Case 2 Asymptomatic And Low Risk For Hsv
MD is a 30-year-old patient . She has had 3 lifetime sexual partners, all male assigned at birth. Neither she nor her sexual partners have ever been diagnosed with an STI. She is getting married in 6 months, and she and her partner want comprehensive STI testing: I want to be tested for everything. She specifically requests herpes testing. Neither she nor her partner have had any symptoms of genital or oral herpes nor any known exposures.
The Different Types Of Herpes
Herpes, or the herpes simplex virus, is a highly contagious and common virus that causes cold sores and genital herpes. You may become infected with herpes simplex virus type 1 or herpes simplex virus type 2 . Each type of virus causes unique symptoms, so its important to understand their differences.
What Affects The Test
Reasons you may not be able to have the test or why the results may not be helpful include:
- If a culture sample is taken from a crusted, older sore.
- If a blood sample is taken before antibodies against HSV have formed. This period is called the window period or seroconversion period.
- If you are taking antiviral medicines, such as acyclovir, famciclovir, ganciclovir, or valacyclovir.
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Submission And Collection Notes
Follow the instructions found in the Virus-Culture Kit Instruction Sheet.
HSV resistance testing is also available at NML (National Microbiology Laboratory, Winnipeg when clinically indicated. Specimens submitted for this test is initially cultured at PHO Laboratory prior to submission to NML for HSV 1 or HSV 2 resistant testing: NML guidelines-Viral Exanthemata and STDs-Viral STI, Polyoma and Herpesvirus unit.
How Do I Know If I Have Genital Herpes
Most people who have genital herpes have no symptoms, or have very mild symptoms. You may not notice mild symptoms or you may mistake them for another skin condition, such as a pimple or ingrown hair. Because of this, most people who have herpes do not know it.
Herpes sores usually appear as one or more blisters on or around the genitals, rectum or mouth. The blisters break and leave painful sores that may take a week or more to heal. These symptoms are sometimes called having an outbreak. The first time someone has an outbreak they may also have flu-like symptoms such as fever, body aches, or swollen glands.
People who experience an initial outbreak of herpes can have repeated outbreaks, especially if they are infected with HSV-2. Repeat outbreaks are usually shorter and less severe than the first outbreak. Although the infection stays in the body for the rest of your life, the number of outbreaks may decrease over time.
You should be examined by your doctor if you notice any of these symptoms or if your partner has an STD or symptoms of an STD. STD symptoms can include an unusual sore, a smelly genital discharge, burning when urinating, or bleeding between periods.
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Benefits And Downsides Of At
To decide if at-home genital and oral herpes testing is right for you, its important to remember that this form of testing has both benefits and downsides.
Benefits of at-home genital and oral herpes testing include:
- Transparent pricing: Costs can add up quickly when patients have testing performed in a doctors office or other medical facility. At-home testing offers transparent pricing that allows patients to rest assured that they understand the total price of genital and oral herpes testing.
- Privacy: At-home testing is private and convenient. Patients can order an at-home genital and oral herpes test kit when they want without having to make an appointment at a medical office or clinic.
- Easy to use: Testing for antibodies to HSV at home is a straightforward and simple process: order your test kit online, collect a small sample of blood from a simple finger prick using supplies contained in the test kit, and return your sample to the laboratory. Unlike testing performed by a doctor, theres no waiting room or blood draw from your arm.
The downsides of at-home genital and oral herpes testing include:
As you consider the benefits and downsides of at-home genital and oral herpes testing, it may be helpful to talk with a doctor or other health professional about testing for HSV in your specific case. It is especially important to talk with a doctor if you have active symptoms of a herpes infection.
Can Herpes Simplex Virus Cause Serious Infections
Yes. The most serious, or life-threatening, HSV infections can occur in newborns who are infected during birth and in individuals with weakened immune systems , such as organ transplant recipients and people with HIV/AIDS. Neonatal herpes is a serious condition, but also very rare. While 25-30% of pregnant women have genital herpes, less than 0.1% of babies born in the U.S. each year get neonatal herpes. This means that most women with genital herpes give birth to healthy babies.
HSV lesions tend to be more extensive and persist longer in newborns and immunocompromised people than in individuals who have healthy immune systems.
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Doctors Dont 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.
Hutchersons motto is pretty simple: Why stress yourself over something if you havent seen anything especially when its something as common as herpes? Lets 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. Its 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. Lets say you get tested anyway and it comes back positive, despite the fact that you have no symptoms. What do you do?
