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All of this tells us that sure, there are some currently available blood tests for herpes that can tell you your status or give you some idea of it but they’re still far from perfect. And when we’re dealing with a illness that’s highly and widely stigmatized the way herpes has become, most people are looking for airtight answers. This is precisely why so many doctors, as well as the CDC, do not recommend getting tested unless you have the common symptoms associated with herpes, such as itching, burning, or a blister.
Is One Virus Better Than The Other
Although incurable, both viruses are treatable and manageable in day-to-day life. Beyond this fact, each persons body chemistry and immune system are unique, and although the virus strains have their preferences, they are not set in stone. Developing awareness of your own body and becoming educated about the herpes simplex virus strains can help you make more sensible decisions and help defeat the stigma of a member of the herpesviridae family.
Questions For Your Doctor About Test Results
The following questions may be useful as patients review genital and oral herpes test results with their doctor:
- What type of test was conducted?
- What is my test result?
- What is the most likely explanation for my test result?
- Are there any follow-up tests that you recommend?
- How should I discuss my test result with sexual partners?
Also Check: How Do I Know If I Have Genital Herpes
Study Setting And Patient Recruitment
Patients who presented to the Sydney Sexual Health Centre between September 1995 and November 1998 within 4 weeks of the first onset of genital symptoms suggestive of genital herpes were asked to participate in the study. The study was approved by the South Eastern Sydney Area Health Service research ethics committee and written informed consent was obtained from all participants. A self administered questionnaire was completed, to obtain details of diagnosed or suspected previous oral and/or genital herpes infections, other past sexually transmitted infections , and recent sexual practices including condom use. In addition, information regarding recent sexual partner was obtained including whether the partner had oral and/or genital herpes or symptoms suggestive of herpes and whether antiviral medication was being used. The SSHC clinical staff performed a genital examination and a swab for viral culture was taken from genital vesicles and/or ulcers. Serum was taken for type specific HSV serology. Patients who were HIV antibody positive were excluded. Tests to exclude other STIs were performed if appropriate.
Genital Herpes Is Common Shouldnt Cdc Recommend Testing For Everyone
CDC recommends herpes testing for people who have genital symptoms to confirm if they have it. Testing allows a healthcare provider to talk with patients about what to expect in the future. This includes talking about medications that help with symptoms. Providers can also tell patients how to lower the risk of transmitting herpes to sex partner.
CDC does not recommend herpes testing for people without symptoms in most situations. This is because of the limits of a herpes blood test and the possibility of a wrong test result. The chances of wrong test results are higher for people who are at low risk of infection.
Blood tests might be useful if:
- You have genital symptoms that could be related to herpes, or
- You have a sex partner with genital herpes, or
- Your provider found signs of herpes, but you still need a test to confirm it.
If you are sexually active, talk openly and honestly with your healthcare provider about what tests are right for you. These tips can help.
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Is There A Cure Or Treatment For Herpes
There is no cure for herpes. Antiviral medications can, however, prevent or shorten outbreaks during the period of time the person takes the medication.11 In addition, daily suppressive therapy for herpes can reduce the likelihood of transmission to partners.11
There is currently no commercially available vaccine that is protective against genital herpes infection. Candidate vaccines are in clinical trials.
Is There A Difference Between Cold Sores And Genital Sores
As mentioned earlier, while each variation of the virus may have a preference for a specific area, either form can make a home orally or genitally. Once either strain enters your body, it remains dormant there for life. Typically, HSV-1 settles in nerves on the base of the neck, while HSV-2 stays close to the base of the spine. HSV-1 statistically has a lower chance of recurrences than HSV-2, but HSV-2 symptoms have been shown to become less severe as time passes. Beyond these differences, the largest difference between these two is the stigma associated with genital herpes.
