transmission Hsv2 and oral sex

[MarsAttack]

3 hours ago, tiredandlonely said:

Do you have HSV-1 or HSV-2?

hsv-2

[tiredandlonely]

8 hours ago, newbieddd said:

I am really interested if anyone knows of anyone who has been infected with herpes 2 from oral sex.  I am dating and recently found out that I have herpes 2.  He did not leave me, thought he would from his initial reaction, but it did take  him a long time to want to have sex with me again, which does not include oral sex.  I have told him that the risk is very low, but his doctor told him that oral sex is risky and most things you read on the internet tells you that you can get herpes 2 from oral sex.  FYI we always use condoms and I am now taking medication.  I really like oral sex, so I am pretty close to just saying, forget about it, and leaving him, sex does not feel spontaneous and fun anymore.  Shame I really like him, but I think by nature he is a very cautious person. 🙄

While it is possible for someone to have HSV-2 orally, it is very uncommon, and the virus reactivates in the oral cavity very, very rarely.

Honestly, if someone is willing to take the risk of getting genital HSV-2 from sexual intercourse, I don't understand why oral sex would be off the table. Their risk of contracting oral HSV-2 is much lower, and the potential consequences (in my opinion) are less severe (genital HSV-2 can recur frequently; it is unlikely to occur frequently - if ever - if you catch it orally).

6 hours ago, MarsAttack said:

I was infected via oral (received, I am male). Cannot be 100% sure, but is the only thing I did "unprotected" with a sex worker. Cannot exclude that I was so "weak" and girl in very shedding phase, that got infected through legs or don't know how.

I got HSV-2 from someone whom I only ever had sex with using condoms. Condoms do not prevent HSV-2 transmission 100% - I think it's a lot more common that you contracted this from sexual intercourse unless you know for certain that the woman who performed oral sex on you was infected with HSV-2 orally.

Oral HSV-2 is extremely rare. It accounts for approximately 1% of oral infections and it sheds 1% of the time (https://herpeslife.com/opportunity/free-ebook-signup.html).

Genital HSV-2 sheds 15-30% of the the time and condoms reduce the transmission rate by only 30-50%. There is also evidence that they are less effective at preventing transmission from women to men (than vice versa). 

https://www.guttmacher.org/journals/ipsrh/2001/12/condoms-reduce-womens-risk-herpes-infection-do-not-protect-men

https://www.healio.com/infectious-disease/stds/news/in-the-journals/{31ed8b2f-7ebc-493d-861f-94056e5a294f}/risk-for-hsv-2-transmission-using-condoms-associated-with-gender

It's not impossible, but statistically it's really unlikely.

[MarsAttack]

3 hours ago, tiredandlonely said:

While it is possible for someone to have HSV-2 orally, it is very uncommon, and the virus reactivates in the oral cavity very, very rarely.

Honestly, if someone is willing to take the risk of getting genital HSV-2 from sexual intercourse, I don't understand why oral sex would be off the table. Their risk of contracting oral HSV-2 is much lower, and the potential consequences (in my opinion) are less severe (genital HSV-2 can recur frequently; it is unlikely to occur frequently - if ever - if you catch it orally).

I got HSV-2 from someone whom I only ever had sex with using condoms. Condoms do not prevent HSV-2 transmission 100% - I think it's a lot more common that you contracted this from sexual intercourse unless you know for certain that the woman who performed oral sex on you was infected with HSV-2 orally.

Oral HSV-2 is extremely rare. It accounts for approximately 1% of oral infections and it sheds 1% of the time (https://herpeslife.com/opportunity/free-ebook-signup.html).

Genital HSV-2 sheds 15-30% of the the time and condoms reduce the transmission rate by only 30-50%. There is also evidence that they are less effective at preventing transmission from women to men (than vice versa). 

https://www.guttmacher.org/journals/ipsrh/2001/12/condoms-reduce-womens-risk-herpes-infection-do-not-protect-men

https://www.healio.com/infectious-disease/stds/news/in-the-journals/{31ed8b2f-7ebc-493d-861f-94056e5a294f}/risk-for-hsv-2-transmission-using-condoms-associated-with-gender

It's not impossible, but statistically it's really unlikely.

