Oral hsv 2 – terri please

[Clarification114]

Recently diagnosed via swab ohsv2 after small ob on tongue. I understand it is rare. Need some professional advise on likelyhood of recurring infections and genuine risk of passing it on via kissing / oral sex to future partners, Or to my (future) kids from kisses etc? Ie the level of exposure I would need to expose them to to pass on. Essentially any info (medically creditable) that you have on hsv 2 oral would be great.

Prefer if this didn’t get posted publicly also if the west over heights doesn’t appear anywhere on my bank statement. I paid via pay pal to ensure this.

[Terri Warren]

First of all, I don’t know how our PayPal works and how this will show up on your bank statement. I think that is something you should clarify with PayPal. That is not within my power to change or even ask about in your own situation. This might have been best to consider and check on before you posted here, I’m afraid

And I have no way to answer this without it being public on this board. Your participant name is very obtuse, I doubt that anyone would know who you are from that participant name, nor do I know who you are. Are you sure you don’t want me to answer your question on this board?

Terri

[Clarification114]

Ok please proceed. Thanks.

[Terri Warren]

Do you think that this is a new infection? Have you recently had sexual contact where your mouth was on someone else’s genitals? If not, then this is likely reactivation from an old infection. About 15% of people who acquire new HSV 2 infection genitally also acquire it orally at the same time. Most often, they are the giver of oral sex to and had intercourse with the same person. So it isn’t that rare but which is uncommon is recurrences in the mouth. How does this description fit with your personal situation?

Oral HSV 2 recurs infrequently and sheds infrequently. And the vast majority of people who have HSV 2 orally also have it genitally. Now if you told me you have only been the giver of oral sex to people and have never had intercourse with anyone, I would revise how I view your situation. But my thought is, if you have had intercourse, you likely also have this genitally, statistically.

Kissing romantic people in the future presents a low risk (not zero) of transmission. Kissing children is completely different and with no sore present does not present a risk for kissing a child. The kinds of kisses we share with partners is normally quite different than the kind of kisses we give our children.

That is a whole book and you can read it here on the website for free, the Updated Herpes Handbook or for more detail and not free, the Good News about the Bad News. You ask for medically creditable information about HSV 2. I think that’s what I”m doing here and I believe that’s why you posted here. I’m not sure I get the inference but I kind of don’t like the tone of this interaction so far. The website ASHASTD.org is also an excellent site for good herpes information and I believe they also have a chat feature.

Terri

• This reply was modified 8 years, 3 months ago by Terri Warren.

[Clarification114]

Sorry no tone. Just frightened and want answers and have found very little on line. That’s what I meant by creditable. It is definitely a new infection following a predominantly oral exposure. Protected genital brief and no symptoms down there. Oral symptoms flared up after 3/4 days with small blistering on tongue.

[Clarification114]

Predominantly oral/genital exposure. On the basis of this do you revise how you view this situation?

[Terri Warren]

If you have both given oral sex to people and have had intercourse, then we cannot know if your infection is limited to oral infection, but it is very unlikely that you are not infected genitally. Have you had any genital symptoms? Is that what you are asking me? I’m not sure at this point about your specific question. You have another question to ask still remaining, perhaps you can clarify?

Terri

[Terri Warren]

OK, I missed the top response and just answered the most recent. My error. Do you know that this is new infection because you had a negative antibody test to HSV 2 at the same time you had a positive swab test for HSV 2? That is the only way you could know if this is true new infection – positive swab for HSV 2 and negative antibody for HSV 2. If your swab and contact were very recent, you could likely still get an accurate antibody test if it has been less than a week since both occurred. Otherwise, you can’t know with any certainty if this is new or old infection if you have given oral sex to other people in the past.

Terri

[Clarification114]

Protected genital brief and no symptoms down there (genitals)

You said above that you would revise how you review the situation if I explained exposure etc better. Basically I’m in committed relationship. No herpes. Stupidly visited ts escort largely unprotected oral / rimming. Small amount of protected insertive anal. Days after I get herpetic lesion on tongue. Swabbed and pos for type two. No genital symptoms what so ever. So essentially an oral only infection from a one off contact. Should have made this clear in original email. Apols. I thought I got two questions after original one. I have not yet asked another question?

Given the nature of exposure and symptoms can we assume it is oral only.

1) is it as difficult to tfr to gf via kissing as it is to catch it orally from genital contact (less likely than hsv1 oral to oral transmission) – essentially what are the chances based on low recurring outbreak rate and low shedding. I read most oral 2 never recur or maybe only once or twice in lifetime on average.

2) now that I have it orally does this give myself immunity from catching it genitally or transferring it to genitals. Eg from urinating or masturbating after touching mouth etc whilst virus present? (Weird concept but just covering bases)

Very sorry for coming across rude I really appreciate your time and responses.

[Clarification114]

In q1 can you also please cover possibility of passing to gf genitals if I perform oral sex on her.

Thanks so much.

[Clarification114]

For clarity if that was not clear – I know you will never assume anything. But for the sake of answering my questions please work on basis that it is solely an oral infection. If it is genital also (from that one exposure) I have a whole lot of other things to worry about.

