Can One Virus Cause Genital Herpes and Oral Herpes at the Same Time?

herpes cold sore on face
Herpes Cold Sore on Face. Todd Keith/E+?Getty Images

Question: Can One Virus Cause Genital Herpes and Oral Herpes at the Same Time?

Answer: Yes

Although common wisdom and some "experts" may say otherwise, concurrent herpes infections are possible. Research has clearly shown that people can have oral herpes and genital herpes infections caused by the same type of herpes virus at the same time.

In short, cold sores aren't protection against a genital herpes infection.

That's true whether both infections are caused by HSV-1, both infections are cause by HSV-2, or one infection is caused by each.

Reducing The Risk of Concurrent Herpes Infections

What this means, from a practical perspective, is that it's important to use barrier methods during sex. That's something that's as true for oral sex as it is for intercourse. If a person has cold sores on their lips, they can transmit them to their partner's mouth during kissing. They can also transmit them to their partner's genitals during oral sex. Similarly, a genital HSV-1 infection can be transmitted to a partner's genitals or their mouth. (HSV-2 oral infections are possible. However, it is somewhat less likely that a genital HSV-2 infection would be transmitted to the mouth. HSV-2 prefers the genitals as a site of infection. HSV-1 is a far more equal opportunity virus.)

Herpes infections are spread from skin-to-skin, so barriers aren't 100% protective.

However, condoms and other barriers can reduce the risk of transmitting herpes to a partner. In addition, if a person knows they are infected, there are other options. Suppressive therapy doesn't just reduce the frequency of outbreaks. It also reduces the likelihood of transmission during sex.

Sources:

Bernstein DI, Bellamy AR, Hook EW 3rd, Levin MJ, Wald A, Ewell MG, Wolff PA, Deal CD, Heineman TC, Dubin G, Belshe RB. Epidemiology, clinical presentation, and antibody response to primary infection with herpes simplex virus type 1 and type 2 in young women. Clin Infect Dis. 2013 Feb;56(3):344-51. doi: 10.1093/cid/cis891.

Embril, JA et al (1981) Concurrent oral and genital infection with an identical strain of herpes simplex virus type 1. Restriction endonuclease analysis. Sex Transm Dis.8(2):70-2.

Garland SM, Steben M. Genital herpes. Best Pract Res Clin Obstet Gynaecol. 2014 Oct; 28(7):1098-110. doi: 10.1016/j.bpobgyn.2014.07.015.

Lafferty et al (1987) Recurrences after oral and genital herpes simplex virus infection. Influence of site of infection and viral type. N Engl J Med. 316(23):1444-9.

Continue Reading