Among the many many dermatologists I visited you are the first one telling me something I didn't know and that FITS my case!

I refer to this part "and the potential consequences (in my opinion) are less severe (genital HSV-2 can recur frequently; it is unlikely to occur frequently - if ever - if you catch it orally)."; this because since my first ob, that consisted in a many tiny ugly pimples on glans, didn't reoccur in that form and never (even the first time) with pain or severe itch (had some mild itch now and then after).

But as you are repeating, is also possible that condom wasn't enough (you mean uncorrect use or how?).

 

[tiredandlonely]

Condoms just aren't 100% effective at preventing herpes transmission because it's transmitted through skin to skin contact and the condom only covers your penis. Condoms do a better job preventing pregnancy and STDs that are transmitted through bodily fluids/membranes.

You don't necessarily get an outbreak exactly where the virus entered your skin. It lives in the nerves, so it can show up anywhere the word enervates. So, just because your penis was covered, if another part of your genital area came into contact with the virus, then you would still have gotten it. 

It doesn't mean you didn't use the condom properly; condoms just aren't all that effective at preventing herpes transmission, especially if this woman had a new infection or didn't know she had it and wasn't taking proper precautions. She may have had a mild outbreak that she didn't know was herpes, or may have been shedding asymptomatically. 

I'm not really sure what you are trying to convey by describing your symptoms as fairly mild (although it's great that your symptoms are mild). Do you mean that you think you got it from oral sex because your symptoms are not severe?

In case it was unclear, my statement that oral HSV-2 is less severe really only applies to the experience of the person with the oral infection. It's generally less severe because it doesn't reactivate as frequently in that site (although the primary outbreak may be unpleasant).

You have the virus genitally, so if your symptoms are not severe, it has nothing to do with whether the person who gave it to you had it genitally or orally; it just has to do with how your immune system is handling it.

[MarsAttack]

Thanks @tiredandlonely , I had sex with the same girl both oral (unprotected) and vaginal (protected), and first ob that I noticed were the tiny bumps on glans penis (no pain, no itch) I do had few other "sores" (or don't know what they were) on arm and leg (opposite sides of body) though. The fact that mainly the very noticeable ob was on glans (well protected by condom during vaginal sex) made me think that I got it via oral sex.

Lately I am getting many sporadic tinglings on inner thighs than other effects... does mean I am almost shedding everyday?

Thanks

[tiredandlonely]

5 hours ago, MarsAttack said:

The fact that mainly the very noticeable ob was on glans (well protected by condom during vaginal sex) made me think that I got it via oral sex.

I understand how it would seem liked you had to have caught this from oral sex because of where your OB occurred, but outbreaks don't occur only on the skin that was exposed at the time you contracted the virus.

The virus enters the skin (in your case, perhaps at the base of the shaft where maybe the condom wasn't covering), incubates, infects your nerves, and then you have an outbreak. It can occur anywhere in your genital area. The skin on your glans is thinner than other skin in your genital area, and is more vulnerable to outbreaks. 

 

Also, tiny bumps with no pain and no itch don't sound like typical herpes. Was your outbreak swabbed? Have you had recurrences? I highly doubt that the "sores" you experienced on your arm and leg (unless it was the upper thigh) were herpes. Did you have them checked out?

Lastly, there is no way to know if you are shedding all the time. How long have you had the virus? Do you take antivirals? 

[MarsAttack]

- One year and half since infection.

- Yes, I think my case is really atypical. I never swabbed it but took many tests in a row, was - unfortunately- able to notice the IGG "curve" raising through months; among the many tests 2 were "positive "others "equivocal" (only the first one I took a month or two after infection was truly negative).

- No recurrences at least not in the same form as the first ob (those pimples on glans). I do have tinier bumps though, like if my penis glans now and then shows more evident "goosebumps" that I don't rmember had before.

- No I am not on antivirals even if want try, specially 'cause I am almost not having sex anymore with girlfriend fearing to infect her.

 

Thanks again for your info

[tiredandlonely]

What were your index values for the IgG positive tests? Have you considered a Western Blot? 

