As with all human herpes viruses, once an
individual is infected with the herpes simplex virus, or HSV, he or she
is infected for life. The presence of antibodies against herpes simplex
means an individual is currently infected with the virus. A positive
antibody test does not indicate merely that one has been “exposed” to
HSV. Nor does it mean you are immune to the virus, without active
The presence of antibodies for HSV-2, the
most common cause of genital herpes, almost always indicates genital
herpes infection with the type 2 virus. We know that genital HSV-2
infection involves almost continuous shedding of virus from the genital
tract. Therefore, the potential of transmission to uninfected sexual
partners is always present. HSV-2 outbreaks represent only a small
fraction of activated virus that is present.
Although the median number of outbreaks with
HSV-2 infection is four to six per year, many outbreaks go unrecognized.
Indeed, 70 percent of individuals with no self-reported history of
outbreaks begin to identify recurrences once they are educated about the
subtle signs and symptoms of genital herpes recurrences. Women, for
example, may have only minor itching, and the symptoms may be even
milder in men.
Serologic, or blood, testing allows us to
screen individuals for infection with herpes simplex. The new tests for
herpes, called type-specific serologic tests, distinguish between HSV-2
and HSV-1, the other type of herpes simplex virus. These newer tests
detect IgG antibodies directed against the cell wall protein specific
for HSV-1 or HSV-2. Older serologic tests did not reliably distinguish
between HSV-1 and HSV-2 and, as a result, were not a reliable way to
make a diagnosis of genital herpes.
Like all tests, the type-specific tests are
not perfect. It takes about three to six weeks for individuals to
develop detectable antibodies for herpes simplex. Virtually everyone
will have detectable antibodies by 16 weeks.
Get tested again if you have a recent
exposure that falls within the window period. This also means that a
first-time recognized outbreak may represent a new infection and may be
occurring during a period in which your body has not yet developed a
detectable antibody response. Again, the recommendation would be to get a
repeat serologic test in four to eight weeks.
Is a blood test for genital herpes usually included when I
ask to be tested for "everything" (all STDs)? Why does CDC recommend
testing for other STDs but not herpes?
Herpes type 2 blood testing may or may not be included in a full STD
evaluation, as STD testing depends on a number of factors, such as
behavioral risk factors (e.g. number of partners, consistent condom
use, etc.) and how common the infection is in the community. When
getting an evaluation, it is important to ask your provider which
infections are being tested for, which infections are not being tested
for, and why. STD screening tests are usually done for infections that
can have serious outcomes if they are left untreated. For example,
finding and treating curable STDs like chlamydia can prevent those
infections from leading to serious complications, such as infertility
(the inability to get pregnant) in women. Genital herpes infections can
cause intermittent symptoms that may be uncomfortable, but infection
does not usually result in serious complications in healthy adults.
Although the symptoms of genital herpes can be treated with medication,
there is currently no cure for herpes infections. HSV blood testing
may be useful for people seeking an STD evaluation, but CDC does not
currently recommend routine HSV testing in someone with no symptoms
suggestive of herpes infection. People who are specifically concerned
about genital herpes should discuss with their healthcare providers
whether they would benefit from testing.
Wouldn’t testing everyone for HSV limit the spread of genital herpes?
For STDs that can be cured with antibiotics, including syphilis,
gonorrhea, and chlamydia, an important public health prevention
strategy is to quickly identify and treat infected persons. When these
infected people are treated and cured, future spread of the infection
is prevented. However, genital herpes causes an incurable, chronic
lifelong infection. It is not clear that the identification of persons
with HSV infection would decrease the spread of HSV in the population.
There is no evidence that detection of HSV infection through testing of
persons with no symptoms suggestive of herpes leads to a change their
sexual behavior. Because the tests can be expensive and the diagnosis
may have adverse psychological or effects for some people, widespread
testing for HSV is not currently recommended.
Edited by SamoneLenior - Feb 11 2014 at 12:11pm