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.
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Use Of Type Specific Tests In Paediatric Sera
Only the HSV-1/HSV-2 gG based Premier type specific test combination from Meridian was tested in paediatric populations in FDA clinical trials. The results prompted a warning in the kit against use of the tests for herpes diagnosis in children. Recently we conducted a blinded study between UW WB and Meridian Premier HSV-1 and HSV-2 kits in sera from 97 children ages 114. The Meridian kits had a 54% specificity for HSV-1 and a 47% specificity for HSV-2. The NHANES survey revealed an HSV-2 seroprevalence of 0.25% in children using immunodot enzyme assay. Eis-Hubinger et al found an HSV-2 seroprevalence of 4% among children with the Gull test and 3% with the Cobas test. Paediatric sera accounted for nearly all of the false positive results in this large comparison study. Performance in paediatric sera by the Focus, POCkit, and other commercial tests are not known. Thus, these tests should be used with caution, if at all, in children under 14.
Commercial Hsv Type Specific Gg Based Serology
Three companies, Meridian Bioscience Inc, MRL Diagnostics , and Diagnology, have received approval from the US Food and Drug Administration for a total of six gG based diagnostic test kits two for HSV-1, three for HSV-2, and one that combines both in one kit . Until March 2001, Meridian Bioscience offered gG based HSV-1 and HSV-2 ELISAs, under the Premier label . The tests were originally developed by Gull Laboratories using affinity purified gG-1 and gG-2. Unfortunately these discontinued Premier HSV tests have the largest fund of performance data of the commercial tests.
Table 3
Selected commercial HSV type specific antibody assays based on glycoprotein G-2
Focus Technologies has three tests: HSV-1 and HSV-2 ELISAs and an immunoblot test combining HSV-1 and HSV-2 antibody detection. All three tests use bacculovirus recombinant gG constructs. All are FDA approved tests and can be purchased as kits. In addition, Focus Technologies’ reference laboratory also tests sera that are sent to their facility in Cypress, California.
Diagnology offers the only point of care or near patient test for HSV-2 antibodies that is designed for clinic use. The antigen for their POCkit-HSV-2 test is lectin affinity purified gG-2. Quidel Corporation has trials under way for FDA clearance of second point of care antibody test .
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Serology In Medicolegal Cases
It is important to note that the performance characteristics of gold standard tests, including WB, have not been determined in children. HSV-2 infections that may have occurred as a result of sexual abuse of children should be diagnosed by culture or PCR, not by serology. No test for antibodies to HSV-1 or HSV-2 can be considered to be completely accurate in determining whether a person has or has not been infected with HSV. Because every serological test has a potential for false positive or false negative results, use of type specific serology in criminal cases to link an alleged perpetrator of abuse or assault with a victim of any age by matching antibody types is not recommended. Similarly, use of serology to infer transmission links for civil lawsuits involving herpes acquisition is not recommended since even the most accurate test cannot reveal when and by whom an individual became infected.
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.
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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.
Reducing The Risk Of Genital Herpes
The herpes virus cant pass through a condom. However, if the virus is present and active on the skin in areas around the genitals not covered by the condom , infection may still occur. Therefore condoms are not 100% protective against the herpes virus.
If your partner has herpes, avoiding sex when they have visible sores reduces your risk of getting herpes.
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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.
Question 2 How Does The Hsv
The HSV-2 IgG inhibition assay measures the differential abilities of lysates of cells infected with HSV-1 or HSV-2 to neutralize patient sample reactivity to recombinant gG2 protein , the HSV-2specific protein used in the HerpeSelect HSV-2 IgG ELISA.2 Separate aliquots of the patient sample are incubated with the 2 lysates, then tested in the HerpeSelect HSV-2 type-specific IgG ELISA. The index value of serum pre-incubated with HSV-2 lysate is then compared to the index value of serum pre-incubated with HSV-1 lysate. The HSV-1 lysate controls for any non-gG2 reactivity present in the serum sample thus, any inhibition that is detected reflects only the absorption of gG2 reactive antibodies by the native gG2 present in the HSV-2 lysate. An example of how the inhibition value is calculated is shown below:
Index value for serum pre-incubated with HSV-2 lysate = 0.23
Index value for serum pre-incubated with HSV-1 lysate = 2.45
Inhibition = x 100 = x 100 = 0.91 x 100 = 91%
Inhibition values > 60% indicate true HSV-2-specific IgG reactivity
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Requesting A Genital Herpes Virus Test
Visit a physician and ask for a type-specific blood test. There are many herpes testing options but you are unlikely to have a false positive herpes test if you undergo one of the latest type-specific serological tests. A serological test for HSV can determine the difference between HSV-1 and HSV-2.
Anyone who fears they have received a herpes false positive test result may be exploring various other herpes testing options. Many experts agree that the molecular tests are best for diagnosing genital infections caused by the herpes simplex virus. Culture tests fail to detect the virus in many patients whereas the molecular test appears to confirm and clearly identify whether the person has HSV-1 or HSV-2.
Naturally, anyone who has been diagnosed with HSV will be concerned. If you feel that you have been handed a false positive herpes test result, you should discuss taking another test with your physician.