Why don't you want to try antivirals? If you are experiencing symptoms that you believe are associated with herpes, it may be worth trying antivirals to see if they help with your symptoms. If they don't, it may be worth considering alternative diagnoses (which is not to say you don't have herpes - it's just that even when you have herpes, not everything is caused by herpes).

Were you with your girlfriend at the time that you believe you were exposed to herpes? Has she been tested? As I'm sure you already know, it is possible to have safe sex and significantly reduce your chances of transmitting the virus to her.

[MarsAttack]

@tiredandlonely, the index values is the thing that is torturing me. I used different clinics... the only one where I got the "POSITIVE" status was at the hospital where  the DON'T give values!!! Probably you didn't see my log of tests, I post you here:

 

One month and half after exposure
Blood test seeking HSV2 IGG, result: 0.50 (still negative).

14 weeks after exposure
Blood test HSV2 IGG, result: value 1 (equivocal).

6 months after exposure
Third blood test seeking HSV2 IGG, result: positive (hospital, not same structure from previous test. no value was given).

9 months after exposure
Fourth blood test seeking HSV2 IGG, result: 0.90 (that is the “highest” number in negative range, weird ’cause it seems lower than previous tests).

One year after exposure
A fifth (and last test for now) at the same hospital (of third test) confirmed the positive HSV2 IGG status.

 

Every test - also included HSV1 IGG, - always negative.

 

The reason why didn't try antivirals yet is a mix of fear of side effects and probably 'cause my outbreaks (given that the mild tingling and spots on thighs means an ob) were very bearable. But... I also have fear of give H to my gf, so think must start at least to help mentally to have sex worrying a bit less.

 

Girlfriend tested few months after my infections and was luckily still negative, I am begging her to test again now, will happen in next month hope.

 

[tiredandlonely]

So you have had no "positive" test where they provided you with an actual IgG value?

Given that it has been over a year and you have never taken antivirals, I would consider the Western Blot. It's more expensive, but in your situation I think it will give you much needed information. 

If you are unwilling to do that, I would at least encourage you to do another IgG at a place where they will give you the index value. 

If your positive value has been below 3.5, which I would suspect is the case, since you've had equivocal results on several tests, then it would need to be confirmed with Western Blot anyway.

IgG would be expected to increase over a period of months after initial infection, but once you reach the positive range, it shouldn't go back down to the equivocal range. 

It's possible you are positive and your body just doesn't have as much IgG antibodies HSV-2 as other types (which is why the Western Blot is more accurate; it looks for all proteins/antibodies to HSV-2 and not just IgG), but it's also possible that you don't have HSV-2. If you've ever had mono or chicken pox, those antibodies could potentially cross react with the IgG test, resulting in an equivocal or low positive score.

Also, HSV-1 being negative doesn't mean as much as you might think. The IgG for HSV-1 misses up to 30% of infections (the IgG for HSV-2 is more sensitive). 

Also, if you do have HSV-2, regarding antivirals, it's worth trying them to see if you even do have side effects. If you have side effects, then you can always stop. These drugs are generally very well tolerated and have been around for decades. If you are having sex and you and your partner are concerned about potential transmission, then it doesn't matter if your symptoms are bearable or not; you would want them so that viral shedding and the risk of transmission is reduced.

[MarsAttack]

Thanks Tired, the thing that terrifies me is that all the info you're giving me - and in part I gathered from web too, - were never suggested by one of the many dermatologists I consulted. This is disappointing and also alarming, I live in a medium sized european town (but also visited a doctor from a near bigger city...) makes me wonder that HSV is still too rare or too underconsidered.

Btw, I will surely check again where got the numeric IGG index, I was a bit pissed to retest there 'cause considered them least reliable than the one at hospital (since they wrote me "positive" without doubt), but want do it again.

I also found strange that my IGG count is weak... in logic, if my body doesn't produce much antibodies, wouldn't I have more visible/painful H effects? Though someone told me that H antibodies are not EVERYTHING in keeping H quiet. What is your opinion?

And now to the worst part. I don't hope for miracles of course, since I know that it happened, the now and then itch is something I never had in my life and above all my glans is not "normal" as before. So I know that I got something, I am more inclined to think that got a rarer strain with less visible effects.

Thanks again, will also find if and where can take a wb test.

