Materiały źródłowe

• #1 Genital herpes – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/genital-herpes/diagnosis-treatment/drc-20356167

  Your health care provider can usually make a diagnosis of genital herpes based on a physical exam and a history of your sexual activity. […] To confirm a diagnosis, your provider will likely take a sample from an active sore. One or more tests of these samples are used to see if you have herpes simplex virus (HSV), infection and show whether the infection is HSV-1 or HSV-2. […] Less often, a lab test of your blood may be used for confirming a diagnosis or ruling out other infections. […] Your care provider will likely recommend that you get tested for other STIs. Your partner should also be tested for genital herpes and other STIs.

• #2 Screening for Genital Herpes | Genital Herpes | CDC

  https://www.cdc.gov/herpes/testing/index.html

  Genital herpes is a common sexually transmitted infection (STI) can be challenging to diagnose. […] CDC recommends herpes testing for people with genital symptoms. […] Diagnosing genital herpes can be challenging. This is for two main reasons: […] A healthcare provider may diagnose herpes by looking at any blisters or sores. […] If a patient has no blisters or sores, providers may use a blood test to see if they have herpes. […] False positive test results show that a person has an infection or condition when they do not. […] The chance of a false positive herpes test result is much higher than when testing for STIs like chlamydia or gonorrhea. […] No. Studies show that HIV risk is not lowered by genital herpes testing or treatment.

• #3 Patient education: Genital herpes (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/genital-herpes-beyond-the-basics

  Genital herpes diagnosis is based on an individual’s medical history, their signs and symptoms, and the results of tests. […] Several diagnostic tests may also be used to diagnose genital herpes. These tests can usually confirm infection and identify which virus (HSV-1 or HSV-2) is responsible. The choice of testing will depend on your symptoms and whether you have any blisters or ulcers at the time you see your doctor. Polymerase chain reaction (PCR)-based testing and culture are the preferred tests for a patient presenting with active ulcers. […] The PCR test is a very sensitive test for identifying the herpes virus in cells and secretions from the urinary and genital tracts. The PCR test is more sensitive than the culture test. […] A culture test determines if herpes simplex virus is present in blisters or ulcers. However, a herpes culture detects the virus in only about 50 percent of individuals with genital ulcers.

• #4 About Genital Herpes | Genital Herpes | CDC

  https://www.cdc.gov/herpes/about/index.html

  Genital herpes is a common sexually transmitted infection (STI) that can be treated. […] Genital herpes is an STI caused by two types of viruses herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2). […] Genital herpes often has no symptoms, but it can cause serious health problems, even without symptoms. […] Most people with genital herpes have no symptoms or have very mild symptoms. […] See your healthcare provider if you notice any of these symptoms. […] Your healthcare provider may diagnose genital herpes by simply looking at any sores that are present. Providers can also take a sample from the sore(s) and test it. If sores are not present, a blood test may be used to look for HSV antibodies. […] A herpes blood test can help determine if you have herpes infection. It cannot tell you who gave you the infection or when you got the infection.

• #5 Genital herpes

  https://www.nhs.uk/conditions/genital-herpes/

  Symptoms of genital herpes include: […] The doctor or nurse at the sexual health clinic will: […] The test cannot: […] Symptoms might not appear for weeks or even years after you’re infected with the herpes virus. […] Treatment from a sexual health clinic can help. […] You may be prescribed: […] Go to a GP or sexual health clinic if you’ve been diagnosed with genital herpes and need treatment for an outbreak. […] Antiviral medicine may help shorten an outbreak by 1 or 2 days if you start taking it as soon as symptoms appear. […] Recurrent outbreaks are usually milder than the first episode of genital herpes. […] Some people who have more than 6 outbreaks in a year may benefit from taking antiviral medicine for 6 to 12 months. […] You can reduce the chances of passing on genital herpes by: […] Genital herpes is caused by a virus called herpes simplex. […] If you have HIV and herpes, you’ll be referred to a genitourinary medicine (GUM) specialist. […] See your midwife or a GP if you think you have genital herpes in pregnancy. […] You may be offered antiviral treatment:

• #6 The Tests You Take to Diagnose Genital Herpes

  https://www.webmd.com/genital-herpes/genital-herpes-diagnosis

  Genital herpes is a common STD; however, many people who have this sexually transmitted disease don’t know they have it. […] When symptoms do occur, they can easily be mistaken for something else. Without adequate testing, you risk infecting a sex partner and not getting medications that can help reduce the severity of your symptoms and accelerate healing. […] Your health care provider can perform tests to see if they are caused by the herpes virus. […] Tests used to diagnose or screen for genital herpes include: […] The PCR test can tell if you have genital herpes even if you don’t have symptoms. […] Cell culture or PCR test may give a false-negative result if the sores have begun healing or if you are recently infected. […] Blood tests can detect the HSV antibodies, which are proteins produced by the immune system in response to an infection.

