[Question #1927] Herpes transmission by kissing

45 months ago
I was married to a man who had HSV2 genital herpes. He took Valtrex and we abstained during occasional outbreaks, but other than that we used no protection. I had never had an outbreak, but after we divorced I had a blood test which shows the HSV2 antibodies. As I have never had an outbreak I don't know if I contracted the virus through vaginal or oral sex. I believe that the virus is shed at the original point of infection.  Is there a test or a way to tell If I contracted it orally, so I can know if  I can pass  it on to a partner by kissing or oral sex?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
45 months ago
It is far more likely that you acquired this genitally - the CDC says when a person test positive for HSV-2, the assumption should be made that this is genital. If people would tested positive for HSV-2 but have no symptoms swab their genitals at home every day for a few months, using the most sensitive test called PCR, 95% Will shed virus during that time from the genitals.  I think it would be a mistake to assume there is an equal chance of Having acquired it at either location–far more likely it is genital. If you happen to have this orally, it will rarely be active and transmission through kissing is very unlikely.   If you get a lesion in either location, be certain to have it swab tested right away - the PCR swab test is the best one. 
If you take daily antiviral therapy you will reduce your risk of infecting other people by about half - and condoms help too!

Terri
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45 months ago
I have looked online and contacted my local health department about the PCR swab test you suggested and it does not seem readily available to me.  Can you tell me how and/or where I can purchase them?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
45 months ago
You would need to see a health care provider to have this test done - the big labs, Quest and LabCorp, both do PCR testing.  Do you have a regular provider who could do this test?  It is only done when a lesion is present.  It is unlikely a public health department would have this available as it is a bit more expensive than the traditional culture test (but much better).


Terri
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45 months ago
I am a little confused by your reply; as I stated in my original question, I have never had an outbreak or lesion anywhere.  Your suggestion to do a PCR swab test of genital area daily at home for several months was to try to confirm that I had not contracted the virus orally.  Your latest answer says that the swab test must be done by a doctor, (not at home), and only when a lesion is present.  Please advise.
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
45 months ago
OK, I didn't understand from your question that you wanted to do daily home swabbing.  Yes, that's a thing a person can do IF they find the right provider to order the test and is willing to send samples home with you for this purpose.  it is also very expensive - usually about $75 per swab.  This is definitely done in research studies to determine if some drug or vaccine is reducing viral shedding, but most people simply cannot afford to do it privately but if you can, go for it. 
So in this case, you need a medical provider to work with you closely to obtain and collect daily swabs (they can be refrigerated or frozen so as to avoid daily trips to the lab to drop off samples) and provide you with continuing results. 

PCR is also the test of choice when swabbing a lesion that is suspect for herpes.  I was responding with the PCR as a test of choice IF you got a lesion somewhere at some time.
I hope this clarifies things, Sheree. 

Terri
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