[tiredandlonely]

1 hour ago, MarsAttack said:

Thanks Tired, the thing that terrifies me is that all the info you're giving me - and in part I gathered from web too, - were never suggested by one of the many dermatologists I consulted. This is disappointing and also alarming, I live in a medium sized european town (but also visited a doctor from a near bigger city...) makes me wonder that HSV is still too rare or too underconsidered.

It's not that HSV is so rare that it is misunderstood. It is that it is very common and most people don't have symptoms so it's not considered a major health issue. Many doctors depend on outdated information, and not all of them fully understand the implications of the IgG testing. You may want to do a little bit of research/call around and see if you can find a doctor who has experience with herpes. 

4 hours ago, MarsAttack said:

I also found strange that my IGG count is weak... in logic, if my body doesn't produce much antibodies, wouldn't I have more visible/painful H effects? Though someone told me that H antibodies are not EVERYTHING in keeping H quiet. What is your opinion?

This isn't totally accurate; the immune system is more complicated, and it creates a lot of different antibodies to HSV-2. The IgG test looks for one specific type of antibody and most people who have HSV-2 will have a lot of this antibody circulating in their system. 

It is possible that you have HSV-2 and that the other antibodies to HSV-2 (the ones that would be detected on a WB) are keeping the virus in check. Everyone's immune system is different, so yours might just be more efficient at making other antibodies. You also may not have HSV-2, and something else may be cross-reacting with the IgG test causing a slightly-higher-than-negative value.

4 hours ago, MarsAttack said:

And now to the worst part. I don't hope for miracles of course, since I know that it happened, the now and then itch is something I never had in my life and above all my glans is not "normal" as before. So I know that I got something, I am more inclined to think that got a rarer strain with less visible effects.

I don't think that you got a rarer strain. I think that if you have herpes, your body is dealing with it in a unique way, so your symptoms are not textbook. I also think it's possible that you got something that is not herpes.

Honestly, if you have herpes, your symptoms sound mild even without antivirals. I would encourage you to give them a shot and see if they can help. When the symptoms are under control, it can really help with the mental acceptance piece.

But also, it's important to determine if this is herpes or not. Because if it's not herpes, you need to figure out what it is so that it can be addressed and treated. There are lots of things that can cause itching/irritation in the genital area. Have you tried antibiotics or antifungals (metronidazole is a good one - it is a prescription in the US).

After I got herpes, everything was out of whack down there, and because the pH was off and there was inflammation, I ended up getting a pretty bad bacterial infection. I spent months thinking it was herpes, but it wasn't. 

I'm a woman, so obviously my parts are different, but it's possible that something happened in your experience that caused things to be off balance down there, and resulted in inflammation. I think it is possible to get this under control and to reduce/eliminate your symptoms. You just need to find a doctor who can work with you to figure out what's going on down there. Sometimes it takes trying a couple of medications to see what does the trick. 

4 hours ago, MarsAttack said:

Thanks again, will also find if and where can take a wb test.

As far as I know, the WB test is only available through the University of Washington. You can contact them directly to have them send you a kit. You will need to find a healthcare provider who can order the test and process/spin the blood properly and then ship it to UW. I know that they have done tests for people in Europe before, so it is possible, but it may be a little extra work. 

For the record, I have no affiliation with UW, and I really don't think the WB is necessary for most people because the HSV-2 IgG is a pretty strong test (I have a positive IgG and it correlated with my symptoms, so I never got a WB myself). But you are in a more unusual situation since you've had several equivocal tests. 

If you find out that your IgG index values were positive and above 3.5, then you can be pretty certain your positive and move forward with trying antivirals if you want to (I'd encourage it because it really improved my quality of life, but I know they're not for everyone). But I'm skeptical that your positive index values were above 3.5 given your testing history. 

I really hope you get to the bottom of this because I know how frustrating it is to not have answers. FWIW if this is herpes, it is really, really not the end of the world. I have had it for over 5 years and I haven't had an outbreak or any symptoms since I started antivirals. It impacted my sex life in the beginning, but it doesn't anymore. It's a total non-issue. 

So, basically what I'm trying to say is that no matter what this is, it's going to be okay.