• #7 Diagnosis of Herpes Simplex Virus: Laboratory and Point-of-Care Techniques

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8293188/

  Herpes can be diagnosed in two ways, by either detecting the presence of the virus in lesions or the antibodies in the blood. […] Different detection techniques are available based on both laboratory and point of care (POC) devices. […] Diagnosis of HSV typically involves detecting the whole virus or viral proteins, genetic materials, or HSV-specific antibodies in the blood. […] The conventional diagnostic strategies include viral culture, serological tests, and molecular techniques. […] Molecular diagnosis of the virus can be achieved by nucleic acid amplification using polymerase chain reaction (PCR) and loop-mediated isothermal amplification (LAMP). […] The POC devices not only enable rapid and early HSV detection but are also capable of specifically differentiating the type of virus (HSV-1 vs. HSV-2).

• #8 Diagnosis of Herpes Simplex Virus: Laboratory and Point-of-Care Techniques

  https://www.mdpi.com/2036-7449/13/2/49

  Herpes can be diagnosed in two ways, by either detecting the presence of the virus in lesions or the antibodies in the blood. […] Different detection techniques are available based on both laboratory and point of care (POC) devices. […] In this review, we focus on the different diagnostic technologies for herpes. These include conventional methods as well as the different advanced technologies, particularly the POC. […] Diagnosis of HSV typically involves detecting the whole virus or viral proteins, genetic materials, or HSV-specific antibodies in the blood. […] The conventional diagnostic strategies include viral culture, serological tests, and molecular techniques. […] Viral culture involves extracting the virus from the specimen, such as swab or needle aspiration, and culturing them for a few days, followed by microscopic analysis for determining HSV cytopathic effects (CPE).

• #9 Genital Herpes: Laboratory Support of Diagnosis and Management | Clinical Focus | Quest Diagnostics Genital Herpes: Laboratory Support of Diagnosis and Management Genital Herpes: Laboratory Support of Diagnosis and Management

  https://testdirectory.questdiagnostics.com/test/test-guides/CF_GenitalHerpes/genital-herpes-laboratory-support-of-diagnosis-and-management

  This Clinical Focus provides information about laboratory tests related to the diagnosis and management of genital herpes. […] Diagnosing infection and determining HSV type can indicate risk of disease recurrence, transmission risks, and prognosis (Table). […] Many laboratory methods, such as viral culture, polymerase chain reaction (PCR), and antibody (serologic) testing, are available to address this difficulty. This Clinical Focus discusses the testing options available for the diagnosis and management of genital HSV infections. […] Diagnosis of genital herpes based on medical history and physical examination is insensitive and nonspecific; clinical indications such as lesions may not be present in infected individuals. Thus, the Centers for Disease Control and Prevention (CDC) recommends laboratory confirmation of infection in appropriate individuals (see Individuals Suitable for Testing section).

• #10 Genital Herpes: Laboratory Support of Diagnosis and Management | Clinical Focus | Quest Diagnostics Genital Herpes: Laboratory Support of Diagnosis and Management Genital Herpes: Laboratory Support of Diagnosis and Management

  https://testdirectory.questdiagnostics.com/test/test-guides/CF_GenitalHerpes/genital-herpes-laboratory-support-of-diagnosis-and-management

  When genital or mucocutaneous lesions are present, viral culture or PCR tests are recommended. […] However, viral culture has low sensitivity that decreases as lesions heal; sensitivity is especially low for recurrent lesions. PCR tests are more sensitive. […] When lesions are absent, type-specific serologic tests are recommended. […] Testing for immunoglobin G (IgG) antibody seroconversion is the recommended method for identifying primary HSV infection. […] In addition to its role in diagnosis of HSV infection, laboratory testing can help distinguish the type of HSV, which has important implications for prognosis and patient management and can indicate risk of disease recurrence and transmission (Table). […] Type-specific testing is recommended by the CDC to confirm any clinical diagnosis of genital herpes.

• #11

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5177552/

  Herpes genitalis is caused by the herpes simplex virus type 1 or type 2 and can manifest as primary or recurrent infection. […] this review article discusses important aspects of the laboratory diagnostics, antiviral therapy and prophylaxis. […] The laboratory diagnosis of acute genital HSV infection or asymptomatic virus shedding is made via direct viral detection. […] The method of choice is demonstration of viral genomes in skin or mucous membrane swabs using the polymerase chain reaction (PCR). […] The PCR test should be able to differentiate between HSV-1 and HSV-2. […] Current guidelines thus recommend starting antiviral treatment when typical herpes genitalis symptoms are present regardless of laboratory results. […] Acyclovir is the first choice therapeutic agent for HSV infections, including herpes genitalis.

