HSV2 Transmission trhough oral sex

[dionysus_123]

I have been dating a girl for 8 weeks.  Four weekis into the relationship we decided both to get tested for STDs.  As expected my results were positve for HSV1 and negative for HSV2.  Her results came back positive for both HSV1 and HSV2. We have not have had intercourse.  Prior to getting tested I recieved unprotected oral sex from her.  

1) I understand that Oral HSV2 is rare; because she has HSV1 also does oral HSV2 become even more unlikely?
2) Is it possible for her to transmit HSV2 to me by performing oral sex on me?

[Terri Warren, RN, Adult Nurse Practitioner]

That's correct, all of it, though infection of the oral cavity in conjunction with new infection in the genital area is not all that rare.  Recurrent oral HSV 2 is rare, though we have seen it in the clinic.  When someone has cold sores, if they got oral HSV 2, they would never know it was different than their cold sores, that's why this is a bit hard to nail down.  

This is my last post on this thread.
Terri

[dionysus_123]

Hey Terri,

Yeah I know you can contract genital HSV2 after contracting either genital or oral HSV1.  My question was specifically about "ORAL" HSV2.   As you mentioned and I have read that Oral HSV2 is rare.  What I was referring to was contacting "ORAL" HSV2 on top of ORAL HSV1. I have read that there has not been a documented case..  Thoughts??  see below:

"Given the widespread practice of oral sex (some three-quarters of all adults practice it, according to The Social Organization of Sexuality, 1994) and the prevalence of genital HSV-2 infection, you might expect oral HSV-2 to be relatively common. It's not.

According to one study, almost 100% of recognizable HSV-2 infection is genital (Nahmias, Scandinavian Journal of Infectious Diseases Supplement, 1990). One reason is that most adults are already infected with HSV-1 orally, which provides some immunity against infection with HSV 2. Another reason is that oral HSV-2 rarely reactivates, so even if an infection does exist, no one knows."

Also.....   :

"Similarly, HSV-2 infection in theoral area-outside its site of preference-very rarely causes problems. First of all, oral, HSV-2 infections are rare, for reasons discussed below. But even when an infection occurs, recurrent outbreaks are uncommon. In one study (Lafferty et al., New England Journal of Medicine, 1987), oral HSV-2 recurred an average of 0.01 times a year in newly infected people. "I've never convincingly seen an oral type 2 recurrence," says Spruance."

[Terri Warren, RN, Adult Nurse Practitioner]

It is quite common to contract HSV 2 after having HSV 1.  There are tons of documented cases of this. I think you must have misread this.  When HSV 2 lives in the oral area, it certainly recurs less often and shed less often.  Viral shedding does decrease over time, yes.  

Terri

[Terri Warren, RN, Adult Nurse Practitioner]

You are correct, HSV 2 orally is really uncommon, and when it does happen, the virus is shed from the mouth on only bout 3 days in a year, so even if she was infected orally, the chances of you getting are very low through receiving oral sex.  

Do you recall what the numeric value of her HSV 2 test was?  If it is between 1.1 and 3.5, the test needs confirmation with another test as there are some false positives in that low range.  Maybe you could call her up and have her get her results so she can double check.  

I hope you will take into consideration all of her characteristics when deciding whether to pursue the sexual relationship with her or not.  Its good that you were both tested (very , very good thing to do) so everybody is clear on what's going on here before intercourse.  

Terri

[dionysus_123]

She told me that she was tested 2 years ago and tested positive for HSv2.  Getting tested again was the easiest way to broche the subject with me.  Like many with HSV2 she has never had an outbreak and was shocked at her results 2 years ago.  We're both in our 40s so her exposre could have beed 20 years ago.

I assume she contracted HSV1 orally prior to her HSV2 exposure as most of us are exposed to HSV1 in childhood.  

1)That said, is it even possible for someone to contract oral HSV2 on top of oral HSV1??  I've read studies that say there has never been a documented case.

2) Also even in rare cases of oral HSV2 I understand that there is rarely a recurrance and that the virus loses it's punch when not at it's site of preference..  True?

3)Fianally, if the virus sheds more in the first year after initial exposure does viral shedding decrease over time?  If someone is asymptomatic and contracted the virus 15 years ago, do they shed less noe than say 5 years ago?  10 years ago??