[Question #11385] HSV-2 oral transmission

14 months ago

Good morning!

I discovered I had antibody to HSV 2 about three years ago.

Random screening.

I have never had a break out.

I went on acyclovir at that time and I have continued it ever since.

400 mg twice a day for the first year or so and then 400 mg once a day for the last year.

My IgG index value has gradually decreased to the point where my 10 panel STD check in February was reported as negative for everything, including HSV 1 and 2.

A confirmatory test, however, was positive for HSV 2 antibody.

My question is, I am male, if I receive oral sex from a lady who is uninfected, with me being on prophylaxis for three years and having a very low IgG index value, have never had a breakout, how likely am I to transmit the virus?

I understand the index value may not mean much.

We talked briefly about this before, and you stated that that would be “low risk.”

Can you offer anything else?

I’m not sure orgasm/no orgasm makes a difference, but let’s say no orgasm.

Thank you!

Terri Warren, RN, Nurse Practitioner

14 months ago

The confirmatory tests are not always correct, both from LabCorp and Quest. The index value says nothing about how infectious someone is, however, those who are asymptomatic shed virus less often than someone who has symptoms.

The reason transmission is unlikely is because HSV 2 strongly prefers the genital area to the mouth. We rarely see HSV 2 infections orally, though I certainly have! It's just seen very rarely. Orgasm makes no difference at all.

Terri

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14 months ago

Thanks very much!

I read one of your posts from 2017 or 2018.

You explained to the questioner that you had seen acquisition of HSV-2 through oral sex, but that was only when the person had genital and oral sex and acquired HSV-2 genitally.

At that time, you stated that in 34 years of practice, you had not seen anyone acquire oral HSV-2 through oral sex only.

After six more years of clinical experience, is that still your experience?

Thanks again!

14 months ago

Sorry…

It looks like that was September 2, 2020

Either #71099 or #71138

Terri Warren, RN, Nurse Practitioner

14 months ago

I still haven't personally seen anyone who told me that they only gave oral sex to someone and got oral HSV 2. Correct. Pretty good odds, I think, that that doesn't happen often

Terri

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