Acquisition of Herpetic Whitlow from sexual genital contact

[Icarus-reborn]

Hi all

This question for Dr, Handsfiled or Dr. Hook,

In March of 2007 Dr. Handsfiled wrote that the risk
of acquiring hsv 2 Whitlow by fingering a known infected
partner was "extremely low". I've pasted part of the quote below for
reference.

I'm just curious if in the past couple of years if there might have been
some science or study on the matter that could be a little more
definitive or supportive today, and if you still believe this (almost zero chance)
to hold true?

In that same post from 2007, the uninfected young man asked if taking Valtrex
immediately after sex with his infected partner would help reduce his
risk of infection. I believe you answered affirmative on that, but you noted that there
wasn't anything conclusive to back it up. So on that one, anything new since
2007 that might support using it as a preventative?

The answers from you or Dr. Hook would be most appreciated as I'm trying to
fill some info gaps in my brain.

Best Regards

by H. Hunter Handsfield, M.D., Mar 19, 2007 12:00AM
Someone else asked almost the same question just a couple of days ago.  There is a theoretical risk of transmission of HSV-2 by fingering, especially if there is a prior skin lesion like a cut, inflammation around the fingernail, etc.  But in 30+ years in this business I have never seen a case, and I am not aware of any reports of it in the medical literature--so common sense says the risk is extremely low, maybe zero, given the frequency of fingering, of genital herpes, and of cuts or lesions on finger.  So statistically, it is an unlikely explanation for your symptoms.

[Terri Warren, RN, Adult Nurse Practitioner]

There is nothing in the research that addresses this question in humans.  However, there is a study in mice indicating mice who are treated with antiviral therapy after being infected with herpes virus.  Those who were treated right away had better outcomes than those who were treated later.  So there probably is no downside to treating prophylactically when there is a risky exposure, but also no guarantee that it will be successful.

Terri

[Icarus-reborn]

Happy New Year to you and the staff of MedHelp. Your advice,
comments, and support are invaluable!

Nope, no lesions, just plain pure curiosity if there were
any recent studies to reinforce Dr. Handsfield's thoughts about
the risk of catching hsv2 whitlow from genital contact. I know
science is quite dynamic and that theories change over time
based on new science and technologies., so was just wondering.

I would appreciate a comment, though, on Dr. Handsfield's
reponse on Valtrex acting as a preventative in catching
herpes if taken after sex. Is there anything published online
anywhere that cites Valtrex or any other related drug acting
as a type of viral prophylactic against Herpes infection?

Many thanks in advance for your response!

[Terri Warren, RN, Adult Nurse Practitioner]

I agree that the risk is very low, and also, that there is no particular scientific study behind this statement by me or him.  However, if you have a lesion on your finger that you believe could be HSV, then the best thing to do is if it comes up again, if it ever came up, then you should go right away to an immediate care setting or your own provider if you can get in the same day, and have a PCR swab test done from this lesion.  That's the best way to know.  I'm assuming you've had an antibody test done as well?

Terri