Herpes HSV-2 transmission?

[johnlassiter]

I have probably a fairly rare situation concerning the transmission of HSV-2.  I acquired gential HSV-2 via oral sex, and know this since I acquired it at a time when I didnt have gential sex which from I read is extremely rare.  Then a few years later I took Valtrex daily to reduce viral shedding and while on it for about 18 months never had an outbreak.  I always used condoms and my new partner at the time for 5 months never contacted genital HSV-2.  However, the first time she gave me unprotected oral sex, which I felt was OK, since it would be extremely unlikely to acquire it, she ended up with oral herpes outbreak 3 weeks later!  Again, from what I read, to acquire HSV-2 orally is very rare indeed.  Its been over 6 months and she hasnt had another oral HSV-2 outbreak, which should be expected since reoccurences of oral HSV hasnt been documented.  

My question given this background:  What is the risk of my partner acquiring genital HSV-2 when she already has oral HSV-2?  How long do the anitbodies need to be developed to effectively protect her?  We still use condoms for genital sex, but at some point may stop since the risk would be extremely low.

[gracefromHHP]

hsv1 orally first isn't 100% protection against hsv1 genitally later on but pretty close. so few folks who have well established hsv1 oral infections contract hsv1 genitally that we can't feasily study that either.

[johnlassiter]

Thanks for your reply.  I would be interested in what is know about those who have had HSV-1 oral, and significant protection it is from getting HSV-1 genitally?  Is there any study that shows those who contact HSV-1 genitally the percentage that has HSV-1 oral as well?  I thought I read somewhere that a very high percentage of those that acquire HSV-1 gentially did not have HSV-1 oral prior?

[gracefromHHP]

we don't have a lot of research on if having hsv2 orally protects you from contracting hsv2 genitally. it doesn't happen often enough to easily test it. Most people who contract hsv2 orally, also contract it genitally at the same time.  It should offer significant protection but how much, we don't know.  

[johnlassiter]

Thanks for the response.  Both my partner and I had culture tests to determine it was HSV-2.  We both had blood tests later that showed I had HSV-1, where she doesn't (she just took the test).  I never had an oral outbreak from HSV-1 that I can remember so likely got it in as a child, and never knew I had it, nor did I pass it on to any partner for over 20 years be sexually active.  

I don't think there is much research about genital HSV-2 passing orally, but from what I understand it can often be passed from viral shedding, and this would have been the case with my partner since I had no outbreaks for a long period of time taking Valtrex.  I think oral HSV-2 is more common then what is thought because most people acquire HSV-2 through unprotected genitial sex, which wouldnt apply to us, and because maybe half of people have HSV-1 oral which helps protect them from HSV-2 oral, and because HSV-2 oral has  reoccurrence in one study I saw of 0.01 per year so no chance to get a culture test other than first breakout.

[gracefromHHP]

how were you originally diagnosed as having hsv2?  had you ever been tested for hsv2 prior to that?

was your partner tested with a lesion culture of her active cold sore to know it's hsv2?

grace