• #12 Diagnosis of Herpes Simplex Virus: Laboratory and Point-of-Care Techniques

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8293188/

  Traditional diagnosis of HSV from lesions involves the direct detection of tissues or cells infected by the virus, viral proteins, whole virus, or genetic materials. […] The sensitivity of HSV detection depends on the cell line, e.g., rabbit kidney shows 100% sensitivity even at low viral inoculum. […] The most common and standard molecular diagnosis technique is polymerase chain reaction (PCR), which allows the rapid amplification of viral genomes and can be used in clinical laboratories for the detection of HSV. […] A comparative study between PCR and viral culture methods showed 100% sensitivity and specificity for the PCR technique in detecting HSV-1 and -2 over the viral culture method, which has a sensitivity of 50% with 100% specificity. […] The Western blot assay is considered the gold standard for the detection of type-specific HSV antibodies and the differentiation of HSV infections. […] The first US Food and Drug Administration (FDA)-approved ELISA POC kit for HSV-2 detection was SureVue-HSV-2 from Fisher. […] The only commercially available FDA-approved microfluidic-based POC device for the detection of HSV-2 is Uni-GoldTM.

• #13 Diagnosis of Herpes Simplex Virus: Laboratory and Point-of-Care Techniques

  https://www.mdpi.com/2036-7449/13/2/49

  The sensitivity of HSV detection depends on the cell line, e.g., rabbit kidney shows 100% sensitivity even at low viral inoculum. […] The electron microscope (EM) uses a thin monochromatic beam of electrons that is focused on the sample using a magnetic lens operating at a high voltage of 200 kV. […] The most common and standard molecular diagnosis technique is polymerase chain reaction (PCR), which allows the rapid amplification of viral genomes and can be used in clinical laboratories for the detection of HSV. […] The PCR method, involving the use of either a TaqMan probe or the HydProbe system that targets specific sequences of the genome, undergoes several thermal cycling processes of amplification and generates the result in the form of fluorescence signal readouts; gel electrophoresis can also be used.

• #14 Challenges of testing for genital herpes – Women’s Healthcare

  https://www.npwomenshealthcare.com/challenges-of-testing-for-genital-herpes/

  The CDC recommends two direct test types as first-line diagnostics: polymerase chain reaction (PCR) assay for HSV DNA and HSV viral culture. PCR has superior sensitivity, from 98% to 99%, compared to culture and is increasingly available. Viral culture was previously the gold standard. Although it is still a recommended option, sensitivity varies greatly between primary infections (80%) and recurrent lesions (25%-50%). Also, the sensitivity declines rapidly. Culture of vesicular fluid has a sensitivity of more than 90%, but sensitivity of a crusted herpetic lesion is only about 25%. Whether using PCR or viral culture, a type-specific test should be ordered. The expected natural course of the infection varies by type. Although both virus types can cause genital infection, recurrences and asymptomatic shedding are generally more frequent with HSV-2 than with HSV-1. […]

• #15 Diagnosis of Herpes Simplex Virus: Laboratory and Point-of-Care Techniques

  https://www.mdpi.com/2036-7449/13/2/49

  The advantages of the fluorescence-based real-time PCR technique have completely revolutionized the PCR-based system for the quantification of DNA. […] This PCR technique is highly sensitive, has high precision, eliminates any post-amplification handling, and can be operated automatically. […] A fluorescence dye (SYBR green) or TaqMan probe is used in real-time PCR to monitor DNA amplification as the reaction progresses. […] The sensitivity of the EM technique has been found to be 96% compared to viral culture and the Tzanck smear method. […] The requirement of bulky and expensive instruments and its low throughput, which are the major drawback of this technique, have limited its utilization. […] The accuracy of any laboratory diagnosis tests for the detection of HSV infection depends on the stage of infection when the sample is collected, the quality of the specimen, the type of tests performed, the accuracy of the method, and the interpretation of the test report by the clinician.

• #16 HSV Tests for Genital Herpes: Test Types (PCR vs. Culture vs Blood)

  https://www.webmd.com/genital-herpes/herpes-tests-what-you-should-know

  Genital herpes is a common sexually transmitted disease. Its caused by two different viruses called herpes simplex type 1 (HSV-1) and herpes simplex type 2 (HSV-2). […] Thinking you have genital herpes naturally can bring up strong emotions. Talk to your doctor about getting tested. It could help you to learn more about the disease and talk honestly with your sexual partner. […] To check for herpes, your doctor usually does a physical exam and then likely orders one of these tests: Viral culture, Polymerase chain reaction (PCR) test, Blood test. […] If you get a positive result from the viral culture or PCR tests, it likely means you have herpes. […] A negative viral culture or PCR result could mean you dont have genital herpes. But in some cases, a person could still have genital herpes and a negative result.

• #17 Diagnosis of genital herpes simplex virus infection in the clinical laboratory | Virology Journal | Full Text

  https://virologyj.biomedcentral.com/articles/10.1186/1743-422X-11-83

  Diagnosis of HSV infection with tissue culture has low sensitivity because HSV is isolated from lesions in about 80% of primary infections but in only 25-50% of recurrent lesions, and in even fewer people whose lesions have begun to heal. […] PCR assays or other NAATs are the most sensitive test currently available to detect HSV in clinical samples. […] The detection rates of the PCR assays were shown to be 1171% superior to virus culture. […] The presence of type-specific HSV-2 antibody implies anogenital infection; thus, education and counseling appropriate for people with genital herpes should be provided. […] Type-specific HSV antibodies can take from 2 weeks to 3 months to develop. […] The distinction between newly acquired HSV and reactivated HSV is helpful for epidemiological studies, and is sometimes helpful clinically for management of psychosocial issues, because it can help clarify the source of infection. […] Laboratory confirmation of clinically suspected genital herpes diagnosis is necessary.

