Herpesviruses use DNA as their genetic material. They don’t cause lupus, but lupus can increase your overall chance of infection.

Lupus is an autoimmune condition, which means that it affects your immune system’s ability to function. Generally speaking, autoimmune conditions can make you more susceptible to infection.

“Lupus, in particular, has been associated with an increased likelihood of several herpesvirus infections,” says Michael Ingber, MD, urologist and female pelvic medicine specialist at The Center for Specialized Women’s Health in New Jersey.

When people think of herpesvirus, the herpes simplex virus (HSV) is typically what comes to mind. There are two types, HSV-1 and HSV-2, and both can cause oral or genital herpes.

According to one 2019 study, people with lupus are more likely to contract HSV than people without it. HSV infections are also more likely to be severe in these individuals.

Severe HSV infections can affect the:

In the same 2019 study, researchers looked at data on 122,520 people — including 24,504 people with systemic lupus erythematosus (SLE) and 98,016 age- and sex-matched controls without SLE — from the National Health Insurance Research Database in Taiwan to better understand the relationship between SLE and HSV.

They found that people with SLE experienced severe HSV infections at roughly four times the rate of those who didn’t have SLE.

The researchers also found that:

  • People with SLE who took more than 7.5 milligrams of oral prednisolone per day were 1.59 times more likely to develop a severe HSV infection.
  • People with SLE and an early, non-severe HSV infection were 2.3 times more likely to develop a severe HSV infection.
  • People with SLE who received intravenous steroid pulse therapy, or steroid medications into a vein, were 5.3 times more likely to develop a severe HSV infection.

People under 18 years were 55% less likely to develop a severe HSV infection than people ages 18 years and over.

How to reduce your chance of herpes simplex virus

HSV-1 primarily spreads through contact with cold sores, saliva, or surfaces around the mouth. HSV-2 typically spreads through skin-to-skin contact with the genitals or anus, particularly when sores are present.

Avoid kissing or sharing cutlery, drinks, and other items that come into contact with the mouth of someone who has a cold sore.

Using dental dams, external condoms, and other barriers can help reduce the chance of genital herpes. Avoiding intimate sexual contact until an HSV outbreak clears can also help reduce the likelihood of transmission.

Varicella zoster virus (VZV) causes chickenpox and shingles.

People typically develop chickenpox shortly after contracting the virus. The virus stays dormant within the body even after recovery, and shingles can develop if the virus reactivates later in life.

People with lupus are far more likely to contract VZV than people who don’t have lupus.

In research cited in a 2017 study, researchers found that 1.5–3 out of every 1,000 people in the United States develop shingles each year, compared with 6.4–32.5 out of every 1,000 people with SLE.

Additional studies cited found that people with SLE were more likely to develop “cutaneous and visceral dissemination of lesions” or VZV infection of the internal organs.

How to reduce your chance of varicella zoster virus

Certain vaccines can help protect against chickenpox and shingles.

The chickenpox vaccine became available in 1995. Most people under the age of 35 years will have been vaccinated during childhood.

People over the age of 13 years who have never had chickenpox or received the chickenpox vaccine can get vaccinated as adults.

Doctors typically recommend the shingles vaccine for adults over 50 years, but adults of any age with a weakened immune system can get it.

Epstein-Barr virus (EBV), also known as human herpesvirus 4, causes mononucleosis.

Over 90% of people will contract EBV during their lifetime. Older research cited in a 2012 study found that 99.5% of adults with SLE contract EBV.

A 2017 cross-sectional study suggests that people with SLE may experience more severe EBV symptoms than people without SLE.

Lupus is an idiopathic condition, which means that it has no known cause. Some research suggests that having a history of EBV infections could increase your chance of developing lupus.

One 2018 study found that a protein created by the virus (EBNA2) binds to locations on human genes known to be associated with lupus.

How to reduce your chance of Epstein-Barr virus

EBV primarily spreads through saliva, which is why it’s known as “the kissing disease.” However, it can also spread through other bodily fluids, including vaginal secretions, semen, and blood.

Avoid kissing or sharing cutlery, drinks, and other items that come into contact with the mouth of someone who has mononucleosis.

Using condoms and other barrier methods may also reduce the likelihood of EBV. Another option is avoiding intimate sexual contact with someone who has an active infection.

Human cytomegalovirus (HCMV) — also known as CMV — may be lesser known, but the virus is incredibly common.

Researchers in a 2019 study estimated that 83% of the global population have HCMV markers in their blood.

They report the highest percentage (90%) in the World Health Organization Eastern Mediterranean region and the lowest percentage (66%) in the European region.

Symptoms, if the virus causes symptoms at all, are usually mild in people who are otherwise healthy. However, HCMV can be life threatening in people with weakened immune systems.

Severe HCMV infections can affect the:

A different 2019 study suggests that HCMV may trigger lupus flares because of its ability to shift between latent and active stages. In other words, HCMV may randomly lead to inflammation associated with the condition.

Emerging research suggests that HCMV, like EBV, may contribute to lupus development.

While the exact mechanism is unknown, researchers suspect that the virus may target UL44, a protein associated with lupus.

How to reduce your chance of human cytomegalovirus

HCMV spreads through bodily fluids, including:

  • blood
  • urine
  • saliva
  • breast milk
  • tears
  • semen
  • vaginal secretions

Frequent, thorough handwashing can help reduce the chance of infection through non-sexual contact.

Aim to avoid contact with tears and saliva, and try not to share cutlery, drinks, or other items that come into contact with the mouth.

Using condoms and other barrier methods may also reduce the chance of HCMV.

Autoimmune conditions like lupus increase the likelihood of a variety of infections, including those in the herpesvirus family.

If you have lupus, you may wish to talk with a healthcare professional about your individual risk. They can advise you on any next steps, including potential vaccinations and other precautions.

Gabrielle Kassel (she/her) is a queer sex educator and wellness journalist who is committed to helping people feel the best they can in their bodies. In addition to Healthline, her work has appeared in publications such as Shape, Cosmopolitan, Well+Good, Health, Self, Women’s Health, Greatist, and more! In her free time, Gabrielle can be found coaching CrossFit, reviewing pleasure products, hiking with her border collie, or recording episodes of the podcast she co-hosts called Bad In Bed. Follow her on Instagram @Gabriellekassel.