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When Is It Ordered
HSV PCR testing or herpes culture may be ordered when you have signs and symptoms of a herpes infection, such as a blister or blisters on or around your eye, mouth, genitals or rectum.
Herpes PCR testing may be ordered when you have signs and symptoms of encephalitis that a healthcare practitioner suspects may be caused by a virus. Examples of these signs and symptoms include:
Prenatal and newborn testing
- A pregnant woman who has been diagnosed with herpes may be monitored regularly prior to delivery to detect a reactivation of her infection.
- A baby born to a mother who has active lesions during delivery may be tested before symptoms appear to assess whether the baby was exposed to HSV during delivery.
- A mother and newborn may be tested for HSV soon after delivery when a baby shows signs of HSV infection, such as meningitis or skin lesions that could be caused by the herpes virus.
HSV antibody testing may be done when your healthcare practitioner wants to determine if you have been exposed to HSV in the past.
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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.
Are There Other Types Of Herpes Viruses Besides Hsv
Yes. There are over 25 viruses in the herpes family and at least 8 types that infect humans. These include herpes simplex virus types 1 and 2 discussed in this article as well as varicella zoster virus , associated with chickenpox and shingles, Epstein Barr virus , which can cause infectious mononucleosis, cytomegalovirus , human herpes virus 6 and human herpes virus 7 , both associated with roseola in young children, and human herpes virus 8 , which has been found in tumors in people with Kaposi’s sarcoma . KS primarily affects people with weakened immune systems, such as those with HIV/AIDS and organ transplant recipients.
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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.
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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Your Health Our Priority
Same day appointments, as much time as you need with the doctor and instant referrals to our network of Consultant Specialists.If you are experiencing health concerns, you don’t have to wait any longer.
- sharing of needles or infected tattoo equipment
- congenital herpes can be passed to an infant
Most people recognise an infection when symptoms appear – typically blisters are appear on the skin, but as discussed above, these symptoms may not be present just after the initial contraction of the virus.
The chances of transmitting genital herpes will increase if there are active, open sores or lesions, however it is also possible to contract herpes even if your partner fails to show any symptoms.
The best way to prevent yourself from contracting herpes is to cease sexual activity with anybody currently showing symptoms of herpes infection. Polyurethane or latex condoms may lessen the risk of transmission, but condoms cannot cover the entire infected area. Thus, genital HSV-1 and HSV-2 can be contracted even if you use a condom.
Australasian Chapter Of Sexual Health Medicine
Recommendations from the Australasian Chapter of Sexual Health Medicine on herpes, chlamydia, candidiasis, ureaplasma & gonorrhoea.The Australasian Chapter of Sexual Health Medicine is a Chapter of the Royal Australasian College of Physicians Adult Internal Medicine Division that connects and represents Sexual Health Medicine Fellows and trainees in Australia and New Zealand.
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Type Specific Tests To Avoid
Tests purporting to identify type specific antibodies have been commercially available for some time. When based on crude antigen preparations, such tests are inaccurate and misleading because the extensive cross reactivity between HSV-1 and HSV-2 generate indistinguishable antibody responses., Two of the tests that we found to be unacceptably inaccurate in 1991 are still on the market. A recent comparison of tests from Diamedix, Zeus, and Wampole revealed HSV-2 specificity values of 61%, 79%, and 85%, respectively. Although the most pervasive problem with these tests is in their inability to detect HSV-2 antibodies in HSV-1 seropositive patients, the tests also mistakenly type antibodies in patients with only HSV-1 infection or only HSV-2 infection.
The American companies that market tests based on crude antigen are listed in table 4. The kit inserts provide instructions for determining HSV-1 versus HSV-2 antibodies and the catologue descriptions may include the term type specific. These instructions are misleading the recent study of Martins et al revealed cross reactivity rates of 82% in positive samples by the Diamedix test 54% by the Zeus tests, and 47% by the Wampole tests. For practical use, the cross reactivity rates indicate that a positive test for HSV-1 or HSV-2 by these manufacturers’ kits can be due to HSV-1 infection, to HSV-2 infection, or to infection with both types.
Tests based on crude antigen
Common Types Of Testing For Microbes
Testing is getting better, and there are a variety of different ways to test, but none of them are anywhere near 100% accurate. Testing is mostly useful for diagnosing acute illness. This is especially true when symptoms of illness suggest infection with a higher virulence microbe that might respond to acute treatment with antibiotics. New innovations may gradually improve testing for chronic illness associated with stealth microbes.
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The Accuracy Of Herpes Blood Tests
As you can see, the accuracy of herpes tests depends on several factors. Certain blood tests are more conclusive than others and as mentioned above, some tests wont tell you which type of herpes you have.
Its possible to get a false positive herpes test result, and that can depend on several confusing factors. One is the duration between contracting the virus and taking the test: the amount of antibodies changes and can impact the test results.
- For best results if you think youve been exposed, the CDC suggests waiting 4-6 weeks from contact to get the blood test.
Its also interesting to note that a high percentage of the population is infected with HSV-1, which can be transmitted orally or genitally. That brings up a lot of questions for some people as to whether knowing about it via blood test is even useful. For example, it wont tell you much about where the virus is located without symptoms.