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Doctors Don’t Advise Getting A Blood Test For Herpes Without Any Symptoms
Hilda Hutcherson, assistant professor of obstetrics and gynecology at Columbia University Medical Center in New York, is one of those doctors. “I usually dont do tests for herpes someone has a lesion or a sore, something I can see, I will do a swab and take it to a culture or check the DNA on the materials I removed,” she says. “If theres nothing there and I do a blood test and the blood test comes back positive, lets say its positive for type 1, what does that really mean? Most people are positive for type 1.” She adds that someone could be HSV-1-positive and either have or not have genital herpes. The result “doesnt mean much, and it makes people go crazy.”
Hutcherson’s motto is pretty simple: Why stress yourself over something if you haven’t seen anything especially when it’s something as common as herpes? “Let’s say they have a blood test come in positive but theyve never had a lesion. Now what? You may never get a lesion,” she says. It’s for this reason that she recommends people do not get tested for herpes unless they have a visible lesion that can be cultured and sent to a lab. Let’s say you get tested anyway and it comes back positive, despite the fact that you have no symptoms. What do you do?
What Are The Complications Of Genital Herpes
Genital herpes may cause painful genital ulcers that can be severe and persistent in persons with suppressed immune systems, such as HIV-infected persons. 5 Both HSV-1 and HSV-2 can also cause rare but serious complications such as aseptic meningitis . 5 Development of extragenital lesions may occur during the course of infection. 5
There are also potential complications for a pregnant woman and her newborn child. See How does herpes infection affect a pregnant woman and her baby? below for information about this.
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Analysis Of Children’s Sera By Peptide
Alternative methods for specific detection of HSV-1 or HSV-2 antibodies include different ELISAs, both commercial methods and recently developed methods based upon the antigenicities of two different oligopeptides specific for HSV-1 and HSV-2 . However, the performances of these methods in a pediatric population have not been evaluated. The two peptide-ELISA methods developed in our laboratories were of particular interest and were used to analyze the sera that were already characterized by the WB-UB method.
If You Get A Positive Result Don’t Panic It Really Doesn’t Mean Much
All of this is to say that unless you have symptoms consistent with the herpes virus, why put yourself through the emotional turmoil of getting a blood test that may or may not give you legit results? As Hutcherson notes, if you do get a blood test and it comes back positive but you’re asymptomatic, what does that mean for you if you have nothing to treat? For many, due to the high rate of stigma still surrounding herpes, it can mean feelings of self-contempt, humiliation, and distress, all of which could be avoided if you aren’t experiencing any symptoms.
To recap, while there are some tests for herpes that can prove correct, none are 100 percent perfect, and blood tests are particularly problematic since they can produce false positives and negatives. We also know that the majority of the population has some form of herpes, so IMO it’s a mystery as to why we’re still making a big deal out of it. No one likes blisters or sores, but neither does anyone love having acne, a widespread condition without the same level of attached shame.
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How Do People Get Genital Herpes
Infections are transmitted through contact with HSV in herpes lesions, mucosal surfaces, genital secretions, or oral secretions. 5 HSV-1 and HSV-2 can be shed from normal-appearing oral or genital mucosa or skin. 7,8 Generally, a person can only get HSV-2 infection during genital contact with someone who has a genital HSV-2 infection. However, receiving oral sex from a person with an oral HSV-1 infection can result in getting a genital HSV-1 infection. 4 Transmission commonly occurs from contact with an infected partner who does not have visible lesions and who may not know that he or she is infected. 7 In persons with asymptomatic HSV-2 infections, genital HSV shedding occurs on 10.2% of days, compared to 20.1% of days among those with symptomatic infections. 8
Finding Out The Hard Way
No good data exist on how often patients with questionable positive results are actually re-tested. Until the 2015 update, CDC herpes testing guidelines had no mention of confirmatory testing for low-positive results, said Johnston. So patients often discovered the option not through their doctors, but through searching the web and reading online herpes forums.