• #18 Herpes Simplex Workup: Approach Considerations, Laboratory Studies, Imaging Studies

  https://emedicine.medscape.com/article/218580-workup

  A thorough history and physical examination are essential in the evaluation of suspected HSV infections. […] Laboratory confirmation may be warranted in certain cases. For the diagnosis of HSV encephalitis, polymerase chain reaction (PCR) analysis of cerebrospinal fluid (CSF) and magnetic resonance imaging (MRI) are critical diagnostic tools. […] The diagnosis of HSV infection is primarily clinical, relying on the identification of characteristic lesions. […] Laboratory confirmation is particularly valuable in severe cases, in immunocompromised patients, pregnant individuals, or when lesions present atypically. A Tzanck smear, obtained from the base of a freshly ruptured vesicle and stained with Wright-Giemsa stain, typically reveals multinucleate giant cells, which are indicative of HSV or varicella-zoster virus infections.

• #19 Herpes Testing

  https://www.ashasexualhealth.org/herpes-testing/

  The accurate herpes blood tests detect IgG antibodies. Unlike IgM, IgG antibodies can be accurately broken down to either HSV-1 or HSV-2. […] For the most accurate test result, it is recommended to wait 12 16 weeks from the last possible date of exposure before getting an accurate, type-specific blood test in order to allow enough time for antibodies to reach detectable levels. […] There are currently several FDA-approved, gG-based blood tests that can give accurate results for herpes. Like any blood test, these tests cannot determine whether the site of infection is oral or genital. However, since most cases of genital herpes are caused by HSV-2, a positive result for type-2 antibodies most likely indicates genital herpes. […] A paper published ahead of print in Sexually Transmitted Diseases finds that commercial blood tests commonly used to diagnose herpes simplex virus (HSV) are frequently not reliable, especially in those with low positive results.

• #20 Patient education: Genital herpes (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/genital-herpes-beyond-the-basics

  Blood tests may be used when a person has no visible ulcers at the time of the patient visit, but has a history of genital ulcers or believes he or she may have been infected with HSV in the past. […] The blood test can detect antibodies (proteins that are produced by the body in response to a foreign substance) to HSV type 1 and type 2. Having a positive test for these antibodies indicates that the person was infected with the virus at some time in the past, although it is usually not possible to know when or from whom the virus was transmitted. […] Determining the type of herpes (1 or 2) can also help to predict the likelihood of future recurrences, given that type 2 recurs more frequently than type 1.

• #21 Genital Herpes: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/genital-herpes/?srsltid=AfmBOorlj8NRjpi0CWT_rzkFwsyey8-HSBMGTE6Wie7klR8EqA8sQ04t

  Genital herpes diagnosis methods include (American Academy of Dermatology Association, 2021): Physical Exam: Visually inspect to see if lesions such as blisters, ulcers, or sores are present. Viral Culture: Swab an open lesion or deface a healing lesion and swab a sample (tissue or scraping) to send to the laboratory for confirmation. […] Asymptomatic/latent infection diagnosis methods include (CDC, 2021a): HSV type-specific antibody blood test: Detects HSV antibodies. HSV nucleic acid amplification tests (NAAT): Most sensitive and specific that identifies presence of HSV-1 or HSV-2; polymerase chain reaction (PCR) tests are the most common NAAT for HSV.

• #22 Herpes simplex virus 1 & 2 – Serology | Public Health Ontario

  https://www.publichealthontario.ca/en/Laboratory-Services/Test-Information-Index/Herpes-simplex-Serology

  Serologic testing is indicated for determining evidence of past infection with HSV and is not indicated for the diagnosis of acute/recent HSV infection where virus detection from active lesions is the test of choice. […] HSV-2 Type Specific IgG assay is indicated for testing sexually active adults or expectant mothers to aid in determining evidence of prior infection with HSV-2 virus. It should not be used to diagnose an episode of suspected genital herpes infection. […] Following infection with HSV, it may take up to 3 to 6 months for HSV IgG antibodies to be detectable in serum/blood. […] HSV type specific IgG (HSV-1 and HSV-2) testing will be performed on all request for HSV serology. […] The presence of HSV IgG antibodies (in asymptomatic persons) provides an indicator of past infection with either HSV Type 1 or Type 2 or both.

