Quest Diagnostics Herpes Test Accuracy

When Are Herpes Tests Accurate

In the table below, we summarize information about the timing of herpes testing.

One of the most important factors in any infectious disease testing is doing it at the right time. This means two things in the case of herpes:

• For the blood test to be accurate, the right amount of time needs to have passed
• The swab test should be done while symptoms are âfreshâ

For each available herpes test, we will mention:

• The earliest testing time
• The ideal testing time

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Question 3 What Are The Advantages Of The Hsv

The HSV-2 IgG Western blot assay has historically been considered the gold standard for identifying HSV-2 IgG reactivity. However, Ashley-Morrow et al have clearly demonstrated that the HSV-2 IgG Western blot is less sensitive than the HerpeSelect HSV-2 IgG assay for detecting IgG seroconversion following newly acquired HSV-2 infection: the median interval between symptom onset and IgG seroconversion is 21 days for the HerpeSelect assay versus 68 days for the Western blot assay.3 There is thus a window of approximately 47 days in which the Western blot assay may give false-negative confirmatory results. In contrast, true-positive specimens in this window are positive in the HSV-2 IgG inhibition assay. In addition to increased sensitivity, the turnaround time for the inhibition assay is shorter than that of the Western blot assay.

The Accuracy Of Various Herpes Tests

This table summarizes the overall accuracy of different herpes tests. Please especially pay attention to the most common test, the IgG testâand most importantly to its false positive and false negative rates.

The table has three columns:

• Test accuracy: how accurate is the test in detecting the herpes virus
• False positive: the test detects the presence of herpes, but the person doesnât actually have it
• False negative: the test doesnât detect the presence of herpes, but the person does have it

Please note: the numbers in the table are averages and may vary from case to case based on factors such as when the test is performed , the testing technique, and the herpes viral load.

* The Washington University test is considered the âgold standardâ blood test. The false-negative and false-positive rates for the commercially available IgG test are based on a comparison to the Western blot results of the Washington University test.

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Why Dont Most Doctors Test Their Patients For Herpes

There are many reasons why many doctors dont test their patients for herpes.

So unless you SPECIFICALLY ASK your doctor to give you a blood test for herpes, it is unlikely that you or your friends or partners have ever been tested. So start asking specifically for a herpes blood test. And sometimes your doctor will even push back and tell you that you dont need a Herpes Blood Test or give you another reason why they dont want to give you a Herpes Blood Test. This may be because your doctor is not up-to-date and doesnt know about the newer, very accurate herpes blood tests. Read on for more info.

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Some research has shown that two-step testing might improve the specificity that is avoid false positive results for the blood test which would be a great thing because these diagnoses create great anxiety and concern for people, he said. In a commentary accompanying the USPSTF guidelines, Hook expressed disappointment that herpes testing had barely improved over the past decade.

There is no perfect test but there are ways to reduce the inaccuracies and reduce the number of equivocal results and those are actively used in other diseases, he said in an interview with STAT. But they havent been used very aggressively for the purpose of herpes.

In the absence of sure-fire test advances, education and a lessening stigma surrounding herpes might help, not only by reducing test-related confusion, but potentially by bringing discussion of the virus out into the mainstream, said Hook.

Theres no major herpes advocacy group, he said. People call attention to diseases that they suffer from, but people with herpes dont feel they can call attention to it. And that creates a lot of suffering.

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How Do Doctors Test For Genital Herpes

There are two types of herpes simplex virus: HSV-1, which causes cold sores , and HSV-2, a similar virus which the World Health Organization says is responsible for the majority of genital herpes cases in the U.S. Genital herpes is usually caused by HSV-2 transmission by skin-to-skin contact during intercourse, but can also be transmitted by genital-to-mouth contact with the HSV-1 virus .

Regardless of whether genital herpes is initially caused by HSV-1 or HSV-2, the end result is the same: recurring flare-ups whose effects can include fever, swollen lymph nodes, painful urination, and stinging, running, itchy blisters, which usually start to scab and heal over within several weeks.