That was the experience of Bryan, a 40-year-old man who lives in Indiana, who wrongly believed he had herpes for about two months in 2011. The misunderstanding actually put him at higher risk, he said: During those months he considered joining the hundreds of thousands of Americans on dating sites for herpes-positive people. Exclusively dating people with herpes would have increased his likelihood of contracting the virus.
The experience of YT, a 33-year-old mom who has suffered from frequent herpes symptoms over the last year, shows another side of the testing breakdown. She believes she was given HSV by a partner who didnt realize herpes wasnt included in his previous STD tests, she told STAT. Having herpes has caused her significant emotional trauma, and has driven her to permanently swear off dating. Had her partner known his true status, she wonders if her story would have been different.
People call and say, I just dont know whats going on, he said. Weve almost become de facto counselors.
Also Check: What Is The Definition Of Herpes
Herpes Simplex Virus Types 1 And 2 Specific Antibodies Blood Test Igg
A Herpes Simplex Virus Types 1 and 2 Specific Antibodies Blood Test, IgG is used in the detection of antibodies specific to herpes type 1 and 2.
Test Code: 164922
CPT Code: 86695,86696
Also Known As: Herpes-1 and 2 HSV Types 1- and 2-Specific Antibodies, IgG HSV-1 and 2 Herpes Simplex Virus 1/2 , Type-Specific Antibodies
Methodology:
Chemiluminescent immunoassay . Reflex of specimens equivocal and low positive for HSV-2 type specific IgG to a membrane based immunoassay.
Preparation:
2-3 days. May take longer based on weather, holiday or lab delays.
Test Code: 6447
CPT Code: 86695,86696
Also Known As: Herpes-1 and 2 HSV Types 1- and 2-Specific Antibodies, IgG HSV-1 and 2 Herpes Simplex Virus 1/2 , Type-Specific Antibodies
Methodology:
2-3 days. May take longer based on weather, holiday or lab delays.
What Do My Test Results Mean
There are two possible antibodies that your body can make to HSV-1 and HSV-2. These are IgM and IgG.
IgM is the antibody that is made first and typically represents a current or acute infection, although this may not always be the case.
IgG is made after the IgM antibody and typically will be present in the bloodstream for the rest of your life.
A negative test result is considered normal. This generally means that youve never contracted an HSV infection.
However, its possible for your results to come back negative even if youve contracted the infection within the past few months. This is referred to as a false negative.
Your body will typically take several weeks to develop IgG antibodies to HSV.
If youre tested earlier in your infection, its possible to have a false negative result. Your doctor may recommend that you return in 2 to 3 weeks to be retested.
A positive test result for HSV-1 or HSV-2 indicates that youve contracted either virus at some point.
The results also allow your doctor to differentiate between HSV-1 and HSV-2, which isnt always possible by visually examining the sores.
Depending on your results, you and your doctor can discuss ways to treat and prevent the transmission of your HSV infection.
When a serum antibody test is recommended for HSV, IgG detection is preferred. In fact, some laboratories are discontinuing their IgM tests in the future.
Also,
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Why Is The Igm Hsv Antibodies Test No Longer Recommended
The Centers for Disease Control and Prevention, the Infectious Diseases Society of America, and the American Society for Microbiology all recommend the use of the IgG antibodies test over the IgM HSV test.
IgG tests are preferred because:
- For herpes, IgG and IgM antibodies show up around the same time â normally, IgM antibodies appear first.
- IgM antibodies may only last a few months and may not be made after the first outbreak â but IgG antibodies last indefinitely and are made during all outbreaks.
- IgG antibodies can distinguish between HSV-1 and HSV-2 and IgM antibodies canât.
