In The Absence Of Answers
Herpes tests arent the only ones with a risk of false positive results. False positives can occur for any test that diagnoses viral infection based on antibodies, i.e., your bodys immune reaction, rather than direct detection of the virus. For similar diagnostics like HIV and hepatitis C testing, protocols automatically call for a second test that directly detects the virus whenever an antibody test comes back positive, said Paul Swenson, laboratory director in the department of public health of King County, Washington. Herpes, however, is a particularly challenging infection to directly test for, because the virus spends most of its time hiding in nerves. Swab tests can sometimes detect the virus during outbreaks, but this isnt an option for people without symptoms. Thus even the Western blot relies on antibodies, and may give indeterminate results to a small number of people.
But two steps of antibody testing are still more reliable than one step todays diagnostics for Lyme disease and syphilis are a two-step antibody testing approach, said Dr. Edward Hook, a medical epidemiologist specializing in STI screening and prevention at the University of Alabama, Birmingham, who questioned why such a standardized two-step approach hasnt taken firm hold for herpes.
Should I Get Tested Again
You may want to go for a repeat test after six months if you do not undergo regular sexually transmitted infection screening. In doing so, you’re more likely to identify an infection without missing the window in which the tests are accurate.
Speak with your healthcare provider about when it’s best for you to get tested, and if there are other tests you should consider.
Is It A New Or Recurrent Infection
Herpes IgM levels tend to go up early in an infection, and levels often go down with time. This means a positive herpes IgM result is most often associated with a new infection. However, individuals with recurrent herpes infections may also have positive herpes IgM blood results.
Individuals may not have a positive immunoglobulin G test, an antibody test that detects IgG, until they’ve been infected for at least several months. However, IgG levels tend to remain high throughout the course of an infection, while IgM levels are more variable.
This means that if an individual has positive results on both IgG and IgM tests, they may be having a recurrent herpes episode, instead of a new infection. A positive IgM test alone is more likely to be a new infection.
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What Is The Hsv Igm Test
The herpes simplex virus, termed as HSV causes an infection called herpes. The virus is categorized into two types, the herpes simplex virus type 1 and herpes simplex virus type 2 . While HSV-1 is caused by physical contact and causes cold sores in the mouth area, the HSV-2 type is transmitted sexually and leads to genital herpes. The virus is highly contagious and causes painful blisters and ulcers at the site of infection. There is no cure for herpes and it can only be controlled by medications and certain home remedies. The HSV IgM test is a blood test that is used to detect the presence of the virus in the system. While the test does not identify the actual virus, it points out certain proteins that are produced by the body in response to the virus.
Study Questions Reliability Of Diagnostic Tests For Herpes
Up to half of those screened for genital herpes may be incorrectly told they are infected
Tests commonly used to diagnose oral and genital herpes are often unreliable, missing some cases of infection and, in others, identifying an infection that does not exist, say researchers at the University of Washington School of Medicine.
In nearly half of patients with commercial test results indicating that they were infected with the most common cause of recurrent genital herpes, herpes simplex virus 2 , a subsequent test showed that the initial diagnosis was incorrect, the researchers report in a paper published today in the journal Sexually Transmitted Diseases.
The high rate of false-positive HSV-2 tests was particularly troubling, said Dr. Anna Wald, who led the research.
These tests arent as good as they ought to be, given that they are used to diagnose someone with a chronic, lifelong sexually transmitted disease. Wald directs UWs Virology Research Clinic and is a professor of medicine, epidemiology, and laboratory medicine.
The investigators examined results from FDA-approved tests used to diagnose HSV-2 and herpes simplex virus type 1 , the most common cause of cold sores.
These tests, called enzyme-linked immunoassays, detect the presence of antibodies to the herpes simplex viruses in a persons blood. When the antibodies are detected, the test is positive, meaning that the person is infected by the virus. No detected antibodies indicates no infection.
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When Should I Get A Genital Or Oral Herpes Test
Testing for the viruses that cause genital and oral herpes may be ordered when a patient develops signs and symptoms of a herpes infection. Although many people who contract HSV never notice symptoms, signs of an initial infection appear 2 to 20 days after infection and depend on the type of HSV causing the infection.
When signs and symptoms of an initial infection occur, they may include:
- Small sores on the skin
- Tingling, itching, or burning on the skin
- Fever, headache, or body aches
- Swollen lymph nodes
After the initial infection, HSV remains dormant inside of the body. HSV can reactivate throughout a patients life, causing symptoms of genital or oral herpes to reappear. While the trigger for an HSV outbreak is often unknown, potential triggers include a fever, stress, physical trauma, and a suppressed immune system.
Generally, expert organizations do not recommend herpes testing for patients without symptoms. An exception may be made for certain patients, including:
- Patients who have a partner with genital herpes
- Patients seeking a more complete STD test panel, including people with multiple sexual partners
- Babies born to a mother who has HSV
Are There Any Risks To The Test
There is no known risk to having a swab test.
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
If you had a lumbar puncture, you may have pain or tenderness in your back where the needle was inserted. You may also get a headache after the procedure.
