Oral HSV-2

[dcquestion]

I’m having trouble understanding my situation. In Nov 2013 I got a cold sore for the first time. It wasn’t on my mouth or lips but on my cheek near my nose. A few weeks after that I was tested and there were no anti-bodies found for HSV1 or HSV2. In July 2014, October 2014, November 2014 I had recurrences of the same cold sore in the exact same spot. In December 2014 I tested positive for the HSV2 antibodies. Shortly thereafter I had a recurrence of the cold sore which tested positive for HSV2 via a swab test. I’ve never had any symptoms of genital herpes or any symptoms on my mouth or lips.

So my question is, what type of herpes do I have (genital, oral, facial) and more importantly, what are the risks for transmission to a partner? When the virus is shedding will the virus be present in my saliva and transmissible during kissing or oral sex? What is the likelihood it’s transmissible via intercourse?

Thanks!

[Terri Warren]

Yours is a unique situation and I can see why you are having trouble understanding what is going on.
Here is my best guess and it is just that, a guess. I think you likely contracted HSV 2 orally sometime around your first cold sore in Nov. 2013, most likely by giving oral sex to someone who has HSV 2 (and may or may not know it). You don’t mention anything about your sexual history in your post so I don’t know well this fits with reality. The reason I think that about the timing is that you had no antibody a couple of weeks later when you were tested. It takes a while to produce antibody.

Whether you have genital herpes also or not we don’t know. If you can think back to the sexual encounters that you had around that time, it might be helpful. Generally speaking, we believe that people who have HSV 2 antibody are at LEAST infected genitally, though they may also be infected orally. If you only gave oral sex to someone around that time, then you may only have it orally.

You are having an unusually large number of outbreaks for someone with HSV 2 oral infection (and I would term it either oral or facial, it doesn’t really matter). The virus is living in your trigeminal nerve and that nerve group supplies nerve to pretty much all of the face. It could be transmitted via kissing, yes and also oral sex.

Have you thought about taking antiviral therapy?

Terri

[dcquestion]

Thanks you, Terri. First, let me say that you’re providing a much needed service and should be commended for your efforts.

To answer your question, yes I’ve thought about antiviral therapy. In fact I requested it from my primary care physician who would not give it me until verifying via swab test that the cold sores on my face were caused by HSV2. So I had to wait to get another cold sore, which has since happened and verified to be HSV2 so now I’ll likely start a suppressive antiviral.

As a follow up, how do I know definitely whether my HSV2 is limited to oral or whether I’m also infected genitally. I’ve read you tell people that once you’re infected orally you’re vaccinated against genital infection. I’d very much like to know whether that’s the case with my HSV2 or not as it’s fairly significant in understanding transmission risk. My sexual encounters around the time of the infection were both oral and vaginal sex.

Thanks!

[dcquestion]

Add on to above: To determine if I’m infected genitally, would it be possible to do a genital swap test for some period of time and see if evidence of the virus was found?

[Terri Warren]

There is really no way to know if you are infected genitally unless you do some daily home swab testing or you get a lesion that you can get swabbed genitally. But if you go on suppression, that idea won’t work because the suppression would likely greatly reduce the chances that you could recover virus.

Terri

[dcquestion]

I’m interested in doing the daily home swab testing to known whether I’m infected genitally before I start on the suppression. I would also like to do daily swab testing of my saliva to know whether there is virus present there.

Is that something you can help facilitate via mail? I’ve read you offering that in the past. What’s the best way to learn more about that procedure, what’s involved, and the cost?

[Terri Warren]

I think the best way to do that is to make an appointment with our clinic for a phone consultation. You will speak with one of our clinicians and they go over the options and costs with you.

Terri

[Author]

Posts