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How Common Is Genital Herpes
Genital herpes infection is common in the United States. CDC estimated that there were 572,000 new genital herpes infections in the United States in a single year.1 Nationwide, 11.9 % of persons aged 14 to 49 years have HSV-2 infection .2 However, the prevalence of genital herpes infection is higher than that because an increasing number of genital herpes infections are caused by HSV-1. 3 Oral HSV-1 infection is typically acquired in childhood because the prevalence of oral HSV-1 infection has declined in recent decades, people may have become more susceptible to contracting a genital herpes infection from HSV-1. 4
HSV-2 infection is more common among women than among men the percentages of those infected during 2015-2016 were 15.9% versus 8.2% respectively, among 14 to 49 year olds. 2 This is possibly because genital infection is more easily transmitted from men to women than from women to men during penile-vaginal sex. 5 HSV-2 infection is more common among non-Hispanic blacks than among non-Hispanic whites . 2 A previous analysis found that these disparities, exist even among persons with similar numbers of lifetime sexual partners. Most infected persons may be unaware of their infection in the United States, an estimated 87.4% of 14 to 49 year olds infected with HSV-2 have never received a clinical diagnosis. 6
The age-adjusted percentage of persons in the United States infected with HSV-2 decreased from 18.0% in 19992000 to 12.1% in 2015-2016. 2
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How Do The Tests Work
HSV tests detect IgG and immunoglobulin M antibodies. IgG antibodies are present soon after infection with HSV and remain in the blood for life. A test result showing IGg antibodies will tell a person that they have experienced an infection in the past and that they have antibodies against the virus.
IgM antibodies appear before IgG antibodies but may disappear when the infection is inactive. Testing for IgM antibodies is not a useful way to distinguish between primary and recurrent episodes of HSV infection. Therefore, doctors do not recommend IgM testing.
A positive herpes antibody test cannot tell people where they have HSV infection or when they contracted the infection. It cannot tell if a person was capable of passing on the infection at the time of the test, nor can it tell if specific symptoms are due to herpes.
Once a sample comes back from laboratory analysis, a person will receive one of the following results:
Related: Syphilis And Gonorrhea Rates Have Risen Sharply In Us Cdc Says
When tests fall between 1.1 and 3.5, more testing is necessary, said Johnston. This recommendation is also noted in the 2015 CDC Sexually Transmitted Diseases Treatment Guidelines. But some patients will never be referred for a second test.
I think most clinicians are unaware and perhaps labs dont have this available and/or it is not straightforward to order, Johnston said of second-step tests.
But while her facilitys Western blot is considered highly accurate, it is expensive and cumbersome to perform. Each test costs over $200 and the University of Washington is the only lab that provides it.
Other confirmatory tests also exist, for instance Biokits HSV-2 Rapid Test and Quests own HSV-2 IgG Inhibition assay. The latter, which adds only $4 to the price of the HerpeSelect test, performed well in a study conducted over a decade ago. Rick Pesano, the medical director for infectious disease at Quest, believes that with more awareness, the test could stand in for the Western blot. But the test was not mentioned in the USPSTF guidelines because it still has not been evaluated in asymptomatic individuals, according to Cindy Feltner, associate director of the RTI-UNC Evidence-based Practice Center, who helped prepare the science review for USPSTF.
We need better diagnostic testing. That is where we are stuck at this point, said Johnston. We dont have a good test thats inexpensive, high throughput, and reliable.
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What Happens During A Herpes Antibody Test
There are different tests for HSV. Doctors will choose a test based on a persons health history and symptoms. Options include the following:
- Swab test: A healthcare professional uses a swab to take a sample of fluid and cells from a herpes sore. They then order a PCR test or viral culture to determine whether HSV is present. This is the most reliable way to test for HSV. Doctors normally do this as standard procedure before ordering any other sort of test.
- Blood test: A healthcare professional uses a needle to take a small amount of blood from a vein in a persons arm.
- Lumbar puncture: Doctors may use this method if they suspect a person has an infection in the brain or spinal cord. It involves numbing the skin of the lower spine and inserting a thin, hollow needle between two vertebrae to collect cerebrospinal fluid.
A doctor will send samples to a laboratory for testing and a person should get their results within a few days.