Quick Cold Sore question

[flyer8080]

I apologize in advance for the stupid question, but I am not sure whether I have ever had a cold sore. I may have when I was a child, but just don't remember. At any rate, I gave a woman oral sex recently and given the lighting didn't get a clear view of her vagina (although I am pretty sure it was clean, no sores). I asked a different question on the std forum, but my question for this forum is strictly in relation to oral herpes, which is not considered an STD. What is the risk of exposure under these circumstances and if HSV-1 or 2 were to appear on my lips how long would it take to show up. I have seen many different estimates on the web. I will be seeing someone I care about deeply in a few weeks who I haven't seen in almost seven months, and am embarrassed about my stupidity, but also want to make sure she is safe from getting HSV1 or 2 if we kiss or engage in other activity.  

[flyer8080]

Thank you! I am not sure if I ever had HSV1 so I was just wondering how long it would take for symptoms to show if I was exposed orally to either HSV1or 2. I am 90% sure the woman had no sores. I am not a promiscuous guy so I am just nervous.

[Bhupinder Kaur, MD]

Hello,
Thanks for posting your query.

I can understand your concern for the transmission of HSV1 or HSV 2 after giving oral sex.

It is true that been HSV1 IS associated with an infection in the mouth, while HSV-2 typically infects the genitals. However, recent research shows that HSV-1 is becoming a more common cause of genital herpes infections as well and similarly HSV 2 can infect the oral cavity also although chances of it are very very less.

Since you had given unprotected oral sex to a woman whom you are not very sure about and you could not see the vagina very clearly, so chances of transmission of HSV 2 from her to you are there although as mentioned earlier, they are very less by oral sex. Since you may have had cold sores in the past, so if she was carrying any HSV 1 infection in the genital area then it should not bother you much. For a person who has had herpes cold sores from herpes simplex virus 1 (HSV1), it is unlikely for HSV1 to be transmitted through oral sex. Having been infected with HSV1, the immune system has already manufactured, and kept on reserve, antibodies to this virus. So if you had HSV 1 in the past, any further outbreaks may not be there as your immune system may have recognized the infection.

However if your girlfriend has not had any HSV 1 or HSV 2 infection then you can transmit any of these infections to her. Most individuals have no or only minimal signs or symptoms from HSV-1 or HSV-2 infection. Herpes simplex is most easily transmitted by direct contact with a lesion or the body fluid of an infected individual. Transmission may also occur through skin-to-skin contact during periods of asymptomatic shedding. Hence it is essential for you to get investigated for herpes infection.

The U.S. Centers for Disease Control (CDC) recommends that both virologic and serologic tests be used for diagnosing genital herpes. Amongst the virologic tests, get PCR done which is more sensitive and specific than viral cultures. Although PCR is more expensive but even small amounts of DNA in the sample can be detected by this test.

Serologic tests are most accurate when performed 12 - 16 weeks after exposure to the virus and they are less expensive than PCR. You can get herpes select done which includes ELISA (enzyme-linked immunosorbent assay) or Immunoblot. Both are highly accurate for herpes virus.

Hope that this information helps and hope that you get better soon.

Wishing you good health.