HSV 2 Transmission

[Mike2689]

Hello doctors.

I'm dating an amazing woman who I really adore, she has genital herpes.  We had sexual contact once where she gave me oral sex and I fingered her, but that was it.  She was asymptomatic at the time.  She has not yet confirmed what she has by blood work, yet I am assuming that it is HSV-2 since she has had multiple genital outbreaks over time.  I, on the other hand, have never had any herpes symptoms of any kind.  Regardless, just today I the HSV 1 and 2 IGG and IGM tests, four in total, to see what my status is.

Here are my questions:  assuming that she has genital HSV-2, and not genital HSV-1, I know that if I performed oral sex on her, it is *unlikely* that it would cause long-lasting, recurring, or serious problems for me orally, if the HSV-2 did manage to make home in my mouth.  However, through my research I have not been able to figure out if an oral HSV-2 infection (in me) could migrate by itself internally through my body to my genitals?  Could I "autoinnoculate" my genitals myself with my own saliva if it touched my genitals, for example?  Or does having the HSV-2 orally make me "immune" to getting it genitally, assuming that my body built up antibodies?

Assuming that she has genital HSV-2, could that infection also be in her mouth?  Could she give me that HSV-2 by kissing or oral sex? Could I spread it to her mouth (assuming it's not already there) by giving her oral sex and then kissing her?

Thank you so much for answering the questions that I have yet to find on the internet!

[Edward W Hook, MD]

Your results indicate that you do not have HSV. That does not mean that if you carry on a relationship with this woman you will become infected.  In fact I have many patients iin long term relationships who do not become infected despite having a regular sexual partner who has HSV.  As I said in my original post "There are several proven ways to dramatically reduce HSV transmission in couples in which one person has the infection and the other does not.  These include telling a partner about the presence of infection, avoiding sex during outbreaks, using condoms and for the person with infection to take daily suppressive doses of antiviral therapy such as acyclovir or valacyclovir.  Each of these measures has been shown to significantly reduce risk for HSV transmission and using some or all of these methods we have cared for couples in which one person has had infection for years yet transmission has not occurred."

I suggest you adopt these behaviors.  EWH  

[Mike2689]

Hello doctor.  I got my test results‚teç IGG for the HSV1, the IGG for the 2, and the two IgMs.  All of them came up negative, and very negative, for that.  The values were like 0.04, around there for all of them I believe.  I was surprised about the HSV1, bc I had read that around 80% of Americans were infected.

I hadn't learned about the uselessness of the IgM tests until after ordering them.  

I'm at a complete loss of what to do now :(  .  I was praying that I actually already had the antibodies, believe it or not!

Do you think that it would be risky/foolish, or even crazy, to get into an oral-sex only sexual relationship with her?  I'm 24 years old and don't want to get infected

[Edward W Hook, MD]

" I'm just still unsure if the HPV2 could go (infect from her genitals --> my mouth --> her mouth (by kissing her) --> my genitals (her giving me oral sex)??"
Not a concern.

IgM blood tests are a waste of time and money.  REsults of IgM tests are, in general, uninterpretable and meaningless.

As for the IgG, let me know the result and we can interpret.  EWH

[Mike2689]

Thank you Dr. Hook!  That did help!  I'm just still unsure if the HPV2 could go (infect from her genitals --> my mouth --> her mouth (by kissing her) --> my genitals (her giving me oral sex)??

Also, say I get a positive result for either the HSV 2 IGG or the IGM?  Where does that put me considering that I've never had any symptoms?  Would we need to protect ourselves?

[Edward W Hook, MD]

Welcome to the Forum. I'll try to help. I think you have a misperception regarding HSV infections. HSV infections are spread by direct contact and do not spread within the body from site to site such as from the genitals to the mouth or vis versa.  HSV infections are primarily infections of nerves and nerve roots which from time to time cause recurrences that are visible in the skin supplied by those nerves.  Thus if your partner has genital herpes type 2, she almost certainly does not have oral infection with the same virus.  Further, auto-inoculation is not a problem for persons with HSV except in the first few days of infection and, even then, it is exceedingly rare.  

Thus you cannot get genital infection by performing oral sex and se cannot give you a genital infection through oral sex on you.

There are several proven ways to dramatically reduce HSV transmission in couples in which one person has the infection and the other does not.  These include telling a partner about the presence of infection, avoiding sex during outbreaks, using condoms and for the person with infection to take daily suppressive doses of antiviral therapy such as acyclovir or valacyclovir.  Each of these measures has been shown to significantly reduce risk for HSV transmission and using some or all of these methods we have cared for couples in which one person has had infection for years yet transmission has not occurred.  

I hope these comments are helpful to you., EWH

[Mike2689]

One other important thing!  Assuming that she has genital HPV-2, I couldn't get GENITAL HPV-2 just by giving her oral sex, right?