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An Intimate Affair: Facts, Risks, and The Relationship between Herpes and MS

Have you ever felt worried or confused about what might happen if you contracted one of the various herpes viruses – and what impact that might have on your MS?

You’re not alone in that concern. I see this subject pop up on MS forums often enough that I would like to address it in some detail and bust a myth or two about herpes viruses in general. And, since I have one of the herpes viruses myself, I can add a personal touch to the discussion as well.

Shingles (herpes zoster) and herpes simplex virus (HSV) 1 and 2

Okay, so let us take a look at the facts behind two categories of herpes viruses that are prevalent within the US population at large and then address their significance among people with MS. They are shingles (herpes zoster) and Herpes Simplex Virus (HSV) types 1 and 2. There are other types of herpes viruses as well, but I would like to focus on these because a) they are the strains that have generated the most discussion on MS forums, and b) because they share some common traits.

Both shingles and HSV are viral skin infections that are spread mostly through contact with open sores. When either of these infections is dormant, the viral cells reside in either the ganglion of the lower spine or of the cranial nerves. The part of the body that experiences an outbreak determines where the dormant virus will reside in the nervous system.

Shingles (herpes zoster)

Shingles is characterized by a painful rash that usually appears somewhere on the torso, but can also appear on the limbs, neck, face and eyes. It usually afflicts people over age 50 and those who have lowered immune systems. The stripe-like rash will develop blisters, then crust over and heal within ten days.

Shingles can only occur if you’ve already had chickenpox (herpes varicella zoster). If you have not had chicken pox and you become infected with shingles, you will have an outbreak of chickenpox instead.

Herpes simplex type 1 (HSV-1)

Herpes Simplex Type 1 (HSV-1) is the more common of the two, is mostly found on the face and lips, and is colloquially known as cold sores. Because it is so easily spread through casual skin contact, 70-90% of the entire adult US population have the antibodies for this type of herpes virus. Transmission occurs when an active lesion makes contact with a moist area such as mucus membranes, or with broken skin. Because of this, around 50% of new genital herpes cases are Type 1, transmitted via oral sex. It is also possible to contract herpes through shedding of the cells while in a dormant state, but the risk of this is much lower.

Herpes simplex type 2 (HSV-2)

Herpes Simplex Type 2 (HSV-2) is predominantly spread through genital contact. It is so similar to Type 1 that if you have the antibodies for Type 1, not only are you protected from being reinfected with Type 1, you are mostly protected from contracting Type 2 as well.

The link between herpes and MS

Various studies conducted since the 1990s have acknowledged a relationship between the broader spectrum of herpes viruses and active MS, though the connection is not well understood. High viral loads of herpes viruses such as Epstein-Barr and roseola, as well as shingles and HSV, have been found in acute MS cases, but absent in the control groups, leading researchers to conclude that herpes may serve as a viral trigger for a flare.

The disruption of the immune system

The relationship is most often described this way: The nature of herpes viruses involves the potential for reactivation, even after very long dormancy periods. This reactivation causes a chain reaction of immune responses that can provoke an autoimmune attack in people with MS.

In other words, herpes doesn’t cause MS. The two are linked in how they each contribute to the disruption of the immune system.

How to avoid getting shingles and HSV

Zostavax, the shingles vaccine

Zostavax, the shingles vaccine, is a live, attenuated vaccine. It is basically a weakened version of chickenpox (herpes varicella zoster). If you’ve already had a case of shingles, the vaccine can prevent a recurrence. If you’ve only had chickenpox, the vaccine can reduce the risk of developing shingles by about 51%.

By the time we reach our senior years, 1 in 3 of us will have developed shingles at least once, most of us after reaching the age of 60. The vaccine has been approved for people over age 50 and recommended for those aged 60 and older. Studies show that the older you are, the more severe a case it will be. If you are concerned about taking a live vaccine, talk to your neuro first. If you are taking steroids or have an otherwise weakened immune system, you probably shouldn’t have the vaccine. As we MSers already know, we each must weigh the risks and benefits of disease-modifying therapies, vaccines, and alternative therapies before making a decision. Do your homework and consult the professionals.

Antibodies and avoiding skin contact with active herpes ulcerations

Unfortunately, there is no vaccine for HSV. Two things can protect you from contracting herpes: already having the antibodies, and avoiding skin contact with active herpes ulcerations. To find out whether you are already infected, ask your doctor to do the blood test that will show whether you are positive for the antibodies. Most people who are positive don’t know they are and have never had an outbreak.

If you have HSV-1 or -2, you can protect your uninfected partner from getting it by: 1) taking an antiviral drug such as acyclovir every day, 2) refraining from both oral sex and genital penetration during outbreaks, and 3) being open to using condoms and mouth dams during dormant periods if your partner prefers it.

Facts about HSV you might not know

HSV-1 and -2 are skin viruses. They are included in the category of sexually transmitted diseases (STDs) because they can be spread through sexual contact and infect the skin of the genitals. But unlike other STDs such as gonorrhea and syphilis, which are bacterial infections, and HIV/AIDS, which is viral, HSV cannot be spread by an exchange of blood or other bodily fluids. Herpes Simplex Virus can only be spread through skin contact with an active lesion or shedding of viral cells during a dormant period. Another distinction between HSV and other STDs is that HSV does not cause organ damage or death. It is not a progressive condition. It is a harmless skin virus much like chicken pox, shingles, and roseola. It causes discomfort during an outbreak, but does no other harm.

Things not to worry about HSV contraction

Besides the harmlessness of the virus as described above, bear in mind that HSV is very common. Most of us already have the antibodies for it. If you do and you’ve never had an outbreak, your antibody-positive status means you will not become infected if you come into contact with an active herpes lesion.

