If You Have Zero Symptoms Getting Tested Won’t Help You
The problem is that blood tests for herpes when no lesions or symptoms are present are often bullshit. I realize that’s a pretty strong word, but after speaking with doctors who have administered these tests, it’s become more and more apparent to me how misunderstood and in some cases, just plain wrong the results they give are.
Part of the reason they’re flawed has to do with the fact that most people have been exposed to HSV-1 or oral herpes. “For HSV-1, close to 100 percent of people in the U.S. are antibody-positive because they have been exposed at some point in their lives, though only a percentage of these individuals will actually get cold sores,” says Adam Friedman, the residency program director at the George Washington University School of Medicine & Health Sciences in Washington, D.C. He adds that blood tests can be misleading because they usually don’t detect the herpes virus itself and instead look at the level of antibodies against the virus, which is merely a sign of immune response to it.
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
How Do People Get Herpes
Herpes is transmitted through human-to-human contact, usually through kissing or sex. As long as there is skin contact, a person with herpes can infect another person, even when they are not exhibiting any symptoms.
Both HSV-1 and HSV-2 are notorious for lying dormant in nerve cells, where they can remain inactive for some time.
When the virus becomes active, it replicates and becomes transmittable through saliva and other body secretions. This process is called viral shedding. During this period, you may or may not experience symptoms.
Once a person becomes infected with the herpes simplex virus, the virus never leaves the body. As a result, the HSV infection may recur from time to time.
Don’t Miss: Can Herpes Spread To Other Parts Of The Body
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?
What Happens If I Dont Get Treated
Genital herpes can cause painful genital sores and can be severe in people with suppressed immune systems.
If you touch your sores or the fluids from the sores, you may transfer herpes to another part of your body, such as your eyes. Do not touch the sores or fluids to avoid spreading herpes to another part of your body. If you do touch the sores or fluids, immediately wash your hands thoroughly to help avoid spreading your infection.
If you are pregnant, there can be problems for you and your developing fetus, or newborn baby. See Im pregnant. How could genital herpes affect my baby? above for information about this.
Also Check: What To Do When You Think You Have Herpes
Why Genital Herpes Comes Back
Genital herpes is caused by a virus called herpes simplex. Once you have the virus, it stays in your body.
It will not spread in your body to cause blisters elsewhere. It stays in a nearby nerve and causes blisters in the same area.
If you can, avoid things that trigger your symptoms.
Triggers can include:
- surgery on your genital area
- a weakened immune system for example, from having chemotherapy for cancer
Which Herpes Test Should You Get
Each method of testing for herpes has advantages and disadvantages, from time and cost, to an increased possibility of false results. Often, people concerned about the virus use a range of herpes testing to get a more accurate, proven picture of whether or not theyre infected with HSV-1 or HSV-2.
Since herpes is a lifelong infection that cant be cured, its important to discuss testing options with your healthcare provider and make sure you receive an accurate result. Your healthcare provider will be able to tell you more about the best options for herpes testing based on your symptoms and situation.
Typically, your healthcare provider will carry out a physical exam before choosing the best testing method for you. As herpes symptoms tend to be worst during the initial outbreak of the virus, its best to talk to your healthcare provider as soon as you start experiencing symptoms.
In the event that you do have herpes, theres no need to panic. Both oral and genital herpes are extremely common, and a variety of effective treatments are available for both.
Our Valacyclovir 101 guide goes into more detail about one of the most common, effective drugs for treating both symptomatic and asymptomatic herpes. You can also learn more about the risk of catching herpes in our guide to how herpes is transmitted between people.
Get the latest from Hims
Also Check: What Medicine Prevents The Spread Of Herpes
Do Condoms Help Prevent The Spread Of Genital Herpes
Yes. To prevent transmission of herpes, we recommend that condoms be used 100% of the time. Many patients will shed the virus and be contagious when they dont have symptoms. Studies have shown that asymptomatic shedding occurs between 1% and 3% of the time in patients with HSV II genital infections. Many new herpes infections occur from partners who are shedding the virus asymptomatically, so condoms are highly recommended.
Condoms may not be an attractive option for monogamous couples or for couples who desire to become pregnant. Couples may opt to have serological tests to determine if either partner has an asymptomatic infection. In close monogamous relationships, the risks of transmission can be weighed against other relationship issues, such as intimacy and pregnancy.
Can I Take The Test At Home
At-home tests are available to test for evidence of an HSV infection. At-home herpes testing typically detects HSV antibodies in a self-collected sample of blood and may require additional follow-up if preliminary results are positive. At-home herpes tests can be obtained online or at a local pharmacy.
Also Check: Do Std Screenings Test For Herpes
What You Need To Know About Herpes And How Its Transmitted
Two versions of the herpes simplex virus can cause this infection, according to the Centers for Disease Control and Prevention : herpes simplex virus type 1 and herpes simplex virus type 2 .
You might be thinking, Oooh, wait, HSV-1 causes oral herpes, and HSV-2 causes genital herpes, right? Technically, yes. But thats not the full picture. Both viruses can infect either your mouth or your genitals through skin-to-skin contact, the CDC explains.
HSV-1 has a predilection for the oral mucosa, but cases affecting the genitals are rising, Susan Bard, M.D., a New York City board-certified dermatologist and adjunct clinical instructor at the Mount Sinai Hospital, tells SELF. This can happen if, say, a person with HSV-1 in their mouth passes the infection to someones genitals while performing oral sex. And although HSV-2 is still behind most cases of genital herpes, it can cause oral herpes when someone with this infection on their genitals passes it to another persons mouth during oral sex.
