From the Guidelines
Herpes can be transmitted from genitals to the mouth through oral sex, and the risk of transmission is present even when no visible sores are present, as asymptomatic viral shedding can occur 1. The transmission of Herpes Simplex Virus (HSV) from the genitals to the mouth is a significant concern, as it can lead to oral herpes. Herpes simplex virus type 1 (HSV-1) typically causes oral herpes but can infect the genitals, while HSV-2 usually causes genital herpes but can infect the mouth. To prevent transmission, several measures can be taken, including:
- Using dental dams or condoms during oral sex
- Avoiding oral contact during outbreaks
- Washing hands after touching affected areas
- Considering antiviral medications like acyclovir (400mg twice daily), valacyclovir (500mg daily), or famciclovir (250mg twice daily) if you have recurrent outbreaks, as these medications can reduce viral shedding even when no symptoms are present 1. If transmission occurs, symptoms may include painful sores, tingling, or burning sensations around the mouth or lips. The virus remains dormant in nerve cells between outbreaks, which explains why transmission can occur even without visible symptoms 1. People with compromised immune systems face higher risks of transmission and more severe symptoms. According to the most recent guidelines, the use of suppressive antiviral therapy, such as valacyclovir 500 mg once daily, can reduce HSV-2 transmission to susceptible heterosexual partners by 50% 1. It is essential to note that genital herpes is a chronic sexually transmitted infection (STI) characterized by recurrent, self-limited genital ulcers, caused by herpes simplex virus type 1 (HSV-1) or type 2 (HSV-2), and accurate diagnosis of genital herpes can be realized using type-specific molecular or virologic tests when genital ulcers are present, and type-specific serologic test to detect antibody when lesions are not present 1.
From the Research
Risk of Transmitting Herpes Simplex Virus (HSV) from the Genitals to the Mouth
The risk of transmitting Herpes Simplex Virus (HSV) from the genitals to the mouth is a concern due to the potential for autoinoculation or self-infection of anatomic sites other than that of the primary infection 2.
- Transmission Modes: Both Herpes simplex viruses HSV1 and HSV2 are transmitted by direct mucosal or cutaneo-mucosal contact between individuals 3.
- Viral Shedding: The virus can be present on mucosa during a symptomatic recurrence or asymptomatically, with most transmissions to neonates and sexual partners occurring during asymptomatic viral shedding 4.
- Oral Transmission: Over the last few decades, behavioral changes in sexual practices have made oral transmission of traditional sexually transmissible infections increasingly recognized, including genital herpes 5.
- Prevention: Prevention depends on abstention from all oral and genital contact during periods of active disease, and the use of a preservative has only a relative protective effect 3.
Key Findings
- HSV1 is the leading cause of orofacial herpes and HSV2 the most frequently encountered cause of genital herpes 3.
- The epidemiology of oral and genital herpes has dramatically changed over the past decade, with Herpes simplex virus-1 implicated in an increasing percentage of genital herpes cases 2.
- The frequency of viral isolation in the absence of lesions ranges from 2% to 6% of days, but studies using more sensitive tests show that viral shedding can occur on the average 28% of days 4.