[Terri Warren]

OK, so let’s assume you only have this orally. If this is indeed brand new infection, and I still think it would be wise for you to get an antibody test to know if this is new – it seems to me that that is key to your situation! If is it brand new, you will be shedding a little more as your immune system gets used to having this. If you know that your regular partner does not have HSV 2 for sure (remember that 80% don’t know they are infected with HSV 2), then I would advise no deep kissing for a while. And if you perform oral sex on your regular partner, there is also some risk of transmission, more with new infection, less with old. You are assuming this is new, I know. People with HSV 2 orally don’t shed often from the mouth, less than 5% of days swabbed I’m sure, but again, in the beginning, they shed more than later on when the immune system more aware of the infections. There is no specific research on the topic of oral only infection with HSV 2 that I know about. Most HSV 2 oral research is combined with genital HSV 2 and the immune response it generates, so I think we need to be cautious in your situation again extrapolating from research that also includes genital HSV 2 infection.

If you have HSV 2 orally, after about four months, you will basically be vaccinated against getting it genitally, if you have not.

OK, one more question/post. I guess those other posts are clarifications.

Terri

[Clarification114]

Tested last year bloods and was neg for both. Given lack of other partners since that test Very likely It is a recent infection and this is an initial ob. How long do I have after exposure to get the blood work done for confirmation? Has been over 3 weeks now so mayve missed the boat.

Your herpes guide says recur 0.01 days (what does this actually mean) and also that shedding for ohsv2 is 1% of days rather than the 5 you quoted. Semantics I know but clarification would be good.

Commentary throughout the forum (as well as medhelp) indicates ohsv2 relatively insignificant in terms of shedding and recurring because it doesn’t like the face , region. Ie that it very rarely causes problems. (Whatever that means) because it is so rarely caught orally (despite the prevalence of oral sex) does this mean it is more difficult to catch / transmit orally or is it rarely noticed due to the minor symptoms / lack of recurrence? Or both?

Also read that it needs to be massaged into tissue eg friction from sex that’s why it rarely infects orally? In which case it would need to be aggressive kissing to transfer to another person mouth to mouth?

I actually took some confidence from the fact it is oral 2 rather than oral 1 (again assuming it is solely oral) as it almost seemed that it was the “better” of the two to get orally in terms of recurrences / transmission etc despite the fact it is the worst reputation socially – Is this a fair position to take?

Or are all these stats based on ohsv2 where co infection with genital is present? Rendering them useless due to lack of data in my situation. In that case am I best off viewing this as a hsv1 infection perhaps with a slightly lower chance of transmitting to partner?

With regard to the shedding – can I only possibly transmit when shedding or ob present? If contact on a shedding day does this mean infection may / could happen as opposed to no chance on day when not shedding or ob not present?

If I had also got it genitally if I was to be symptomatic I would likely get something in the first couple weeks?

Lesion on tongue appeared a few days after and now almost 3 weeks later it is barely noticeable to the eye but I can feel it there when I talk etc. How long before it goes completely? It was quite minor – drs at gum clinic aswell as dentist dismissed it as not looking herpetic on inspection in first few days, because it was so minor and thought traumatic eg bit tongue. I knew by feel/stinging something wasn’t right. If I get recurrent ohsv2 infection will it be on the tongue again or on the outer mouth? And will it likely be less severe than original ob?

When you say no deep kissing for a while – how long? (Tough one to answer but a best guess be appreciated)

That’s probably to many questions for one post (hope not) I hope you are able to cover them though, as think it covers most of my thoughts / concerns.

Apols again for the poor demeanour earlier. Wasn’t intentional just wasn’t really sure of the protocol in terms of background info etc. You have been very helpful / professional.

Thanks.

[Terri Warren]

Yes, the research we have about oral HSV 2 is in subjects who have HSV 2 genitally as well. So that’s why my numbers to you are not consistent with the literature. I am not aware of any literature about the person who has HSV 2 orally only and shedding rates. It is true that HSV 2 does not like the mouth and certainly does recur less often there and sheds less often from there. Outbreaks in the future could be anywhere innervated by the trigeminal nerve – basically the face, including the eyes. It could look like a cold sore for sure on the outside of the lips or could stay internal. I think you’ll just have to wait and see. Yes, future outbreaks will likely last a shorter time and be less noticeable. And yes I think if you were going to have genital symptoms you would by now. However, I don’t think we can say with 100% certainty that you don’t have it genitally though it I think it is unlikely.

It is possible to transmit herpes virus when symptoms are present and when they are not present, due do asymptomatic viral shedding.

If you had previous antibody testing done and no new contacts in between, then I don’t think an antibody test now will be useful, especially three weeks later.

I don’t know how long to avoid deep kissing really, maybe four months? Most people have mounted a sound immune response by four months, so that’s why I am picking that number. It is a guess.

Glad I could be of help. We’ve used all three questions now. If you have more questions, you can sign up for two or three more at the subscription page should the need arise.

Terri

I think HSV 2 oral infection transmission is less common because of the low shedding rate, and not anything mechanical.

[Clarification114]

Sorry terri – not extra questions but more queries re some of the info you have provided.

You have previously stated on medhelp –

In a person with ONLY HSV 2 orally, who is HIV negative, shedding occurs on about 1% of days in a year. That’s about 3 days. If the infection is only oral, then it isn’t shed from the genital area. It is not likely to be transmitted through kissing because of the lack of oral shedding.

This differs from the info you gave me.

Also if the low transmission rate is not mechanical but due to low oral shedding rate – why don’t more people acquire it genital to orally? As the low oral shedding rate is n/a ?

[Clarification114]

Hi terri are you able to clarify re above. It isn’t an extra question but merely confirmation on an answer you have provided which appears to be contrarian to a previous statement from you in the archives? Specifically part one of above with regard to info about oral hsv2 in isolation ie no genital. You told me no info available in this scenario yet I found the above quote in the archives. Which do I take on board? Thanks.

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