Routine Genital Herpes Testing Not Recommended
Early diagnosis won’t change course of the STD, which is incurable, advisory panel says
TUESDAY, Dec. 20, 2016 — Routine blood test screening for genital herpes is not recommended for teens and adults — including pregnant women — who don’t have any signs or symptoms of the sexually transmitted disease , a panel of U.S. health care experts says.
The newly released recommendation from the U.S. Preventive Services Task Force reaffirms one issued in 2005.
After reviewing available evidence, the group concluded that the potential harms of screening outweigh the benefits. Blood test screening for genital herpes is highly inaccurate and there is no cure, so screening, early identification and treatment are unlikely to affect the course of the disease, according to the task force.
The recommendation was published online Dec. 20 in the Journal of the American Medical Association.
The task force is an independent panel of national experts in prevention and evidence-based medicine.
“Because current screening methods are often inaccurate, harms of screening include high false-positive rates and potential anxiety and disruption of personal relationships related to diagnosis,” task force member Ann Kurth said in a news release from the panel. Kurth is dean of the Yale School of Nursing in New Haven, Conn.
Many people who have herpes have no symptoms, or very mild symptoms, so most people who have the disease don’t know it, the CDC noted.
Are There Any Serious Consequences Of Genital Herpes
Some people believe that genital herpes is associated with cervical cancer but this is not the case. Instead, genital herpes is confused with the human papillomavirus. HPV has been linked to cervical cancer and also causes lesions. This sexually transmitted disease is one of the reasons why women should get screened regularly to test for early signs of cervical cancer.
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
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How Test Accuracy Is Measure
The accuracy of all medical tests, including herpes tests, is measured based on two values: sensitivity and specificity.
Sensitivityis how often a test correctly identifies someone with a disease. A test that is 90% sensitive will correctly identify 90 people out of 100 who have the disease. Ten people will have a false-negative result.
Specificity, on the other hand, refers to a test’s ability to correctly identify someone who doesn’t have the disease. If a test is 90% specific, that means that 90 people out of 100 will be correctly diagnosed as not having a disease and that 10 people will have a false-positive result.
The higher the sensitivity and specificity, the lower the chances of a false result.
Taking A Genital Or Oral Herpes Test
Testing for genital and oral herpes may be performed with a blood sample or a sample of fluid swabbed or scraped from a sore. Both types of samples are collected by a health professional when conducted at a doctors offices, clinic, or community organization.
If a patient is experiencing an outbreak, a doctor can collect a sample for testing by swabbing or scraping a sore. Material from the sore can be used for a herpes viral culture, PCR testing,
A Tzanck smear or an antibody test.
If a patient is not currently experiencing an outbreak, a blood test may be used to identify HSV antibodies. If a doctor suspects a brain infection with HSV, a lumbar puncture may be performed to obtain a sample of cerebrospinal fluid for analysis.
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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?
No One Should Feel Shame For Having A Viral Infection
Having herpes really just means you have a viral infection. Thanks to stigma some people experience a sense of shame with their diagnosis. Although its easy to say just get over it, whats important to remember is that people with herpes can and should live their lives in the way that want, have relationships, have sex and experience intimacy.
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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
There Are Two Common Blood Tests Used To Identify Herpes And Theyre Often Misleading
I had a patient once who underwent this test, which was positive, and was told she has herpes, which to her was devastating and life-altering, Friedman says. She burst into tears when I explained the significance or lack thereof with this test, which is very misleading. There are two common blood tests used to identify herpes: IgG and IgM. The IgM test is still used by some doctors even though it has been denounced by the Centers for Disease Control and Prevention . According to the American Sexual Health Association , IgM tests can lead to deceptive results, as well as false assumptions about how and when a person acquired HSV.
And thats not all: IgM tests fail to accurately distinguish between HSV-1 and HSV-2 antibodies, leading them to provide false-positive results for HSV-2. In other words, if youve been exposed to oral herpes , results of the IgM test could lead you to believe youre positive for genital herpes, when in fact you simply have antibodies against HSV-1.
IgG tests, on the other hand, are more accurate, but arent without their own issues. For instance, ASHA says that while an IgG test can distinguish between HSV-1 and HSV-2, the problem is that the time it takes for IgG antibodies to reach a detectable level varies from person to person. This means that even with accurate results, someone could get a false-negative if they have the test administered too soon after contracting the virus .
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How Soon Can You Be Tested
The incubation period for herpes is 2 to 12 days, which means that the best time to get tested for the herpes virus if you havent had an initial outbreak is after 12 days. If youre worried that youve been exposed to herpes but have not yet been diagnosed, here are some steps you can take:
- If youre currently sexually active, stop all sexual activity until you can receive a formal diagnosis.
- Reach out to your doctor and schedule an appointment for once the incubation period is up.
- If youre having an outbreak, you dont have to wait to get tested. Its possible to receive a diagnosis based on the lesions.