Because these symptoms can lie dormant for long periods of time, and because the virus can easily spread in a variety of ways, herpes is highly transmissible and should be tested for promptly if you have any suspicions of an infection. There are a few different types of tests your doctor can perform to diagnose genital herpes, including:

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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Flawed Herpes Testing Leads To False Positives And Needless Suffering

Blood tests can be highly unreliable

Herpes is a lifelong infection, but Lauren had it only for six tumultuous months. Or rather, she believed she did, after a request for sexually transmitted disease testing returned a positive result. But after weeks of Googling, chatting with members of online herpes forums, and reading scientific papers, she asked for a different test, which eventually confirmed her suspicion her herpes diagnosis was wrong.

In the six months that passed between the tests, the mistake led her to keep a romance at bay and left her anxiously patrolling her health.Every tingle I would get in my leg or any kind of itch down there would just set me off, sending her into a new flurry of research, she said. And that was just to try to calm my own anxiety, but it would only really make it worse.

Genital herpes, predominantly caused by herpes simplex virus type 2, is a sexually transmitted disease thats very common 1 in 6 people aged 14 to 49 in the United States have HSV-2, and this number goes up with age. Most of these people, however, dont have obvious symptoms and wouldnt know they were carriers without blood tests.

Herpes Pcr Tests Very Accurate

A PCR test can be done on cells or fluid from an active sore and is more sensitive than typical lab culture tests. PCR finds the genetic material of the HSV virus and can tell the difference between HSV-1 and HSV-2. Although this test may be more expensive than lab cultures, it is definitely more accurate and less likely to result in a false negative or false positive. However, you still need to get tested while you are having an active outbreak, or else the HSV cells may no longer be present on the surface of your skin.

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Herpes Blood Tests Very Accurate Can Be Done Even When Symptoms Are Not Present

Many out-of-date doctors will tell you that there are no reliable blood tests for herpes that can accurately distinguish between HSV-1 and HSV-2. These doctors *used to* be right. And some of the old, inaccurate blood tests are still out there. But medicine has made great strides, and since 1999, there are several NEW IgG blood tests now available that DO very accurately distinguish between HSV-1 and HSV-2 and are 97-100% ACCURATE, if taken no earlier than 12-16 weeks after your possible exposure to the virus. Please note that despite the relatively high accuracy of these blood tests, false positives and false negatives do occur. If you have conflicting results on 2 different herpes blood tests, you should probably order the Western Blot herpes blood test see below.

Since some doctors and clinics are still using the older, inaccurate blood tests. Always make sure to find out the name of the company and test that your doctor or lab is ordering for herpes blood tests, and make sure it is one of the tests on the good list and not one of the tests on the bad list.

How Can People Test For Herpes

A person can ask for a herpes test at any sexual health clinic or a doctors office. A healthcare professional will either swab a blister or draw a blood sample.

At-home herpes tests often require a blood sample through a finger prick.

Once a person receives their test results, they should contact a doctor to discuss treatment options, if necessary.

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Never Just Assume That Your Doctor Already Tested You For Herpes

Most doctors NEVER test their patients for herpes, even when they are testing you for other STDs. Thats right. A herpes blood test is NOT INCLUDED in the Standard STD Panels. Most doctors will NOT test you for herpes UNLESS YOU ASK SPECIFICALLY FOR A HERPES BLOOD TEST. If you arent sure whether or not your doctor tested you for herpes last time, ASK them for a copy of all of your last STD test results. If you dont see a blood test result for both HSV-1 and HSV-2, then you were not tested. The majority of people have NEVER been tested for herpes and dont know they have it.

The best way to diagnose herpes when you are not having symptoms is to request a herpes blood test. Or if you are having an active outbreak then immediately go to the doctor to get a herpes lab culture AND a herpes blood test. You must SPECIFICALLY REQUEST that your doctor give you a herpes blood test and a herpes lab culture or else your doctor might just do a visual inspection and may easily misdiagnose herpes as something else such as jock itch, a yeast infection, or rough sex. When your symptoms go away usually within a few days to a few weeks, you may not even realize that you just experienced a herpes outbreak.

