[Question #2147] Oral Hsv2. How rare is it really?

45 months ago
Hello, I had a few questions about oral hsv2. Everything I read says that oral hsv2 is very rare, but as I read through hsv2+ people's stories I am quickly realizing that most of them have oral hsv2 as well as genital hsv2. If this is so rare then why are they claiming that they have oral hsv2? My problem is that about three months ago I preformed oral on a guy that might have been hsv2+ at the time, but he might not have been because he told me that he was diagnosed with herpes a week after me by a girl that was sexually promiscuous (just stating facts, I realize anyone can have hsv) and the symptoms he explained to me really sounded like a primary outbreak and she admitted that she showed symptoms but never thought anything of it. STILL this doesn't put my mind at rest because of course I have trust issues and can't trust what he's saying. He also said that his ex, which would be the only sexual encounter he had for at least a year, got a herpes blood test done and it came out negative. She was the only girl that he had sex with before me in a relative amount of time and she tested negative. Ok so I preform oral on the guy ONLY ORAL and flash forward 3 months and I have major anxiety about the whole situation though I have never had an outbreak and believe me there have been many times I thought I was having one and freaked out. Recently though I have been getting what I believe to be gingivitis because the area of gum above one tooth on my right and left side have become inflamed like gingivitis but it doesn't really hurt more than when I brush my teeth I can tell that there is something wrong, but also I started freaking out because they say gingivitis is due to poor oral health so like a dumby I started brushing my teeth really had and I think I cut myself on my lower gums near where my gums and lip meet. After extensive late night overthinking research (even after being told it was not caused by herpes) I found heretic gingivostomatitis. So now I am freaking ou
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
45 months ago
I'm so sorry you are freaking out.  While it is certainly possible to have HSV 2 orally, you are correct that is not common.  Oral and genital infection happen at the same time most often when someone has sex with someone else who has genital herpes and the encounter involves both genital and oral sex.  The symptoms that you describe sound nothing like first infection herpes to me.  Have you had an IgG test for herpes before?

Terri
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45 months ago
I just got one done yesterday because I was freaking out so much and I should be getting my results back at anytime. I went to the doctor about 2 months after to do an std test and they said that they can only do it if there was an active outbreak which I wasn't getting and then she told me that if I had gone this long without having an outbreak then I am probably good. Originally I did the blood test to put my mind at ease but when I found the symptoms of herpetic gingivostomatitis I started freaking out all over again. Have you come into experience with that? When I look it up on the internet it seems that the effects are severe and I barely know I am having symptoms of gingivitis unless I flex my jaw or brush my teeth. I have major anxiety and I'm not sleeping at night which I think is causing more symptoms related to herpes like headaches but I know I can't say it's herpes just because of that but I don't know what to do. I called the office that I got the blood test done and they said it would be ready in about 15 minutes. I'm so nervous. I keep telling myself all the facts he laid out in front of me trying to convince me that theres no way I have herpes from him but it's not helping. Also, if they say its so rare to have oral hsv2 do they mean without the presence of genital oral hsv2. Could that be because if people are going to preform oral then they are probably going to have sex with that person as well but really they catch both oral and genital hsv2 so it's really not all that uncommon?...
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
45 months ago
I do not necessarily agree with your Dr. That if you were infected you would already have an outbreak.  About 80% of those infected with HSV-2 have  had no symptoms that they believe are consistent with herpes. But most of those people are not looking as closely at their bodies as you are right now and minor symptoms could be easily messed. Since you said five hours ago that your test to be ready in 15 minutes I'm thinking you already have the results. The answer to your last question is yes people don't seem to think through that if you give oral sex to someone an have intercourse with them as well that you could get this infection both orally and genitally. One study done many years ago found that about 15% of people who had new herpes genitally also had it orally.  Your mouth symptoms don't really sound like herpes to me but the testing Will give more information. Please let me know what you find out.

Terri
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45 months ago
I don't know if this will help but I did a herpesSelect test with the whole <0.09 negative, 0.09-1.09 equivocal, and >1.09. My hsv1 test was negative and of course my hsv2 was equivocal with 1.02. Everything I have read says that if you wait three months before getting a blood test then it should show reliable results but mine did not. They told me to come back in 6 weeks, but in the meantime do I just completely put my life on hold because I dont know if this is negative or positive? Shouldn't it be either negative or positive since I waited the correct amount of time? Also, before I did this test everything seemed to say that it was a reliable test but now that I have taken it and got my results I was told by even the doctor I went to go see that the HerpesSelect test messes up a lot, and I have now read an extraordinary amount of people on the internet saying that they tested positive in the low range for hsv2 and with a follow up blood test or a Western Blot Test they tested negative. So, I feel like I have been waiting forever to see if I actually have hsv2 or not and now I have to wait even longer. Is this common? 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
45 months ago
I really think even if you did the western blot, you would not confirm as positive.  Sometimes it does turn out equivocal - we rarely know why.  If you have waited 12 weeks from your last exposure, do the western blot if you like for a more accurate answer.  The problems with the IgG test is false positives with HSV 2 between 1.1 and 3.5 and with HSV 1, lack of sensitivity - it misses 30%.  We all, including you, would like a more perfect test - we just don't have one

Terri
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45 months ago
Ok so you believe that I also did not wait enough time to correctly be diagnosed? So you're saying that I should just go back in a couple weeks and get another done and it'll be positive? In the meantime though how do I proceed with relationships? Do I act as though I do have it or do I just go about my life acting as if I don't? Another question, considering that I am positive, should I always be taking some form of medicine daily or do people just take that when they have a out break or when they are in a relationship with someone that is negative for hsv and want to lower the risk of transmission? Since I have oral hsv2 what are my risks of transmission? Should I treat it as though it is oral hsv1 and use protection when giving oral? What about kissing? Should I just not kiss when I have an outbreak or what is the risk with that? 
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
45 months ago
If you waited 12 weeks from time of last possible exposure and have taken no antiviral medicine, that is long enough.  You are not positive on this test.  You do not know that you have oral HSV 2 unless I"m missing something in this post?  I'm not going to advise you on what to do about this as your are not positive!  If you need more reassurance than you already have, get a western blot for more certainty. 

Terri
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