You might think these signs would make it really obvious that something is up with your health if you have herpes. But its also entirely possible to have herpes without exhibiting any symptoms at all. The virus can lie dormant in the body without ever making itself known. Thats why so many people have herpes without realizing it, the CDC explains.
What Should I Do If My Test Results Are Positive
Many at-home services have independent physicians or nurses reach out to people with positive test results. Theyll discuss your results with you and suggest a plan of action, possibly including medication.
If your results are positive, its important to let any recent sexual partners know so they can also get tested.
Recommended Reading: How To Treat Oral Herpes Outbreak
How Is The Test Used
Herpes testing may be used a few different ways:
The U.S. Centers for Disease Control and Prevention does not recommend screening for herpes in the general population, but it may be helpful in some cases, such as:
- If you have signs and symptoms, such as genital sores that may be related to herpes
- If you have or had a sex partner with genital herpes
- If you would like to have a complete exam for sexually transmitted diseases , especially if you have multiple sex partners if this is the case, you should discuss STD testing with your healthcare practitioner.
Useful Methods Include Testing An Actual Lesion
Keep in mind that theres no such thing as safe sex, only safer sex, which means using protection and being open and honest with your partner. It can definitely happen, Friedman says of the chances of transmitting the virus to a partner without a visible outbreak. Its called asymptotic shedding there are studies showing that the rates of transmission of HSV-2 are the same for symptomatic and asymptomatic. He adds that this is why using protection during sexual contact is so important, regardless of what blood tests say. Unfortunately, you can never ensure your risk of transmission will be zero, whether or not you know you have herpes, but using a condom or dental dam will get you closer to it.
Like Hutcherson, Friedman also doesnt recommend blood tests for herpes in the absence of symptoms. The tests that are useful involve sampling the actual blister or cold sore, he says, which can involve smearing scrapes of skin cells from the sore onto a slide, targeting the infected cells. As with some of the blood tests, though, this sampling test still wont tell you what type of herpes virus is present. A viral culture, on the other hand, will tell you which virus you have, though it takes some time to come back. Direct fluorescent antibody is by far the best, Friedman says, as you can get a result in a matter of hours which can be as useful as a culture. Not all hospitals have access to this method, however.
Also Check: What’s Good For Herpes
Symptoms Of Genital Herpes
Many people who have genital herpes may not be aware they have the infection, because they may not have any symptoms.
The first episode of herpes can cause considerable pain and distress. Symptoms of the first episode may include:
- flu-like symptoms such as feeling unwell, headaches and pains in the back and legs, with or without enlarged glands in the groin
- small blisters around the genitals these break open to form shallow, painful ulcers, which scab over and heal after one to two weeks
- small cracks in the skin with or without an itch or tingling
- redness or a distinct rash
- some people also have considerable pain and swelling in the genital area, and hence may have additional pain and difficulty passing urine.
What Happens During An Hsv Test
HSV testing is usually done as a swab test, blood test, or lumbar puncture. The type of test you get will depend on your symptoms and health history.
- For a swab test, a health care provider will use a swab to collect fluid and cells from a herpes sore.
- For a blood test, a health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
- A lumbar puncture, also called a spinal tap, is only done if your provider thinks you may have an infection of the brain or spinal cord. During a spinal tap:
- You will lie on your side or sit on an exam table.
- A health care provider will clean your back and inject an anesthetic into your skin, so you wont feel pain during the procedure. Your provider may put a numbing cream on your back before this injection.
- Once the area on your back is completely numb, your provider will insert a thin, hollow needle between two vertebrae in your lower spine. Vertebrae are the small backbones that make up your spine.
- Your provider will withdraw a small amount of cerebrospinal fluid for testing. This will take about five minutes.
- Your provider may ask you to lie on your back for an hour or two after the procedure. This may prevent you from getting a headache afterward.
Also Check: Can You Treat Herpes At Home
Recommended Reading: How Do You Know If You Have Mouth Herpes
So Why Is This Test Not Included Doesnt The Medical Community Care About Preventing Transmission
Although it may not feel this way, the doctors and researchers who established these guidelines have been quite thoughtful about them. If you read the documents, you can see that the researchers sensitively consider their decision from many different angles. In fact, you can learn a ton about the research on genital herpes and transmission where they discuss the reasoning for their decision.
The biggest contributing factor to the guidelines is that 1) standard herpes blood tests are not totally reliable and 2) receiving a herpes diagnosis can have a significant impact on mental health while being virtually non-threatening to your physical health.
Std Awareness: Asymptomatic Shedding Of Herpes
ByAnna C.|May 28, 2013, noon
Pictured above: From
Q: Can I catch herpes if my partner isnt having an outbreak?A: Yes, your partner can transmit the virus even if he or she isnt experiencing symptoms. In fact, most genital herpes infections are transmitted in the absence of symptoms.
When most people think about genital herpes, they think about the symptoms that are associated with it: clusters of blistery sores around the genitals or buttocks. But most genital herpes infections dont have symptoms they are asymptomatic or the symptoms are so mild or nonspecific that the person suffering from them doesnt even make the mental connection. It is estimated that only 10 to 15 percent of people with herpes exhibit symptoms, which may be a silver lining for the millions who unknowingly carry the virus, but it also helps it spread more easily.
What is genital herpes, anyway?
An outbreak occurs when genital herpes symptoms appear. The most well-known symptom is a cluster of blisters or open sores in the genital or rectal area. Other symptoms, which might be mild or might not be recognized as being part of an infection, include:
- very small lesions
- tingling or shooting pains below the waist
- during the first outbreak: flu-like feeling, fever, chills, or swollen glands
How is herpes spread without an outbreak?
If I have genital herpes, how can I protect my partner?
Don’t Miss: Can Herpes Be Tested Through Urine