[Question #6232] Oral HSV2- why is it rare?

18 months ago
Hi!  I'm curious about why oral HSV2 is rare.  I've read in many places that the virus just doesn't like the oral region.  I've also read that hsv1 might serve as some sort of protection.  I'm wondering if there's more specific information out there on this.  Given the prevalence of oral hsv1, I feel like its generally & rightly assumed that the hypothetical person has it when these sorts of questions are asked, but I'm curious about if the "protection" of preexisting oral hsv1 is taken away.  Specifically, I don't have HSV1 orally, would hsv2 be equally as averse to my mouth as it would be to someone with oral hsv1?  Or without that "protection" of prior infection, is oral hsv2 much more likely to infect?  Is there any scientific lit I could read about on this that you're aware of?
Also- do semen & vaginal secretions transmit hsv?  I thought it was always skin to skin contact but there's a lot of misinformation on the internet so just wanted to double check.
Thanks!
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
18 months ago
There really isn't much specific information about this topic.  It has to do with the "site preference" that this viruses have.  I'm afraid we just don't know much about why this is, only that it is.  HSV 2 is way "fussier" than HSV 1, in term of site preference.  While we certainly see more genital HSV 1 we are not seeing a corresponding increase in oral HSV 2.  While the presence of oral HSV 1 is one factor, it is not the only factor as we don't see oral HSV 2 often at all in people who have genital HSV 2 only, not oral HSV 1.  I wish I had more evidence for you about this - I jut don't.  Semen and vaginal secretions, without skin to skin contact, is likely NOT a good transmitter of virus not, particularly semen which has been studied more extensively. 

Terri
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18 months ago
Okay, thank you!  Do you have any more specific information on how rare oral hsv2 is?  Either from personal experience or some sort of study?
Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
18 months ago
This article may be of interest to you.  This article addresses the frequency of oral shedding in both HIV - and HIV + people who also have HSV 2 genital infection.  it does NOT address the frequency of HSV 2 oral infection.  I am not aware of a paper that discusses this.

2006 Aug 15;194(4):420-7.
Oral herpes simplex virus type 2 reactivation in HIV-positive and -negative men.

Terri

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