sex with herpes

[pleasehelp_us]

My girlfriend and I have recently been diagnosed with hsv 2.   I have never had any symptoms and she has had one genital outbreak.  Now that we both have the virus do we need to be careful with sex?  We of course would have no sex when symptoms are present, its when they are not present that worries me.   I have read a lot on the internet about the subject and am having trouble finding clear answers to these questions.

  
1. Does having genital hsv 2 provide some protection from getting oral hsv 2?
2. I know that oral hsv 2 is rare.  But when it does happen are the symptoms worse then hsv 1?  
3. Can hsv 2 cause a sore throat?
4. Can ocular herpes be caused by hsv 2?
5. If she gets some of my semen in her eye or if I get some of her fluids in my eye would that increase our risk of ocular herpes?
6. Can we spread the virus to other parts of our body like arms and torsos and faces and eyes by getting each others bodily fluids on our bodies?    

[H. Hunter Handsfield, M.D.]

Sorry to hear about your diagnosis.  But if you have to have genital herpes, you and your partner are in the best situation you can be in:  neither of you will ever get infected again with HSV-2, at any body site, either from each other or any future partners.  The two of you do not need to take any precautions against transmission.

1) Yes.  You cannot get a new HSV-2 infection anywhere on your body.  (The risk may not be truly zero, but it is teeny and you shouldn't worry about it.)

2,3) Irrelevant; it won't happen.  If it does, probably you will have few or no symptoms.  Herpes causes sore throat only with the initial infection, not with recurrent outbreaks.

4) Auto-inoculation, to the eyes or anywhere else, occurs primarily during the initial outbreak.  It is rare in people with recurrent or long-standing herpes.  You and your partner should use common sense hygience when you have outbreaks, such as washing hands after using the toilet or touching any genital lesions.  Otherwise don't worry about it.

5) Same thing.  No realistic risk.

6) See above.  Don't worry about it.

You need to do some basic reading about herpes.  See www.metrokc.gov/health/apu/std, www.cdc.gov/std, www.ashastd.org, and/or www.westoverheights.com.

Good luck--  HHH, MD

[ali-jay]

I'm not a doctor, but I think I can answer your questions :

1. Yes, however, there is no way of knowing from the results of a blood test that either or both of you were not infected orally, although this is extremely unlikely. Very little is known about the frequency and shedding rate of oral HVS2. Some HSV2 shedding studies have been carried within the HIV+ homosexual population which show that oral HSV2, even though it is rare, will shed orally on certain days, especially when there is a genital outbreak.

2. Probably not, but it depends on the patient.

3. Yes, but this is only likely to happen prior to an outbreak. A sore throat does not mean that an outbreak is definitely on the way.

4. I think that HSV1 is the main culprit when it comes to ocular herpes, - which, if I'm right, is even rarer than oral HSV2.

5. Highly unlikely, in my opinion.

6. Also highly unlikely. If you deliberately touch and pop the blisters, I suppose this could happen. As both of you have the virus, I really think there is nothing to worry about. There is no risk of either of you becoming reinfected, even if your girlfriend has a visible outbreak. However, friction, too much contact etc may result in the outbreak becoming worse and spreading. Still probably best to avoid physical contact around the infected area, especially during the blistering phase.

I'm sure the doctor will be able to reassure you !

Hope this helps,

AJ

[monkeyflower]

Since you both have HSV2, you don't have to worry about taking extra precautions during sex. You already have it genitally, which means you won't have to worry about getting it orally--nor do you have to worry about spreading it elsewhere, or triggering outbreaks in each other :-) And while semen in your eye *hurts*, you don't have to worry about getting ocular herpes, either.

If either of you get frequent or severe outbreaks, you might want to consider suppressive therapy. Otherwise, you're both fine.

[estrellab]

I think you guys are fine. I am sure you have read about my situation. I have hsv 2 genitally (recently found out) and my husband has it orally hsv 1. I am and have been the freaked out one and he is just like, apparently I won't get yours and you won't get mine. We are going into our 15th yr and in the clear from the other persons type. It baffles the daylights out of me. I can see me not getting cold sores as I avoid kissing him when he has them, but his not getting genial hsv 2? I don't get it. My symptoms are weird and not classic so I don't know for sure when it is coming. I get irritated and skin tears. The whole thing makes me crazy. You guys asked intelligent questions and I thank you for them. I do agree with the doc. You guys are fine. Take care, EB

[pozgirl]

I think AJ's answers are right.