kissing + hsv2 + hiv

[nutme]

Hi Dr. Hook,

I got hsv-2 on lips from deep kissing a girl for about a minute in a dark place. The kissing exposure was in 2 parts whereby the first kiss lasted 20-30 seconds followed by another deep kiss 5 or so minutes later that lasted another
minute or so. What are the chances of simultaneous HIV transmission keeping in mind that she might have had a recent exposure to hsv-2 and hiv herself. I understand kissing is stated to be no risk event but I got a hsv-2 (not hsv-1) breakout exactly 3 days after kissing and suffering multitude of other copybook symptoms 3 weeks since the exposure. I understand hsv-2 by kising is a very rare event but what do I make regarding the risks with an additional fact that my oral and dental health are also not in good shape. Looking forward to your response. I have always been exremely careful with regards to safe sex and always presumed kissing was safe after reading many of the Doctor's responses here.

In HIV Prevention Community forum I have been advised by few helpful folks that this is not a risk for HIV infection(http://www.medhelp.org/posts/HIV-Prevention/kissing--hsv2--hiv/show/1826107).
I would like to get your take on it.

Thanks..

[Edward W Hook, MD]

Straight to your questions:

1. Do MS related throat lesions which cause plaque collection in throat  over them increase the risk. I suffer from MS for last 2 years.

I am not a specialist in MS.  I am a specialist in STDs.  You should ask your doctor this question.

2. Does skin growth on top of old rotthen root canal cement base with lose metallic cap compromise the skin tissue to get infected during kissing in presence of minor blood. I mean does this cause porus skin edges for virus to seep in even if no active bleeding is noticed from human eye. I generated extra saliva  and rinsed my mouth thinking it would act as a disinfectant. On hindsight, I doubt whether that would have increased my risk.

sigh- your anxiety is working overtime-- NO!!!  

3. Lastly, I have read in community HIV Prevention forums that virus becomes inactive and unable to infect outside the host. If someone gets some infected fluid in mouth, can it be considered outside host almost instantly whereby it loses its outside shell and becomes unable to infect or does it take a a while.

No, during oral sex or transfer of fluids during sex the virus is not outside the body,.  EWH

[nutme]

Hope you can answer these last few questions so I can draw final conclusions and read no further HIV related posts on medhelp which in many ways have been helpful but reading community forums and posts regarding different transmission scenarios sometimes becomes very scary. My queries pertain to your response regarding different skin structure in mouth and especially from the fact that if I got hsv-2 from the girl, i might have gotten some blood in mouth if she had a lesior or sore in  her mouth(however, I understand that sometimes hsv can be transmitted even without existence of sore)

Just FYI: without being judgemental, but in order to provide you correct information, the girl looked filthy and high on something other than alcohol. I could not see her mouth as lighting was not good.

1. Do MS related throat lesions which cause plaque collection in throat  over them increase the risk. I suffer from MS for last 2 years.

2. Does skin growth on top of old rotthen root canal cement base with lose metallic cap compromise the skin tissue to get infected during kissing in presence of minor blood. I mean does this cause porus skin edges for virus to seep in even if no active bleeding is noticed from human eye. I generated extra saliva  and rinsed my mouth thinking it would act as a disinfectant. On hindsight, I doubt whether that would have increased my risk.

3. Lastly, I have read in community HIV Prevention forums that virus becomes inactive and unable to infect outside the host. If someone gets some infected fluid in mouth, can it be considered outside host almost instantly whereby it loses its outside shell and becomes unable to infect or does it take a a while.

These will be my last interaction on this thread. Hope you can proide insight and help me run away without looking back at this incident anymore.

I hope I am not overusing your services for what I paid for but answering the above queries will greatly help me out. Thanks for all your help.

[Edward W Hook, MD]

You continue to worry far too much.  Brief answers to your "what if" questions.

1.  As I said before there is no risk from kissing. This the presence of a HSV sore does not change that.  The mechanics and realities of kissing and sexual intercoursse are quite different, as is the skin sturcture involved.  

2. HSV infections do not migrate from site to site.  If your cold sores occur on the right side, that is a reflection of where your original infection was.

3.  You are correct.  Your exposure remains NO RISK!!!  Do not over think this.  EWH

[nutme]

Hi Doctor,
Thanks for your calming reply. I went through all your replies on the forum and they are really helpful. I just needed to clarify few things. Many times you have said that for HIV transmission to occur, the infected fluid has to be injected deep into the tissue.

1. Now, while deep kissing for say a minute or 2, if the non-infected person get herpes infection while kissing, does it create enough micro tears simultaneously upon massaging the HSV virus onto the skin for HIV to penetrate deep into the tissue(i mean if it has already become suspectible tissue within few minutes of acquiring herpes - as I kissed twice for about a minute with a 5 minute gap in between)? How is it different from sexual intercourse and its been pretty well documented that hsv and hiv many times get transmistted together during sexual intercourse.


2. Also, herpes outbreak appearing on the right side of the lip mean that the sore location was the original sight of exposure where herpes enter my system from or is it possible that even though hsv got massaged elsewhere in my mouth but the sore appears on lips only?

3. I got a hsv sore 3 days after exposure followed by painful throat at 10 days and growing wisdom tooth pus(it does get infected every now and then) with difficulty in eating at about 15-16 days due to wisdom tooth infection & another mouth sore below a tooth not doing too well after exposure. A couple itchy chest rashes at about 3 weeks. And maybe, one night sweat and warm feverish feeling at 25-26 days. I guess these symptoms are pretty widespread from HIV perspective as I have read that HIV symtoms all appear at once and not one after another. Am I correct in these assumptions.

Do let me know your thoughts. I have started having normal physical relation with my girlfriend since last few days. Hopefully, I am OK.
Your first reply was quite informative but besides this incident I do need to make sure that I keep myself safe in future also as even though I knew kissing was no risk, this event shook me a bit. Thanks again for helping folks like me out. I lead a completely no risk life and completely made a judgement error the other day which I am very ashamed of while having a very loving girlfriend.

[Edward W Hook, MD]

Welcome to the Forum. Can you tell me how your diagnosis of HSV-2 was made?  

No matter how the diagnosis was made, this remains a no risk event.  The likelihood that your partner had HIV is minuscule and even if she was, there has still be no report of HIV transmission through kissing and the presence of oral sores of any way do not change this.  Thus while there are no studies of the specific circumstance you ask about I would not worry.  EWH