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What Is Neonatal Herpes
Neonatal herpes can be a very serious infection. Babies generally contract the virus from their birthing parent during childbirth even if the parent doesnt have active lesions. They may also get HSV-1 if an adult with an active cold sore kisses them. Breastfeeding babies can also get HSV-1 from the breast if there are lesions present. But babies cant get herpes from breast milk, so its safe to pump and feed.
Herpes simplex can be more dangerous for young babies because they dont have a fully developed immune system. But most babies with neonatal herpes can recover fully with treatment.
The dangers of neonatal herpes are much higher if the infection spreads to the babys organs. If youre pregnant and have herpes, speak with your healthcare provider about how to lower the risk of passing the infection to your baby.
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Type Of Tests Used To Diagnose Herpes
There are four main types of diagnostic tests that can be used to diagnose herpes. Your doctor will determine which type of test to use based on whether an outbreak is present or not.
If youre experiencing what you believe to be a herpes outbreak, your doctor can use a viral culture test or virus antigen detection test. If youre not experiencing symptoms, you can have an antibody test.
- Viral culture test.This test is used to determine if a sore contains the herpes virus. This test can sometimes produce a false-negative, meaning that it may not detect the virus even though its present.
- Virus antigen detection test. This test is used to determine if antigens to the herpes virus are present in a sore or lesion.
- Antibody test. If youre not experiencing an outbreak yet but still believe you may have been exposed, you can opt to have an antibody test performed. This test will only show a positive result if the antibodies to the virus have been developed. Therefore, this test isnt necessarily recommended for recent exposure.
- Polymerase chain reaction test. With this test, a healthcare provider can screen a sample of your blood or tissue from a sore. They can use this to determine if HSV is present and which type you have.
How Common Is Genital Herpes
According to the Centers for Disease Control and Prevention, approximately 40 million to 50 million adults in the United States have genital herpes. HSV II infection is more common in women and in people who have had more than five sexual partners. Most people with HSV II do not know they have it, because it does not always cause symptoms.
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What Does The Test Measure
At-home genital and oral herpes testing detects antibodies to the herpes simplex virus. Antibodies are produced by a persons immune system to defend the body against a potentially harmful substance, called an antigen.
Antibodies to HSV are only present in patients who have been infected with HSV at some point in their life. At-home genital and oral herpes tests cannot distinguish between a new or recent infection and an infection that occured in the past.
Antibodies to HSV are specific to the type of HSV and develop within a few weeks of being exposed to the virus but may take longer depending on the type of herpes. Antibodies to HSV remain in the body indefinitely. Some at-home kits test for only one type of herpes while others test for both HSV-1 and HSV2.
After a persons first outbreak of genital or oral herpes, the virus initially infects a persons skin cells and eventually moves to their nerve cells. The virus may stay inactive in the nerve cells forever without causing another outbreak, or it may become active again in the future.
Testing for other herpesviruses
While at-home tests are often called herpes tests, its important to keep in mind that these tests do not detect all forms of herpesvirus, including shingles, Epstein-Barr virus , and cytomegalovirus . When purchasing an at-home herpes test, its important to look carefully at the types of herpesvirus the test is designed to detect.
How To Choose The Right Herpes Test For You
Every herpes test has its own benefits and drawbacks. Its best to discuss your options with a medical professional to make the right choice for your healthcare needs.
It may be helpful to choose your herpes test based on your symptoms. Early in the disease, before a clear herpes outbreak appears, some test methodologies like a PCR test and an antibody blood test can yield false-negative results. On the other hand, a viral culture may yield false-negative results later in the disease.
If you want to receive test results that provide a comprehensive evaluation of your infection, consider using multiple herpes testing methods. If getting a rapid result is your priority, a PCR test is the fastest option.
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Genital Herpes Cdc Fact Sheet
Genital herpes is a common sexually transmitted disease that any sexually active person can get. Most people with the virus dont have symptoms. Even without signs of the disease, herpes can still be spread to sex partners.
Basic Fact Sheet | Detailed Version
Basic fact sheets are presented in plain language for individuals with general questions about sexually transmitted diseases. The content here can be syndicated .
Recommended Specimens And Tests In Symptomatic People
NAAT
NAAT approaches sensitivity and specificity of 100%, with rapid turn-around of resultsFootnote 1Footnote 22Footnote 23.