Should I Tell My Partner/s I Have Herpes
There isnt a rule as to whether you should tell a partner about having herpes. Some people dont tell their sexual partner/s and choose not to have sex during an episode and practice safer sex by using condoms/dental dams. Suppressive therapy plus safer sex can reduce risk of transmission to a partner significantly.
If youre concerned about passing on genital herpes, be upfront with your sexual partner/s before you engage in sexual activity. Communication is key at this point. If someone is genuinely interested in you before you tell them you have herpes, they should be after you tell them as well.
Given that a majority of Australians have been exposed to the herpes virus, theres a good chance they have already been exposed as well. If you have your first episode while already having a sexual partner then they have probably already been exposed but most likely will not have symptoms. And remember first episode doesnt necessarily mean it came from a current partner, you could have been exposed many years ago.
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How To Get Hailey Biebers Viral Glazed Donut Manicure
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 theyre still far from perfect. And when were dealing with a illness thats 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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How Do I Get Tested
In many cases, a doctor or nurse may diagnose herpes by looking at the affected skin and can only tell if you have the virus if you have signs or symptoms of Herpes. Theyll want to confirm this by taking a swab of fluid from the infected area, if they can. The swab will be sent to a laboratory. The result will usually be known within 13 weeks. A swab looks a bit like a cotton bud but is smaller and rounded. Its wiped over the parts of the body that could be infected and easily picks up samples of fluid. This only takes a few seconds and may sting for a moment if the blisters and sores are tender. Theres a specific blood test that can be done to look for antibodies to the virus. This isnt used as a routine test for genital herpes and may not be reliable.
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Are Canker Sores Caused By The Herpes Virus
Canker sores are not caused by the herpes virus or by any other virus. In fact, the cause of canker sores is unknown, although they may be triggered by a minor injury in your mouth from dental work or brushing too hard, an allergy, a vitamin B deficiency, stress, or a food intolerance. Some medical conditions, such as celiac disease and inflammatory bowel disease, may also cause canker sores, and they often occur in families, so it’s possible genetics or environment play a part, too.
Canker sores typically appear as small, round, or oval whitish sores with a red border, according to the Mayo Clinic. They typically occur on the tongue, inside the cheeks, inside the lips, or on the gums. The medical term for a canker sore is aphthous ulcer. Canker sores can be quite painful, but they usually heal within about two weeks without leaving any scarring.
Unlike cold sores, which usually occur outside the mouth, canker sores occur only inside the mouth. Like cold sores, canker sores are recurrent, but they are not contagious: You cant give a canker sore to another person. Canker sores occur more often in teenagers and young adults, and they are more common in women than men.
What Are The Complications Of Genital Herpes
Genital herpes may cause painful genital ulcers that can be severe and persistent in persons with suppressed immune systems, such as HIV-infected persons. 5 Both HSV-1 and HSV-2 can also cause rare but serious complications such as aseptic meningitis . 5 Development of extragenital lesions may occur during the course of infection. 5
There are also potential complications for a pregnant woman and her newborn child. See How does herpes infection affect a pregnant woman and her baby? below for information about this.
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A Lot Of People Have It Already
Sorry to be the one to tell you this, but a lot of people have herpes and just dont know that they do. According to the World Health Organization, 67% of the population under the age of 50 has HSV-1. Thats 3.7 billion people, people!
Meanwhile, the Centers for Disease Control and Prevention estimates, about one in six people between 14 and 49 years old in the U.S. currently has genital herpes. While weve been systematically trained to believe having herpes means being covered in sores for life, this is not the case for the vast majority of people. In fact, its estimated that up to 90% of people with HSV-2 are never diagnosed. They simply never wind up having an outbreak.
Something important to note is that even if you dont have symptoms, you can still spread HSV. Herpes is most infectious during an active breakout , but it can still be spread when there are no soresmedically known as shedding the virus.
Herpes Blood Tests Are A Complete Waste Of Time And Money They Can Even Destroy Relationships Heres Why:
If I had a dollar for the number of couples I have had in my office at breaking point because some other doctor recommended Herpes blood tests as part of a sexual health screen .or worse yet they thought they were smart enough to take themselves off to a lab to do a battery of tests with no counseling.
These poor couples are furious with each other because they have tested positive for Herpes and they want to know who cheated
Well, I dont know that ANYONE cheated.
You see Herpes Simplex is just one of many of the family of Herpes viruses that can stay in your body for years and years, very quietly causing no symptoms. A Herpes virus lives in your nerve roots, Then when you get run down, your immune system cant hold it at bay, so it travels down the particular nerve root its living in, to the skin that the nerve supplies and causes blisters and ulcers. If its your mouth you get oral Herpes and if its your genitals you get genital herpes. Thats why you tend to get cold sores in the same spot.
Now the thing with Herpes Simplex is that You may never have had a symptom when you got it 70% of people dont! so you may have contracted it and never got a blister.so how would you have known when or how you contracted it?
Herpes Simplex doesnt even have to be sexually transmitted. What about Herpes 2 I hear you say? Isnt that the one that causes Genital Herpes? Well lets clear that one up right now:
What a mess!!!
But what if I do get blisters?
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