Genital herpes frequently does not have symptoms, or symptoms may be mistaken for something else. Genital herpes also can be passed to others without knowing it, if you are infected or contagious.
Testing seems like it would be straightforward to do, but there are many things you should know before you decide to be tested.
Viral testing:
First, it is important to know that even if you have an active herpes lesion swabbed and cultured, it may come back falsely negative. False negatives occur because the lesion may be too small or already in the process of healing.
It is best to test blistered lesions in the first 48-72 hours after they appear.
Polymerase chain reaction (PCR) testing is another type of viral test can be performed on fluid swabs from active lesions, with more accuracy than viral cultures.
PCR testing can detect DNA from the herpes virus and can also differentiate between HSV-1 (oral herpes type 1) and HSV-2 (genital herpes type 2). HSV stands for herpes simplex virus.
Though PCR fluid testing is only recommended by the CDC to test cerebral spinal fluid to rule out herpes encephalitis, labs often use PCR testing to test other herpes samples since it has more accuracy, stated University of Maryland Medical Center.
Blood testing:
Blood tests can be done when a person does not have active symptoms. One type of blood test does not test for the herpes virus but will measure whether or not you have developed antibodies to HSV-1 and HSV-2.
According to Dr. Jennifer Gunter, OB-GYN and Pain Medicine physician, “there is only one reliable and commercially available type of blood test for herpes antibodies called a Type Specific IgG”.
Do not allow anyone to test you for IgM to detect herpes. IgM may elevate at the beginning of an exposure but it is highly unreliable and cannot differentiate between types of herpes.
Gunter stated that the IgG test can reliably tell the difference between HSV-1 and HSV-2. However, it takes three to six months to develop these antibodies so you must wait that amount of time in order to get an accurate test.
WebMD said that a PCR blood test, like the PCR fluid test, can detect the DNA of the virus in the blood. It is a more expensive blood test than IgG antibody testing so this may not be the first choice for general screening.
Requestatest.com stated that PCR blood test may be ordered by patients who have received negative results for herpes antibody testing but are still concerned that they have herpes.
Neither an IgG or PCR test alone can tell you how long you have had the infection or what part of the body it is in.
“More than 90% of the population is positive for herpes 1 and about 16% is positive for herpes 2, but many people don’t know they are positive, because most people with herpes do not have outbreaks,” warned Gunter.
Typically, people develop HSV-1 in the mouth which, when active, appears as cold sores. HSV-2 mostly appears as genital herpes but each virus can occur in the other area from having oral sex.
In fact, Gunter stated that 50 percent of new cases of genital herpes are actually HSV-1.
The CDC does not recommend routine screening for herpes, as there is no evidence of a benefit to testing.
Gunter pointed out that routine testing is unlikely to change sexual behavior. She explained that testing is needed when a recurrent lesion that seems atypical for herpes should be checked. It is also important to check the partner of someone who is positive for herpes to decide if antiviral medication is needed to decrease risk of transmission.
Since testing is not entirely accurate, can be expensive and requires retesting to continue checking to see if you test positive, it could take months before you have a real answer.
In the meantime, you should practice safe sex as if everyone you have relations with has herpes.
Sources:
Understanding blood tests for herpes. Dr. Jen Gunter Word Press Blog. Retrieved July 28, 2013.
http://drjengunter.wordpress.com/2013/01/19/understanding-blood-tests-fo...
Herpes simplex. University of Maryland Medical Center (UMMC). Retrieved July 28, 2013.
http://umm.edu/health/medical/reports/articles/herpes-simplex
Herpes Tests. WebMD. Retrieved July 28, 2013. http://www.webmd.com/genital-herpes/herpes-tests
Herpes 1&2 DNA PCR Testing. RequestATest. Retrieved July 28, 2013
http://requestatest.com/herpes-simplex-12-dna-pcr-testing
Genital Herpes Screening. Centers for Disease Control and Prevention, Retrieved July 28, 2013.
http://www.cdc.gov/std/herpes/screening.htm
Michele is an R.N. freelance writer with a special interest in woman’s healthcare and quality of care issues. Other articles by Michele are at http://www.helium.com/users/487540/show_articles
Edited by Jody Smith