[Question #1369] Oral hsv2 and kissing.

46 months ago


I recently corresponded with Terri Warren and have a few further questions. I am married with a child  but foolishly kissed another woman on the lips lightly several times  but with mouths open a  bit, her tongue I think lightly touching my lips.  I also kissed her on the face, neck and shoulder. I understand oral hsv2 is quite rare and only sheds asymptomatically 1% of the year. Is it known to be spread through kissing?  She had no visible cold sores, and says she never has. I believe largely due to my ocd and feelings of guilt, I am thinking of getting a herpes test. I know that I have hsv1 oral due to 2 or 3 very mild outbreaks a  year. I understand having hsv1 can skew a herpes test, making the likelihood of a false positive for HSV 2 more likely.  Am I way over-reacting here? If I get a test, is there a specific one I should ask for? Thanks for your help. 

  




Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
46 months ago
Well, you've got me again here and my response will be the same to you.  I think that Drs. Hook and Handsfield would agree (and I will ask one of them to post a quick response here as well since we've talked elsewhere before) that there is virtually zero risk of you acquiring HSV 2 from kissing, especially in the way that you describe.  I am not aware of a single case of HSV 2 being transmitted via kissing only  And I don't think that you need a herpes antibody test at all given your situation.  However there is one error in here and that is that having HSV 1 does not make it more likely to have a false positive on the HSV 2 test.  This is information that we obtained from a large study recently that is being submitted for publication very soon.  Your worry and guilt are driving this unnecessary worry.  I'm sorry you are afraid, but right now, you need to let reason take over here and put your emotions aside. 

Terri
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H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
46 months ago
Greetings. Terri asked me to weigh in. I agree exactly with her:  I too have never seen a case of either oral HSV2 acquired by kissing, or genital HSV2 from receiving oral sex. As your own research has found and Terri supported, oral HSV2 is uncommon, sheds infrequently, and is rarely a source of HSV2 transmission. I also agree with Terri that you should not have HSV2 testing on account of this event. The chance of a falsely positive result -- with all the anxieties it would bring -- is a lot higher than the chance you were infected.

As for the effects of prior HSV1 on newly acquired HSV2, it has long been known that the initial symptoms of HSV2 tend to be less severe, and by extension, may more frequently be asymptomatic. The data are conflicting on whether HSV1 actually reduceds the chance of catching HSV2 if exposed. The best summary is that it probably does reduce the risk, but not by very much. (Certainly people with HSV1 cannot consider themselves significantly immune to HSV2.) In those who do acquire HSV2 in the presence of HSV1, here is no known effect on development of HSV2 antibody or the reliability or timing of positive test results.

I would reinforce Terri's comments about your unnecessary worry. Try to separate your guilt and anxiety over a sexual decision you regret (which was very low risk anyway!) from the infectious implications of it. They aren't the same. Deal with the former as you need to, but you can disregard the latter.
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Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
46 months ago
Thanks so much, Hunter.

Terri
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46 months ago
Thanks for the speedy and authoritative response from both of you. I think my very real ocd over germs in general and my guilt  is at the heart of this. Dr. Handsfield stated that transmission of oral hsv2 is rare, yet he nor yourself are aware of it happening at all through kissing alone. Does this make it more of a theoretical possibility than a real world risk in my situation?  If so, I can  understand how a test would be overkill. (The event I described happened over 2 separate incidents).
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
46 months ago
Yes, I would say a very very low theoretical possibility.  not a real world one.

Terri
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46 months ago

Thanks so much for your response. I understand why I should avoid getting tested, yet the double-edged sword that is the internet (which I need to stay off of), keeps my anxiety going. A few days ago I quite easily found (although I was hoping not to), a young man who  appears to be giving a very compelling case for how he got oral hsv2 through French kissing alone. He stated that after ending a long-term relationship, he tested negative for hsv2 on an igg test before engaging in any further sexual contact. He then had a 2 month relationship with a woman who stated she had genital herpes, so they agreed to only (French) kiss. Contemplating going further, he did some research and learned about the uncommon instances of oral hsv2. He then went for an igg test that came back low positive at 1.7 for hsv2, then another that came back 1.3. He then had a confirmatory test done with a biokit and it also came back positive. (This was a year ago, visible to anyone, posted publicly on Honeycomb support network). However, reading your posts, I have learned that low values like that have about a 50% chance of being false positive, and that "only a Western blot should be used to confirm low positives". This fellow is quite distraught. Does it appear to you that with such low values and the biokit, he may well actually be negative all along? If so, I can contact him and refer him to ASHA's on-line services- he is convinced due to the testing he is positive for hsv2 through kissing alone.

Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
46 months ago
I really discourage people from believing everything they read on the internet as people post things there for reasons and motivations that you may not understand. 
Yes, a western blot is recommended for him.  If you do test, and get a low positive, confirmatory testing would also be recommended.  We kept data for 8 years of HSV 2 testing, and we found that the data was very clear - 5.3 to 5.7% of people fell into the low positive range, which means that 95% of the time, people had a clear answer with their test.  Have you ever had a herpes antibody testing in the past to know that you were not infected with HSV 2 prior to this?

You've used up all of your posts here - you can renew if you have more questions.

Terri
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