Testing by NAAT is appropriate when:
- HSV infection is suspected
- Neonatal herpes is suspectedFootnote 21Footnote 24
Viral culture
Cultures from lesions caused by HSV can yield positive results within 24 hours.
Culture permits the identification of HSV typeFootnote 25Footnote 26. It also provides information on susceptibility, making it appropriate when antiviral resistance is suspectedFootnote 27.
Sensitivity varies depending on the lesion being sampled Footnote 21. Sensitivity of culture declines when lesions start to heal and is low for recurrent lesionsFootnote 21. Due to its superior sensitivity, consider NAAT when a false negative culture result is suspectedFootnote 1Footnote 23. If NAAT is not available, viral culture can be repeated on fresh lesions.
Type-specific serology
Consult the local laboratory for the availability of HSV TSS.
A study of TSS showed a sensitivity of 80.5% and specificity of 98.5% for HSV-2, and a sensitivity of 91% and specificity of 96.4% for HSV-1Footnote 28.
TSS testing can demonstrate whether partners are serodifferent or serodiscordant or concordant .
TSS may be useful in the following situations:
TSS should not be used for screening asymptomatic people because:
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If You Have Genital Herpes Already Can It Be Spread To Other Parts Of The Body Such As The Arms Or Legs
No. Genital herpes cannot be transmitted to another part of your body such as your arm, leg or hand after the first infection occurs. If you have genital HSV II, you will not get HSV II at another site in your body. The immune system produces antibodies that protect other parts of your body from infection. However, there are cases where a person has multiple site infections from the same virus. This is usually acquired at the time of the first infection. For example, if someone has never had herpes but then has oral and genital sex with an infected partner, they can acquire the infection at both sites.
How To Diagnose Herpes
Genital herpes is typically diagnosed through examination by a medical professional and a blood test. If you suspect you have genital herpes , you can take an antibody test.
To test for 6 other common STIs like chlamydia, gonorrhea, hepatitis C, HIV, syphilis, and trichomoniasis, try the Everlywell home STD Test for women or the STD Test for men. After you collect your sample at home, it is received and analyzed at the lab, and the test results are sent to you quickly and discreetly via our secure, online platform.
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You Got A Positive Herpes Test Now What
If you receive a positive herpes test, start by educating yourself about the herpes virus. There are many pervasive herpes myths that you shouldnt believe. The truth is that herpes is treatable and outbreaks can even be minimized or prevented with the right treatment measures.
Genital herpes and cold sores can both be addressed with a variety of household remedies, over-the-counter options, and prescription medications.
Acyclovir, for example, is an antiviral medication that treats infections caused by the herpes simplex virus, including genital herpes. Its best to start taking acyclovir as soon as you notice the first signs of an emerging outbreak. This medication stops the herpes virus from growing and spreading during an outbreak, although it cannot remove the virus from your body completely. Most people experience relief within just a few days of taking acyclovir.
If youre looking for a natural therapy to control herpes outbreaks, the Luminance RED is another option. The Luminance RED handheld devices shine red wavelengths of light over the skin of affected areas. The company has one device designed for oral herpes and one for genital herpes.
Medically-optimized red light is metabolized to accelerate the bodys healing process and strengthen its defenses against future attacks. Studies show that regular use of high-powered light treatment not only shortens the healing time of active outbreaks but can also prevent future outbreaks altogether.
Why Is Testing For Genital Herpes Only Recommended For People Who Have Symptoms
CDC recommends herpes testing for people who have genital symptoms for herpes to confirm that they are infected. These events are called having an outbreak, and they appear as blisters on or around the genitals, rectum, or mouth. The blisters break and leave painful sores that may take weeks to heal. Testing allows a doctor to talk with you about what to expect in the future, which medications are available to help manage any symptoms, and how you can lower your risk of spreading the infection to your sex partner.
If you have a partner with genital herpes, testing can tell if you also have the virus. If you are not infected, your doctor can talk to you about ways to lower your risk of getting genital herpes. If you are a pregnant woman and have a partner with genital herpes, it is very important to get tested. If you get genital herpes during pregnancy your baby could also become infected. Herpes infections in babies can be life-threatening. If you are infected, your doctor will talk to you about your diagnosis and the possible symptoms of genital herpes. In addition, herpes blood testing may be useful if you are seeking a complete STD exam, especially if you have multiple sex partners.
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