• #23 Challenges of testing for genital herpes – Women’s Healthcare

  https://www.npwomenshealthcare.com/challenges-of-testing-for-genital-herpes/

  Routine screening of asymptomatic patients is not recommended. In fact, serologic testing may lead to more questions than answers. Serologic testing is significantly limited by low sensitivity and specificity. This is especially true in low-risk individuals, in whom there is a higher likelihood of a false-positive. The likelihood that a positive result indicates a true infection is called the positive predictive value. In low-prevalence populations, the positive predictive value for herpes serologic tests can be as low as 50%, meaning that half of the positive herpes results are false-positives. Unfortunately, no confirmatory test is commercially available. […] […] According to the CDC, serologic testing is useful in the following scenarios: Recurrent genital symptoms or atypical symptoms with negative HSV PCR or culture; Clinical diagnosis of genital herpes without laboratory confirmation; A patient whose partner has genital herpes; Persons presenting for an STI evaluation (especially those with multiple sex partners), persons with human immunodeficiency virus (HIV) infection, and MSM [men who have sex with men] at increased risk for HIV acquisition. […]

• #24 Core Concepts – Genital Herpes – Self-Study Lessons – National STD Curriculum

  https://www.std.uw.edu/go/comprehensive-study/genital-herpes

  Screening for HSV-1 or HSV-2 infections in asymptomatic persons with type-specific serologic testing is not recommended for the general population. […] For persons who have recurrent or atypical genital symptoms with negative HSV PCR or culture results, type-specific HSV serologic assays can be useful.

• #25 Genital Herpes: Laboratory Support of Diagnosis and Management | Clinical Focus | Quest Diagnostics Genital Herpes: Laboratory Support of Diagnosis and Management Genital Herpes: Laboratory Support of Diagnosis and Management

  https://testdirectory.questdiagnostics.com/test/test-guides/CF_GenitalHerpes/genital-herpes-laboratory-support-of-diagnosis-and-management

  A positive result indicates the presence of detectable antibody to the corresponding virus (HSV-1 or HSV-2), which indicates current or previous exposure to the virus; however, it does not indicate the site of infection. […] The CDC recommends confirmatory tests, such as inhibitory testing, for certain low-index HSV-2 ELISA results (eg, testing by HerpeSelect). […] If clinical suspicion of genital HSV infections is high, then repeat antibody testing should be considered 4 to 6 weeks later.

• #26 HSV-2 Tests for Genital Herpes Can Produce False Reactive Results – Letter to Clinical Laboratory Staff and Health Care Providers | FDA

  https://www.fda.gov/medical-devices/letters-health-care-providers/hsv-2-tests-genital-herpes-can-produce-false-reactive-results-letter-clinical-laboratory-staff-and

  The U.S. Food and Drug Administration (FDA) is reminding health care providers and clinical laboratory staff about the potential for false reactive (false positive) results in herpes simplex virus type 2 (HSV-2) serological tests for genital herpes. […] The FDA recommends that health care providers and clinical laboratory staff do the following: Review the CDC guidelines before ordering HSV-2 serological testing to reduce the risk of false reactive results. […] According to the Centers for Disease Control and Prevention, clinical diagnosis of genital herpes can be challenging. […] The FDA encourages users to report false reactive results with HSV-2 serological tests.

• #27 New Research Highlights the Need for Improved Herpes Diagnostics

  https://www.ashasexualhealth.org/new-research-highlights-need-improved-herpes-diagnostics/

  A paper published in Sexually Transmitted Diseases finds that commercial blood tests commonly used to diagnose herpes simplex virus (HSV) are frequently not reliable, especially in those with low positive results. […] Herpes detection in people without symptoms typically involves a blood test to find HSV-specific antibodies that the immune system produces in response to the virus. […] An index value above 1.1 is considered positive, but some experts regard values less than 3.5 as low positive and recommend a confirmatory test such as the HSV Western Blot, long considered the gold standard with regards to accuracy and consistency of results. […] Researchers from the University of Washington in Seattle and the Westover Heights Clinic in Portland, OR found that patients with low positive HSV-2 results on commercial EIAs frequently tested negative with the more sensitive Western Blot.

• #28 Challenges of testing for genital herpes – Women’s Healthcare

  https://www.npwomenshealthcare.com/challenges-of-testing-for-genital-herpes/

  Serology is not appropriate in this case. This occurrence is suspicious for a primary outbreak in someone previously uninfected, and if so, antibodies are not going to be present. It takes 3 weeks to several months after exposure to the herpes virus for antibodies to be detectable in the blood. […] […] Clinicians may be tempted to test for herpes immunoglobulin M (IgM) in an effort to determine if this is a new infection. In the case of HSV, however, IgM is not exclusively produced with initial infections. It can reappear with recurrences years after initial infection. The presence of herpes IgM cannot help differentiate between initial and established infections. […] […] Given that the patients symptoms and the characteristics of the lesions are consistent with herpes, the clinician recommends presumptive treatment with an antiviral medication and reviews other comfort measures. Antiviral medications should be started within 72 hours of an outbreak to offer the most relief. […]

• #29 Herpes antibodies: Overview, test, symptoms, and more

  https://www.medicalnewstoday.com/articles/herpes-antibodies

  Once a person has a herpes infection, they develop antibodies. Herpes antibody tests can allow doctors to see if an individual has antibodies in their system. […] A person can have an antibody test to find out if they have HSV. A healthcare professional can take a swab of an active lesion or perform a blood test to find out if a person has ever had herpes. […] However, doctors rarely order HSV antibody tests except in certain clinical situations. There is a high chance of false-positive results from antibody tests. […] A herpes antibody test is a simple and typically painless test that can reveal whether a person has ever had a herpes infection. Tests work by looking for antibodies that occur once herpes is in the system. […] Doctors usually test for herpes using PCR tests or viral culture because antibody tests have a high rate of false-positive results. PCR and viral culture can detect acute infections more accurately.