Herpes Testing: Types Accuracy Timing And Necessity

In this section, weâll give you information about herpes testing.

Testing is what ultimately establishes or rule out a diagnosis of herpes. All the other weâve talked aboutâwhat you feel, what you see, and your odds of getting itâhelp us with the diagnosis, but theyâve canât establish it or confirm it.

This section will summarize the different types of herpes tests, their accuracy, how theyâre interpreted, and when theyâre necessary. Tables with important statistics will be followed by FAQ answered by âDr. F,â an STD expert.

So, if you want to know all about herpes testing, this chapter is for you!

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Does My Healthcare Provider Include A Blood Test For Genital Herpes When They Test Me For Everything

Herpes blood tests may or may not be part of the tests your healthcare provider gives you. They may choose tests based on several factors .

They will also evaluate you for signs or symptoms of herpes to choose which tests to use. This is why its important to talk openly and honestly with your provider during your visit. Ask them which infections they are and are not testing you for and why.

Additional Resources

Best Subscription For Herpes Test: Letsgetchecked

• Collection method: finger prick blood sample
• Results: within 25 days
• Follow-up care: nurses available through LetsGetChecked to discuss positive results
• Pro: tests for both HSV-1 and HSV-2
• Con: does not accept insurance

The LetsGetChecked home kits can test for both HSV-1 and HSV-2. This test kit may be best for people who require regular testing as the companys subscription options can offer significant discounts.

A person receives a collection kit with all the tools they need to collect their samples at home. This includes needles, a prepaid envelope, alcohol swabs, and a tube. The tests come in discreet packaging so that other people will not know what the person has received.

The person also has access to an instruction video on the company website that explains how they should take their test. LetsGetChecked suggests that people take a blood sample before 9 a.m. and return it to the laboratory on the same day.

The company states that it issues the results within 25 days.

Individuals who receive a positive result can contact a nurse through the company, and they may suggest a treatment plan.

LetsGetChecked offers a one-time purchase for $119. Anyone who requires regular testing can purchase a LetsGetChecked subscription and get discounts on its tests. For instance, a 3-monthly subscription will give a person a 30% saving on the cost of the kits.

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Quick Answers For Clinicians

Virologic and serologic testing methods are available to confirm herpes simplex virus infection. Direct detection of the virus by polymerase chain reaction or viral culture is recommended for neonates and patients who have an active infection with lesions, to test for disseminated bloodborne infection in immunocompromised patients, and for cerebrospinal fluid testing. Serologic testing for immunoglobulin G can be used to determine if a person has ever been exposed to HSV but cannot determine exactly when the exposure occurred or the site of infection. Type-specific serologic testing for HSV-1- and HSV-2-specific glycoproteins can determine the subtype of the virus, which provides useful information about prognosis and informs treatment and counseling.

Genital herpes is most often caused by herpes simplex virus type 2 , but HSV-1-associated cases are increasing. Recurrence and subclinical viral shedding occur more frequently in cases caused by HSV-2 than in cases caused by HSV-1, which may impact treatment and counseling decisions. Therefore, subtyping HSV using polymerase chain reaction or serology testing can guide treatment decisions and patient counseling. Subtyping may also provide epidemiologic information about transmission of the virus.

Getting Help With Confirmatory Testing

I’ve found that an important part of mental health for patients with herpes is to feel a sense of understanding and agency around their diagnosis and test results and to learn information that can help them make a decision about whether they want to pursue confirmatory testing or not. I often refer patients with low positive results to consult with a medical expert if they have additional questions. The healthcare provider I trust the most with these types of questions is Terri Warren, NP, who has been an excellent resource for many of my patients. There may be other healthcare providers who can navigate appropriate confirmatory testing, but many providers have not learned how to do this. If you are questioning your diagnosis and want to learn more about confirmatory testing, you can do so here. If you need help coping with the diagnosis or with awaiting results, therapy or a support group can often help.

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