If you are HSV negative, become infected and have an outbreak, that primary outbreak will likely be the most severe one you will ever have. Symptoms last from 7-10 days. After that, you can keep it dormant by taking an antiviral drug. This drug will also reduce your viral load and make you much less likely to pass it on to someone else.

On the other hand, things to worry about HSV contraction

Okay, so you’re an MSer, and that means you want to avoid possible triggers for a relapse. We know that viruses can trigger relapses. But we don’t all relapse when we contract viruses. So having herpes might not impact your MS at all. If you’re HSV-negative and also one of the unlucky people that gets mowed down by every cold virus you pick up, however, then you might want to take extra precautions to avoid getting the herpes virus.

  1. Get a blood test to find out if you are positive or negative for HSV antibodies.
  2. If you are positive, then you don’t have to do anything more. You can’t get re-infected.
  3. If you are negative and you get involved with someone with herpes, then ask your infected sex partner if they are taking an antiviral drug. For maximum protection, use condoms and mouth dams, and refrain from sex during outbreaks.

On a personal note

I have Type 1 genital herpes. I contracted it genitally from my partner’s facial cold sore. As I mentioned earlier, this is exactly how a large number of new cases occur. My primary outbreak was severe. It did not cause an MS relapse. In the seven years since, I have had no additional outbreaks. I took Tysabri for a year, and although it is an immunosuppressant, I did not have a herpes outbreak. I take acyclovir twice a day. I have not infected any partners since becoming single, and that’s without using any protection other than the antiviral drug.

Fact: The risk of transmission for dormant HSV-1 while taking an anti-viral drug is only 2%.

For some perspective on that number, consider the fact that the risk of dying in a car accident every time you get behind the wheel is also 2%.

Fact: Using a condom/mouth dam in addition to an anti-viral reduces that risk to near 0%.  

Further information and resources

For more information about HSV, see Adrial Dale’s “The H-Opp” materials at: Sign up for the mailing list to get a free download of the herpes fact sheet and e-book.

For further details about shingles, chickenpox, and vaccines with live attenuated varicella zoster, see information provided on the Centers for Disease Control (CDC) website.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.


  • Dorry
    8 months ago

    My Husband contracted the Herpes Simplex Virus which turned in to ADEM (Acutedisseminatedencephamylitis) Encephalitis which left him with short term memory loss. This started 3 weeks before the onset of diagnosis with flu like symptoms and pain in the legs. Then loss of feeling in legs and collapse. Weakness in the legs is another sign. My husband was never the same. He suffered with short term memory loss which is the result of brain injury. He had to take 6 months off work and returned due to finances being short. My husband later went on to develop MESOTHELIOMA. Cancer of the lining of the lung which was dormant in his body for 40yrs the incubation period when the disease develops in to an incurable inoperable tumor and is terminal. (caused by the dust from cutting asbestos). It was the MESOTHELIOMA that claimed his life 7 yrs ago. Living with a disease is hard on everyone. Life is hard but for many of us we soldier on crying inside being one’s only release often from the pain and frustration of something we can’t change.

  • UberTea
    2 years ago

    I was diagnosed with HSV1 when I was 18 – diagnosed with MS in 2015 – the question I want answered is not whether the herpes will instigate a relapse, but will the MS cause more flare ups of the herpes? I can go years without a break out, but since the MS diagnosis I’ve had 3; just wondering if there is a cause/effect type thing going on.

  • danielcurtiz
    2 years ago

    Write to Dr Andrey in dubai to get your HSV cured using his whatsapp channel; +971544951982

  • UberTea
    2 years ago

    Just to clarify – I was 18 in 1988

  • Nyag5
    2 years ago

    You can definately catch herpes even having the same antibody type in your body… It’s not impossible.

  • hikinggirl
    2 years ago

    I am apparently in the minority as I was first exposed to the Herpes Simplex virus by my partner when I was 32 years old. I didn’t even know what it was at first. I had many outbreaks that first year, and continue to have 2-3 a year seventeen years later despite taking lots of Lysine and avoiding triggers. About two years after I contracted the herpes, I had my first symptom of numbness which led to being diagnosed with MS. This leads me to think there is a connection. I had never had any issues before then. I had been running marathons in my twenties. My mother and two of her sisters (out of seven total) also have MS, so I truly believe there is a strong genetic connection. But I also think the herpes virus was the trigger that activated it in me. Just the fact they are doing research on this shows enough people are having this happen to do the research.

  • sherry3714
    3 years ago

    Hi Kim,
    Thank you for sharing this article and your personal story. I enjoyed reading it. You said that you take acyclovir. May I ask if you were diagnosed with MS or HSV1 first? Also, how many relapses if any have you had since taking acyclovir? I am sorry if these questions are personal, I have MS and have been told that a antiviral might help with relapses and other information and I am trying to find answer to help me.
    Thank you again,

  • Diane
    5 years ago

    I would like to add a concern which needs to be in the forefront with HSV1 and autoimmune disorders. The incidence with HSV1 and Herpes Encephalitis occurring with an autoimmune disorder ranks fairly significantly. And unfortunately the symptoms of HE may be confusing if you are admitted to the ER. I bring this up as a result of personal experience. I contracted HSV1 and while the lesion was active I began experiencing new neurological symptoms (formed hallucinations and confused verbal abilities) My neurologist put HE high on the possible list of causes and up until that point no one had ever suggested this may be a concern. It is now in my medical records as a precaution as encephalitis does not get tested routinely when those of us with autoimmune disorders report something is new or amiss.

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