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Avatar universal

Second thoughts after relationship HSV 2 with family

Hello Doctors,

I was in a relationship with an HSV 2 genital young female for a little under a year  (I am male).  We engaged in oral sex (both her to me and me to her) and had genital sex only a few times.  The oral sex was not protected, the genital sex was.  She was not on any medication, however we were mindful of outbreaks.  I waited the 6 months to have my blood test with herpeselect and it was negative for HSV 2 and positive for my oral HSV 1.  

I know the tests are somewhat accurate but not entirely.  One of my children had developed what  appeared to be a cold sore.  I would not be surprised if this is HSV 1 since both my ex wife and I have the oral infection (my ex wife occasionally has oral lesions).  I kiss my kids often and of course there is no sexual abuse.  Still, seeing a cold sore on my child alarmed me.  What should I do?  Were my kids at risk for HSV-2?  I suppose engaging in oral sex would make kissing my children a now risky behavior?
7 Responses
239123 tn?1267651214
MEDICAL PROFESSIONAL
Welcome to the forum.  Thanks for your question.

You were at less high risk for catching your partner's HSV-2 than you might think.  Among couples with one infected partner, who have unprotected sex an average of 2-3 times per week, HSV-2 is transmitted in about 5% of couples (1 in 20) every year.  That works out to around one transmission for ever 1,000 episodes of unprotected vaginal sex.  Oral sex is little or no risk at all.  Further, if you had been infected, probably you would have known because of symptoms.  (Asymptomatic infection is common, but people who are worried about exposure and on the alert usually notice symptoms if they catch the virus.)

So even without testing, the odds you had caught HSV-2 were very low.  And when we factor in your negative blood test at 6 months, you can be even more confident.  There really is no realistic chance you have HSV-2.

Finally, even if you have HSV-2, your children would never be at risk.  Of course you could infect your wife sexually, but probalyy not orally; HSV-2 doesn't easily infect the mouth.  And without sexual abuse HSV-2 is never transmitted to children in the household, regardless of sharing eating utensils, bathrooms, towels, etc.  It simply never happens.

Given your and your wife's shared HSV-1 infection, there is little doubt that if your child's facial lesion in fact was herpes, you can be confident s/he has HSV-1, not HSV-2.

For all those reasons, you should not e at all worried.  I'm sure your child's apparent oral herpes is HSV-1, either acquired from you or your wife from normal parent-child contact, or perhaps from another child in school, day-care, etc.

Best regards--  HHH, MD
239123 tn?1267651214
MEDICAL PROFESSIONAL
I would add that it would be wise for your child to see the pediatrician for diagnosis of the apparent cold sore.  There are many potential causes other than herpes.  (Also, I assume by "cold sore" you understand that this means a lesion on the face or lips, not inside the mouth.  One or two open sores in the mouth usually are canker sores, which have nothing to do with herpes.)
Avatar universal
The lesion has since healed.  It was on her upper lip.  I am unsure if it crusted or not, or if it was simply irritation.  I supposed diagnosis at this point would be impossible, and HSV blood testing on toddlers/young children I have read is not reliable.  
Avatar universal
Is there any additional testing for myself or my daughter you would recommended now or in the future?
239123 tn?1267651214
MEDICAL PROFESSIONAL
If and when your daughter has another similar sore, it should be examined by her pediatrician, preferably within a day or two of onset.  Other than that, I recommend no further testing of any kind for you or anyone in your family.
Avatar universal
Sorry Doctor.  I know you don't care for questions from anxious folks on this forum, but I have a lingering concern with our conversation.  Your advice to see a pediatrician if the lesion reccurs on my daughter within 1-2 days.  Is that so the pediatrician could swab and type the cold sore in the off chance it is HSV2 if the pediatrician sees fit, or is it general medical advisement?  I was feeling pretty confident I shouldn't worry about HSV2 with my daughter, but the comment to have her examined triggered a bit of anxiety.  Have you ever seen cases of transmission to children when not at birth?
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