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STDs (Expert Forum)
Transmission risk
Answered by
Edward W Hook, MD - HIV Prevention, stds
Welcome to the STD Forum, which is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.
Transmission risk
by sammy4321, Nov 07, 2009 08:03PM
Dr. I've had oral hsv1 for 15 years. I had my first OB recently. As far as we know, my wife does not have it. We are working through the details of getting her tested. My questions are:
1. Assuming I never have an OB again, what are her risks of transmission?
2. Is there statistical data to prove this?
3. Should we refrain from unprotected oral sex forever?
4. Can i give it to my kids with a simple kiss on the lips without lesion?
Please help
1. Assuming I never have an OB again, what are her risks of transmission?
2. Is there statistical data to prove this?
3. Should we refrain from unprotected oral sex forever?
4. Can i give it to my kids with a simple kiss on the lips without lesion?
Please help
Doctor's Answer
by Edward W Hook, MD, Nov 07, 2009 10:50PM
, Nov 07, 2009 10:50PM
Welcome to the Forum. If you know you have had HSV-1 for 15 years, how could you have just had your first OB? Not sure this makes sense.
You are asking many questions which related to the natural history of HSV infections. In general less is known about oral HSV-1 infections than genital HSV because it is less well studied. There are many parallels however. Let's see what I can say about your questions:
1 and 2, Your wife may already be infected as is the case for about 60% of American adults, 90% of whom are not even aware of infection. Your wife’s chances of infection are even higher than average since you are infected and she has been exposed to you. Testing is a good idea and the proper place for her to start. Persons with HSV-1, like persons with HSV-2, are known to have asymptomatic shedding of the virus when the virus is present on normal appearing skin,. The rates of asymptomatic shedding do tend to go down over a period of years following infection but it can still occur. Most exposures to partners with asymptomatic shedding, whether we are talking about genital HSV of oral HSV-1 do not lead to infection. The precise risk of transmission of oral herpes to another person is not known (no studies).
3. I would not. Chances are low. If it does happen, it really is not the end of the world. I am not trying to be cavalier about this, this is the case. Just think about how many people who have oral HSV but don't know it have had oral sex and how rare transmission is (very low).
4. This is a possibility but it should not interfere with you being affectionate towards them other than avoiding kissing hem should you get a recurrence of your cold sores. After all, if they were to get it, they would just be in the same situation as most people.
Hope these comments help. EWH
You are asking many questions which related to the natural history of HSV infections. In general less is known about oral HSV-1 infections than genital HSV because it is less well studied. There are many parallels however. Let's see what I can say about your questions:
1 and 2, Your wife may already be infected as is the case for about 60% of American adults, 90% of whom are not even aware of infection. Your wife’s chances of infection are even higher than average since you are infected and she has been exposed to you. Testing is a good idea and the proper place for her to start. Persons with HSV-1, like persons with HSV-2, are known to have asymptomatic shedding of the virus when the virus is present on normal appearing skin,. The rates of asymptomatic shedding do tend to go down over a period of years following infection but it can still occur. Most exposures to partners with asymptomatic shedding, whether we are talking about genital HSV of oral HSV-1 do not lead to infection. The precise risk of transmission of oral herpes to another person is not known (no studies).
3. I would not. Chances are low. If it does happen, it really is not the end of the world. I am not trying to be cavalier about this, this is the case. Just think about how many people who have oral HSV but don't know it have had oral sex and how rare transmission is (very low).
4. This is a possibility but it should not interfere with you being affectionate towards them other than avoiding kissing hem should you get a recurrence of your cold sores. After all, if they were to get it, they would just be in the same situation as most people.
Hope these comments help. EWH
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