify any std's or do you have to specifically ask the doctor to look for std's?

[Suppressedimmunity]

Thank you for your responses, they were very helpful.

I've had on-going issues with a irritations and related burning sensations on scrotum, leg creases and anal region since early July. Also a diagnosed/treated e-coli UTI and a 2 weel oral fungal infection treatment. It's been a struggle determining the source and cleaning it up. Lgg type specific test at 16 weeks was negative but immune system issues related to RA is problematic when it comes to health issues and just looking for reassurance as to elimination of potential sources.

[H. Hunter Handsfield, M.D.]

To my knowledge, no data exist on whether the sort of immunosuppressive treatment you are receiving would interefere with HSV antibody testing.  It might depend on the doses of the drugs you are taking, but in the doses normally used for rheumatoid disease, I doubt it would have any effect.  Your rheumatologist might have a better understanding of this.

Sorry I can't be more helpful.  I'll ask Dr. Hook to take a look at this thread and add a comment if he has more information than I do.

Best wishes--  HHH, MD