Exposed to Herpes - what now?

[Delpariffic]

Last week I had intercourse with a woman, who later that evening began to feel the itching/tingling of the onset of a herpes outbreak.  We used a condom for the entire vaginal intercourse, and happened to jump right in the shower after the event, but we performed unprotected oral sex on each other prior to vaginal intercourse.  It has only been 4 days since the event, and so far I have not had any symptoms.  I have an appointment with an STD doctor later this week, but I am freaking out.  Is it a foregone conclusion that I've contracted the virus, or is there a chance that I may not have?

I have recently tested negative for herpes via blood test, so I don't think that I had Herpes prior to this event.  I know that many people don't get symptoms at all, and that it can take months for a blood test to show exposure.  How can I prevent passing it on to someone else?  I always wear a condom, but do I run the risk of infecting someone if I kiss them, even without symptoms?  

Thanks for answering.

[Edward W Hook, MD]

Welcome to our Forum.  I see you have asked the same question of Terri on the HSV Expert site.  I suspect our answers will be similar.

Let's first be clear on the facts.  There first step is to ascertain whether or not your partner definitely has HSV or not and the location of infection.  It sounds as though your partner knows that she has a HSV infection- is this correct?  if so, can you tell me if her infection is oral or genital?  If her infection is genital, your condom use will reduce your risk for infection from the genital exposure and interestingly, genital HSV is relatively rarely transmitted to the mouth through oral sex.  

If she had herpes, let's assess your risk.   The fact is that most exposures to partners with HSV infections of any sort do not lead to infection.  While most HSV infections are spread through exposure to persons who do not know that they have HSV and are asymptomatic, current estimates are that exposure to an infected, asymptomatic infection leads to transmission of infection in less than 1 out of a thousand exposures (0.1%).  If your partner was experiencing the symptoms which sometimes precede recurrences of HSV ("prodromal symptoms")  there may be a slightly increased chance that she was shedding HSV but that is by no means absolute and your risk of infection remains low- probably less than 1%.

If indeed you were exposed, you need to observe and see what happens. When persons acquire HSV, they typically develop lesions at the site of infection with 14 days of exposure.  If you do not develop lesions in this time period, there is little chance that you have acquired HSV and it is time to stop worrying.  We do not recommend blood tests for follow-up after possible exposure. they are just not that reliable and the chances of having a false positive test are higher than the chance of diagnosing newly acquired infection.

Finally, congratulations to your commitment to condoms and safer sex. This will go a long way towards reducing your risk of acquiring HSV or other STDs.  Please continue to do so.  

Hi hope this comment is helpful to you.  Take care. EWH

[Edward W Hook, MD]

If it was recurrent genital herpes, she most likely had HSV-2.  Genital herpes due to HSV-1 rarely recurs.  The type of HSV woul not change my opinion however- you risk of infection, particularly with condom protected sex, is rather low. EWH

[Delpariffic]

Thank you very much for your prompt answer, Dr. Hook.  You have certainly made me rest a little easier.  The woman has genital herpes, and has had outbreaks in the past. The encounter was a one-night-stand, and I was alerted to her prodromal symptoms via a (trusted) mutual friend in whom the woman confided around the time we had intercourse.   I am not sure if it is HSV-1 or HSV-2, and given the nature of the relationship and how I found out, it is unlikely whether I will be able to find out which strain she has.  Would you answer change any depending on the strain?

Thanks.