Herpes in the Liver. Possible and how?

March 21, 2008 10:27 AM

STD question

The question setup: Person is male and as genital herpes. Person B is female and does not.

Has anyone heard of a situation in which person A comes in contact with person B, and passes the disease to person B, but instead of the herpes going to work in the genitals as one would expect, it attacks the liver without ever showing symptoms in the genitals?

Is this possible and why would it attack the liver rather than the genitals?

posted by anonymous to health & fitness (6 comments total)

Don't know if it helps, but googling "herpes of the liver" turned up this:
http://pathweb.uchc.edu/eAtlas/GI/279.htm

Also try searching for info on herpetic hepatitis.
posted by katillathehun at 10:35 AM on March 21, 2008

Is your friend immunocompromised? Have HIV? It's pretty unlikely to say the least.
posted by sero_venientibus_ossa at 11:37 AM on March 21, 2008

I'm going to forward this question to mr. gaspode, who is a liver pathologist. Back soon.
posted by gaspode at 11:47 AM on March 21, 2008

There are certainly plenty more likely causes of liver damage, including excessive consumption of Tylenol (!). Mind you, kfb = not a doctor, but it's looking like herpetic liver infection is unlikely if the patient doesn't have some immunodeficiency, so my guess is that her liver ailments are caused by something more common.
posted by kittens for breakfast at 12:28 PM on March 21, 2008

So, I am somewhat of a herpes virologist. I've never read anything that mentions hepatic herpes, but then I tend to skip articles that focus on the actual disease rather than the biology of the virus. However, looking though PubMed and Fields Virology (the bible of human viruses), the only instances I can find where herpes attacks the liver happen in individuals with compromised immune systems or babies (which don't have fully developed immune systems).

As to whether the virus could skip genital symptoms and go straight for the liver, I'd say the answer is no. The virus has to first replicate at the site of infection before moving into the nerves that innervate the first area infected. To the best of my knowledge, it is only after the virus has made its way to the nerves that can it move to somewhere else, and generally that is restricted to where the infected nerve innervates or other nervous tissues (i. e. the brain). I'd say that if person B has hepatic herpes minus the initial symptoms, it is probably because person B is reactivating. Still, i can't explain why exactly it would reactivate in the liver and not the normal locations. Actually, I'd first question whether it really was herpes in the liver. The only way that I am really seeing that herpes could get to the liver like this is if virus from person A somehow contacted a deep cut in person B and person B happened to already be immunocompromised.

I might be wrong on all this, however.
posted by The Bishop of Turkey at 5:27 PM on March 21, 2008

All my husband had to say was 1) yes, you can definitely get herpes in the liver, because he's seen it; 2) It would only be in immunocompromised individuals and 3) he thought it would be possible (though unlikely?) to get it while being asymptomatic in the genital region.

then he got all paranoid about me saying medical things on the interwebs.
posted by gaspode at 9:47 PM on March 21, 2008