• #30 Recommendation: Genital Herpes Infection: Serologic Screening | United States Preventive Services Taskforce

  https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/genital-herpes-serologic-screening

  The USPSTF recommends against routine serologic screening for genital herpes simplex virus infection in asymptomatic adolescents and adults, including pregnant persons. […] Currently, routine serologic screening for genital herpes is limited by the low predictive value of the widely available serologic screening tests and the expected high rate of false-positive results likely to occur with routine screening of asymptomatic persons in the US. […] The USPSTF concludes with moderate certainty that the harms outweigh the benefits for population-based screening for genital HSV infection in asymptomatic adolescents and adults, including pregnant persons. […] The USPSTF found adequate evidence that currently available, FDA-approved serologic screening tests for HSV-2 have low specificity and a high false-positive rate for population-based screening.

• #31 Diagnosis of genital herpes simplex virus infection in the clinical laboratory | Virology Journal | Full Text

  https://virologyj.biomedcentral.com/articles/10.1186/1743-422X-11-83

  Thus, a clinical diagnosis of genital herpes should be confirmed with laboratory tests. […] The laboratory diagnosis of genital herpes is recommended in various situations: Confirmation of clinically suspected genital herpes. […] Because HSV-1 has become a frequent etiology of genital herpes, species typing is also a cornerstone of genital herpes diagnosis. […] Even though up to 50% of first-episode cases of genital herpes are caused by HSV-1, recurrences and subclinical viral shedding are much less frequent for genital HSV-1 infection than genital HSV-2 infection. […] When molecular testing is available, its use should be preferred over viral culture. […] The recommended sites and methods to be used in the direct diagnosis of genital herpes lesions are presented in Table 4. […] Confirmation of HSV in viral culture demonstrating cytopathic effect is recommended since other viruses may exhibit a cytopathic effect similar to that observed in herpes culture, and allows viral typing.

• #32 Genital herpes guide: Screening and diagnostic testing – Canada.ca

  https://www.canada.ca/en/public-health/services/infectious-diseases/sexual-health-sexually-transmitted-infections/canadian-guidelines/herpes-simplex-virus/screening-diagnostic-testing.html

  Screening for HSV is not recommended in people with no history of anogenital lesions. […] Healthcare providers should routinely inquire about any history of signs and symptoms that may suggest genital herpes. There is insufficient evidence to support screening during pregnancy when neither risk factors nor a history of genital lesions are identified. […] Herpes is diagnosed using viral identification techniques such as NAAT or viral culture. Type specific serology (TSS) may also be helpful when viral identification techniques are negative in a person with a history compatible with genital herpes. […] When NAAT or culture is positive for HSV, the type of HSV should be determined, so that appropriate counseling can be provided. […] NAAT approaches sensitivity and specificity of 100%, with rapid turn-around of results.

• #33 Genital Herpes Simplex: Causes, Symptoms, and Treatment

  https://patient.info/doctor/genital-herpes-simplex

  Genital herpes simplex is caused by infection with the herpes simplex virus (HSV). […] It is important to confirm diagnosis and identify the type of HSV involved. This will affect management, prognosis and counselling. […] Suitable tests are: Viral culture. […] DNA detection using polymerase chain reaction (PCR) of a swab from the base of an ulcer. This increases rates of detection by up to 71% when compared with viral culture. […] Type-specific serology tests can identify those with asymptomatic infection and can distinguish between the two types of HSV. […] Serological tests may take up to 12 weeks to become positive after primary infection. […] It may be useful: If a person’s partner has genital herpes and the person wants to know if they have been infected. […] If there are recurrent/atypical genital ulcers with negative culture or PCR results.

• #34 Genital Herpes – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/herpesviruses/genital-herpes

  HSV serologic testing should be considered for the following; to evaluate patients who have no suspicious genital lesions but who require or request evaluation (eg, because of past genital lesions or high-risk behaviors), to help determine risk of developing lesions, to identify pregnant women who do not have genital lesions but are at risk of transmitting herpes to the neonate during delivery, to determine whether a person is susceptible to infection from a sex partner with genital herpes. […] Diagnose based on characteristic genital lesions in patients with lesions and confirm by culture, PCR (preferred), and/or serologic tests for HSV.

• #35 Herpes Test | HSV 1 & 2 Test | Herpes Blood Test | Quest®

  https://www.questhealth.com/product/herpes-hsv-1-2-test-17169M.html?srsltid=AfmBOoqh1iOvjZjSv9XeFNthG6y5B5SsxaP65k8wuJQPtHXxAKFVNljK

  This herpes test detects both types of the herpes simplex virus (HSV), a sexually transmitted infection, in your blood. […] This test is specifically used to check for an antibody response to the virus, which can take time to develop. […] This herpes blood test checks for HSV 1 and HSV 2 which can cause painful sores around the mouth (oral herpes) or genitals (genital herpes). […] Although there is no cure for herpes, HSV tests can help with early detection, inform treatment to relieve symptoms, reduce future episodes, and prevent transmission. […] Herpes Simplex Virus 2 serologic screening is not recommended among the general population. Additionally, if an active lesion (sore) is present, please seek further testing from your doctor as direct detection of virus (by methods such a culture, PCR, or DFA) is preferred.

