Concerned on multiple levels

Dear Doctor,

First I would like say that this site is very informative and if I have learned anything; it is that there is life with HSV.

I had unprotected oral sex with a woman (gave and received)21 days ago. No vaginal sex and this was the only time we had oral sex. (9) days later she informed me that she is HSV II positive.  She has been HSV II positive for (15) years and in that time span she has had approximately (12) re-occurrences. She had been married and sexually active for (12) of those years, without her husband becomming infected. Also she is on suppressive antiviral therapy.  Which one is not known to me.

As of today I haven't had any symptoms, that I can detect, which would accompany a initial outbreak of Oral HSV II.  And I understand that it is rare to become infected orally by HSV II, and less likely from female to male, but it can happen and it does.  However, our minds tend to wander and think what they want.

(5) days post exposure, I had performed oral and had vaginal sex with a woman I have been seeing on and off for the past few months. Both unprotected.  Naturally I am beside myself that I have now infected her.  

My questions are:

After (21) days with no apparent symptoms, how worried should I be?

If in fact that I have been infected with HSV II orally. What risk after (5) days post exposure have I put this woman into?

By kissing her and performing cunnilingus?

Thank you for reading my story and everyone elses.  It HELPS!!

[H. Hunter Handsfield, M.D.]

Your risk of getting HSV-2 from the exposure you describe was zero or close to it.  In regard to your statement "I understand that it is rare to become infected orally by HSV II, and less likely from female to male, but it can happen and it does":  It is so rare that no such case has ever been documented to occur--ever.  There is no reason to believe it is less likely from female to male than the other way around.

So after 21 days with no symptoms, combined with the very low risk, you can definitely assume you are not infected.  Even if you had been infected, there was zero risk of transmission to your second partner by cunnilingus or kissing.

Bottom line:  Relax and stop worrying about it.  You're home free.  Good luck--

HHH, MD

[klukaia]

After reading Magua088's question, I was wondering about the possibility of getting genital HSV-2 from fellatio.  In the FAQ it states that it is not possible.  However, if it is possible, albeit very rare, to get oral HSV-2, if someone does have it, and then performs fellatio on someone that doesn't have it, wouldn't there be a chance of oral to genital transmission? Or is that only a theorectical risk that is not really measurable in the real world and has never been documented?  Thanks.

[H. Hunter Handsfield, M.D.]

Maybe "not possible" is too strong.  You've got it exactly right in your closing questions:  "...a theorectical risk that is not really measurable in the real world and has never been documented".

HHH, MD