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How Is Herpes Treated
Herpes cannot be cured, but it can be managed. Medications are available that can prevent or shorten the duration of herpes outbreaks. There is a medicine that you can take on a daily basis that can help prevent outbreaks and also lower your risk of spreading the virus to others. Talk to your healthcare provider about your options. Antiviral medications such as acyclovir, famciclovir and valacyclovir can suppress outbreaks and shorten the duration of symptoms and active shedding of virus.
When Is The Hsv 2 Blood Test Most Useful
If someone wants to know if they have genital herpes because of their sexual history, then the HSV 2 blood test can provide conclusive information about whether or not they have been infected. This result can then help to reduce future transmissions to additional sexual partners. It is also useful to confirm a herpes diagnosis if someone is suffering from the symptoms of an active infection.
The symptoms of an HSV 2 infection can be so mild that they are undetectable. Many people who are infected with genital herpes do not know that they have it. If there are active symptoms, however, they will typically involve the presence of a small blister that will eventually break and ooze fluid. The blister than scabs over and becomes a painful sore that takes several weeks to heal.
There may also be flu-like symptoms experienced with the first outbreak of symptoms after the initial infection. This may include a fever, chronic and severe fatigue, nausea, and dizziness.
The issue with an HSV 2 infection is that the body is always shedding the active virus. People can transmit HSV 2 even if they arent experiencing active symptoms. The herpes virus can also make people 2x more susceptible to other STD infections, particularly HIV. This is because small, unnoticeable cracks in the skin can occur around the genital region to allow the virus to have access to the body. Herpes also attracts the cells that HIV likes to infect.
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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 Do Healthcare Providers Test For Herpes
How are you tested for herpes at a clinic or healthcare providerâs office? Healthcare providers will examine the location and severity of any active blisters or sores around the mouth or genital area. They may take a tissue sample of the sores to send to a laboratory for examination. A blood sample will be needed if an antibody test is used to check whether you have been infected with the herpes virus.
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What Is A Serum Herpes Simplex Antibodies Test
A serum herpes simplex antibodies test is a blood test that checks for the presence of antibodies to the herpes simplex virus .
HSV is a common infection that causes herpes. Herpes can appear in various parts of the body, but it most commonly affects the genitals or mouth. The two types of herpes infections are HSV-1 and HSV-2.
HSV-1, commonly known as oral herpes, usually causes cold sores and blisters near the mouth and on the face.
Its transmitted through kissing or sharing drinking glasses and utensils with a person who has an HSV infection.
HSV-2 is typically responsible for causing genital herpes. Its generally transmitted through sexual contact.
HSV-1 and HSV-2 dont always cause symptoms, and people may not know they have the infection.
The serum herpes simplex antibodies test doesnt actually check for the HSV infection itself. However, it can determine whether someone has antibodies to the virus.
Antibodies are special proteins that the body uses to defend itself against invading organisms such as bacteria, viruses, and fungi.
This means that most people who have an HSV infection will have the corresponding antibodies.
The test can detect antibodies for both types of HSV infections.
Your doctor may order a serum herpes simplex antibodies test if they suspect you have an HSV infection.
The results will determine whether youve contracted an HSV infection. If you have the antibodies to HSV, youll test positive even if you dont currently show any symptoms.
What Does A Positive Herpes Igm Test Result Mean
A herpes IgM test is a blood test that can detect early herpes simplex virus infection. HSV is a contagious condition that causes sores around the mouth or genitals.
The IgM test does not detect herpes directly. Instead, it looks for IgM, a type of antibody. This is a protein produced by the immune system in response to a herpes infection.
This article explains the purpose of the herpes IgM test. It also discusses what the results mean, as well as retesting considerations.
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What Happens During A Herpes Test
If you have blisters or sores, your doctor or nurse will gently take a sample of fluid from the sores with a swab and test it.
If you dont have any sores, talk with your doctor or nurse about whether a blood test for herpes makes sense for you. But herpes tests arenât normally recommended unless you do have symptoms.
The idea of getting tested may seem scary, but try to chill out. STD testing is a regular part of being a responsible adult and taking care of your health. And herpes tests are quick and usually painless.
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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.
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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.
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?
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How Does The Herpes Antibodies Test Work
A herpes antibodies test works by looking in your blood for HSV-1 antibodies or HSV-2 antibodies â typically the IgG type but sometimes the IgM type.
These tests only indicate exposure to either HSV-1 or HSV-2 at some point in your past. This does not necessarily mean that HSV is causing any current symptoms that you may have â since the exposure could have been years ago.
If you are worried about a new infection, it might be useful to take the test again around 21 days later to make sure that your body has had enough time to produce the antibodies.
The tests can give false-positive results. You may want to repeat the test or try other forms of testing to confirm the results.
Cost And Health Insurance
Depending on where you live and the lab you use, your HSV IgG blood test can cost between $35 and $80. Public clinics tend to be cheaper.
Genital HSV is considered an STI. But don’t assume that a free STI clinic will have the test or provide it free of charge. Some may only offer free testing for:
- Select STI screening tests
Search for free or low-cost STI clinics in your area by using the GetTested locator offered by the CDC.
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