• #36 Recommendation: Genital Herpes Infection: Serologic Screening | United States Preventive Services Taskforce

  https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/genital-herpes-serologic-screening

  The USPSTF found adequate evidence to bound the potential benefits of serologic screening for genital herpes in asymptomatic adolescents and adults, including pregnant persons, as no greater than small, based on the natural history and epidemiology of genital HSV infection and limited evidence of benefits of screening and early treatment in asymptomatic persons. […] The USPSTF found adequate evidence to bound the potential harms of screening in asymptomatic adolescents and adults, including pregnant persons, as at least moderate, based on evidence of high false-positive rates of the screening tests in asymptomatic populations, potentially resulting in anxiety and disruption of personal relationships related to diagnosis.

• #37 Herpes (HSV) Test: MedlinePlus Medical TestLock

  https://medlineplus.gov/lab-tests/herpes-hsv-test/

  For a blood test, a health care professional will take a blood sample from a vein in your arm, using a small needle. […] If your provider thinks you have an HSV infection in your spinal cord or brain, you may have a test of your cerebrospinal fluid (CSF) to look for signs of the virus. […] The meaning of your test results depends on the type of HSV test you had. […] Negative/Normal test results mean that signs of the herpes virus were not found in your sample and you are unlikely to have an HSV infection. […] Positive/Abnormal test results mean that signs of HSV were found in your sample. […] If you have HSV, treatment can help reduce the number of outbreaks and control your symptoms. […] It’s also important to take steps to avoid spreading HSV to others.

• #38 HSV Tests for Genital Herpes: Test Types (PCR vs. Culture vs Blood)

  https://www.webmd.com/genital-herpes/herpes-tests-what-you-should-know

  For this test, your doctor scrapes or swabs one of your sores to take a sample. A lab then checks the sample for the herpes virus. […] As with the viral culture, your doctor swabs or scrapes a sample from one of your sores. A lab gets the sample and looks for genes from the herpes virus. […] A small amount of blood is sent to a lab that then checks it for herpes antibodies. […] You might get a blood test if you think you have been exposed but you dont have any symptoms. […] Labs may use different types of blood tests. With some you can get results the same day, but others may take up to 3 weeks. […] Theres no cure for genital herpes, but it can be treated. […] If you do have it, your doctor can help you manage it. There are drugs that can shorten or prevent outbreaks, ease symptoms, and lower the chances your sex partners will get it.

• #39 Serum herpes simplex antibodies Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/tests/serum-herpes-simplex-antibodies

  Serum herpes simplex antibodies is a blood test that looks for antibodies to the herpes simplex virus (HSV), including HSV-1 and HSV-2. HSV-2 most often causes genital herpes. […] The test is done to find out whether a person has ever been infected with oral or genital herpes. It looks for antibodies to herpes simplex virus 1 (HSV-1) and herpes simplex virus 2 (HSV-2). […] About 20% to 50% of adults will have antibodies against the HSV-2 virus, which causes genital herpes. […] A positive test means you have been infected with HSV recently or at some point in the past.

• #40 Herpes simplex virus 1 & 2 – Serology | Public Health Ontario

  https://www.publichealthontario.ca/en/Laboratory-Services/Test-Information-Index/Herpes-simplex-Serology

  Please be aware that a non-reactive IgG level does not always indicate the absence of current infection. It may take up to 3 to 6 months for HSV IgG to develop after exposure especially if a patient has been treated with antiviral medication. […] In symptomatic patients indeterminate levels of antibody may indicate rising antibody levels following acute infection. In asymptomatic patients indeterminate levels of antibody may be due to genuinely low levels of IgG antibody many years after the initial infection.

• #41 Genital Herpes: A Review | AAFP

  https://www.aafp.org/pubs/afp/issues/2016/0601/p928.html

  Serology confirms infection and the viral type. […] Because HSV-2 is almost always genitally acquired, the presence of HSV-2 antibody implies anogenital disease, even if there is no history of symptoms. […] However, the site of HSV-1 infection cannot be identified by positive HSV-1 serology results alone. […] Considering the increased incidence of new genital HSV-1 infections and changing sexual practices, clinicians should counsel patients who test positive for HSV-1 antibody that they may be able to transmit HSV to uninfected partners through oral or genital sex, and that they remain at risk of acquiring HSV-2 infection.

