Can HSV2 be transmitted through oral sex?

By Jayne Leonard    

Reviewed by Judith Marcin, MD

Herpes simplex virus type 2 is a form of herpes virus that can be sexually transmitted and causes lesions, such as sores and blisters, to form on the skin.

Herpes simplex virus type 2 (HSV2) is spread by skin-to-skin contact and can be transmitted even when the herpes lesions are not visible on the skin. Although HSV2 is rarely contracted through oral sex, transmission is possible in some cases. People with compromised immune systems are especially at risk.

This article looks at how the herpes simplex virus is transmittted and suggests steps that can be taken to reduce the transmission of HSV.

Types

There are two known forms of the herpes simplex virus - herpes simplex virus type 1 (HSV1) and HSV2.

Cases of oral herpes, also known as cold sores or fever blisters, are caused by HSV1 and are estimated to affect over half of adults in the United States

Genital herpes, on the other hand, tends to be caused by HSV2. The American Sexual Health Association estimate that 1 in every 6 people aged 14 to 49 in the U.S. is infected with HSV2.

The majority of these people are unaware of the infection because they do not have any symptoms, their symptoms are mild, or the symptoms are attributed to another condition.

Both HSV1 and HSV2 can occur in either the oral or genital regions, but having one form of the herpes simplex virus does not mean you will get the other.

HSV1 and HSV2 are genetically similar, so the body of an infected person will produce antibodies to fight the virus and potentially reduce the risk of contracting the other form. Nonetheless, it is possible to have both types of HSV.

Transmission

Skin-on-skin contact is necessary for the transmission of HSV2. It cannot be transmitted through semen, from touching toilet seats and other objects, or from using hot tubs.

HSV2 passes from one person to another when infected areas come into contact with mucous membranes or open areas on the skin of uninfected people. A mucous membrane is a moist lining found in certain parts of the body, including the vagina, anus, and mouth.

Once infected with HSV2, the initial symptoms usually appear within 2 weeks after exposure. This is known as the primary outbreak, and it may be more severe and last longer than future outbreaks.

When the virus is active, it will travel to the infected skin or mucous membrane and replicate, in a process known as "shedding." This can lead to the appearance of sores and lesions on the infected area, and the virus can now be easily passed on to another person.

The virus will eventually move through the nerves from the skin to near the base of the spine, to a location known as the sacral ganglia. Here, it will lie dormant for a time until it becomes activated once again.

It should be noted that symptoms are not always present even when the virus is active, and HSV2 can still be transmitted during this time.

HSV2 and transmission through oral sex

HSV2 is typically passed along from one person to another through vaginal or anal intercourse. It is less common to transmit HSV2 through oral sex.

However, as the mouth is lined with mucous membranes, it is still possible to transmit the HSV2 virus through oral sex. If a person is infected with HSV2 in the genital area and the virus comes into contact with mucous membranes in another person's mouth, it may enter the nervous system and cause oral herpes.

Similarly, a person who is infected with HSV2 in the oral area can potentially cause genital herpes in others by giving oral sex.

Some people are more at risk than others of contracting the HSV2 virus through oral sex, including people with compromised immune systems from HIV or AIDS, people undergoing chemotherapy, transplant recipients, or people with autoimmune diseases such as lupus.

HSV1 and oral transmission

The HSV1 virus is typically transmitted through kissing or sharing drinks and utensils. The majority of people with the HSV1 virus were infected during childhood from non-sexual contact and by kissing family members and friends.

Less commonly, HSV1 can spread from the mouth to the genital area through giving oral sex. It can also be transmitted through receiving oral sex, vaginal intercourse, anal intercourse, and the use of sex toys.

Symptoms

The symptoms of both HSV1 and HSV2 are similar. People with the virus may display no symptoms, very mild symptoms, or mistake their symptoms for something else. The absence of symptoms does not mean the virus cannot be transmitted to others.

People who do have symptoms may experience:

• an itching, tingling, or burning sensation around the lips and mouth or in the genital area
• painful red sores
• irritated skin
• small blisters that ooze or bleed

Prevention

There is no cure for either HSV1 or HSV2, so it is important to take steps to decrease the risk of contracting or passing on the virus. Some ways to decrease the transmission of HSV include:

• using condoms or dental dams during all forms of sexual activity. Condoms and dental dams are available for purchase in pharmacies and online.
• getting regular STI tests and ensuring sexual partners also get tested regularly
• reducing the number of sexual partners
• being in a long-term monogamous relationship with an uninfected person
• avoiding sexual activity during outbreaks of the herpes virus
• using anti-herpes medication daily if one partner has the herpes virus
• abstaining from sexual activity

Remember that the herpes virus can be active and easily transmitted even when symptoms are not present. Also, using a condom or dental dam does not guarantee the virus will not be transmitted, as a barrier cannot cover all infected areas.

Takeaway

The herpes simplex virus is prevalent. Both HSV1 and HSV2 can be transmitted through anal and vaginal sexual activity and, in some cases, through oral sex. Even if no symptoms are present, it is still possible to pass HSV from one sexual partner to another.

As no cure exists for HSV, steps should be taken to decrease its transmission. However, it is possible to live with HSV and still enjoy a healthy sex life and sexual relationships.

Anyone who suspects they have contracted HSV2 should see a doctor, who can advise them on strategies to manage the virus, to reduce the number and severity of outbreaks, and to decrease its transmission to others.

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SOURCE: MEDICAL NEWS TODAY