• #42 How to Test for Herpes: at Home, in the Lab, and More

  https://www.verywellhealth.com/herpes-diagnosis-3132769

  It is possible to screen for asymptomatic herpes infections using a blood test. […] The presence of antibodies is evidence that your body has confronted an infection, either recently or in the past. […] Most healthcare providers do not routinely test for herpes unless you specifically ask or have symptoms including genital pain, redness, swelling, sores, or blisters. […] If you have been exposed to genital herpes or would like to be tested, talk to your healthcare provider. […] Herpes infections are typically diagnosed based on test results, often but not always in the presence of skin lesions like cold sores or other symptoms.

• #43 Recognising genital herpes (HSV-2) and common symptoms

  https://www.herpes.org.nz/symptoms-and-diagnosis/recognising-herpes

  Genital herpes symptoms are often mild and infrequent, often going unnoticed. […] If you have concerns or think you may have genital herpes, talk to your healthcare provider. […] A diagnosis of genital herpes is made most easily and correctly at the time of the first herpes infection. […] Accurate diagnosis of genital herpes includes taking a history and doing a physical examination. […] To confirm the presence of the herpes simplex virus, the healthcare professional should perform a swab test, in which a sample of the fluid from a blister, or a swab from ulcers, is taken and sent away for analysis. […] Diagnosis is easier if early ulcers or blisters containing the fluid necessary for laboratory confirmation are present, but we would still encourage you to be seen by a clinician and get an HSV swab taken if you have a painful break in the genital or anal skin. […] Because it is possible for a person with genital herpes to have another sexually transmitted infection (STI) at the same time, a full check for STIs may be appropriate.

• #44 Herpes Simplex Workup: Approach Considerations, Laboratory Studies, Imaging Studies

  https://emedicine.medscape.com/article/218580-workup

  Definitive diagnosis can be established through viral culture, seroconversion for the appropriate serotype (in primary infections), PCR, and antigen detection. […] Samples for culture should be collected from the base of a vesicle or a freshly ulcerated lesion. […] In cases of suspected HSV encephalitis, PCR of CSF and MRI are utilized for diagnosis. […] Differentiation between HSV and herpes zoster is crucial, as herpes zoster rarely recurs and is characterized by more severe pain and larger vesicular lesions that follow a dermatomal distribution, typically not crossing the midline. […] The presence of clusters of vesicles or ulcers on an erythematous base is atypical for genital ulcers caused by pathogens other than HSV. […] In instances of recurrent herpes infections that do not resolve or respond to antiviral therapy as expected, there is a need to consider the possibility of immunocompromise, such as that associated with HIV infection.

• #45 Can Herpes Be Confused With Something Else? 3 Conditions Mistaken For Herpes

  https://www.letsgetchecked.com/articles/can-herpes-be-misdiagnosed-3-conditions-sometimes-mistaken-for-herpes/?srsltid=AfmBOopHX5A92NsIdP5mGx0YAE3K8wq2ay2-5IGcvJAscQ_yXOtZZIT2

  According to statistics from the Centers for Disease Control and Prevention (CDC), around 12% of people between the ages of 14-49 have genital herpes. […] If you think you may have contracted herpes, it’s important to get tested either with your doctor or with an at-home screening test kit. […] Although the signs and symptoms of herpes may sometimes seem indistinguishable, there are a number of other conditions that can potentially be mistaken for the virus which makes proper testing essential for identifying and diagnosing herpes. […] False-positive test results refer to a test result that says a person has a certain condition or disease when in actual fact, they don’t. This can happen with a number of different types of diagnostic tests and herpes testing and other sexual health tests are no exception. According to the Centers for Disease Control and Prevention, „False-positive HSV-2 results can happen, especially in people who are at low risk for a herpes infection.”

• #46

  https://www.who.int/news-room/fact-sheets/detail/herpes-simplex-virus

  People with symptoms suggestive of genital herpes should be offered HIV testing. […] Pregnant women with symptoms of genital herpes should inform their health care providers. Preventing acquisition of HSV-2 infection is particularly important for women in late pregnancy when the risk for neonatal herpes is greatest.

• #47 Genital Herpes: Causes, Symptoms, and Diagnosis

  https://www.healthline.com/health/sexually-transmitted-diseases/genital-herpes

  Genital herpes does not always require treatment. However, genital warts can be painful. Antiviral treatments can reduce the symptoms and severity of outbreaks. […] It’s important to tell your doctor that you have genital herpes as soon as you know you’re pregnant. […] Your doctor will discuss what to expect before, during, and after you deliver your baby. They can prescribe pregnancy-safe treatments to ensure a healthy delivery. They may also opt to deliver your baby via cesarean. […] A doctor can help create a treatment plan to manage outbreaks.

• #48 Herpes Simplex Virus (HSV): Types Symptoms, & Treatment

  https://my.clevelandclinic.org/health/diseases/22855-herpes-simplex

  Herpes simplex virus (HSV) can infect many different parts of your body, most commonly your mouth area (oral herpes) and genitals (genital herpes). […] A simple blood test can tell you if you have HSV in your body. […] Healthcare providers diagnose HSV infections by doing a physical exam and testing. During an exam, your provider will look for signs of infection (like sores). They may take a sample from the sores to send for lab testing. If your provider suspects encephalitis and/or meningitis, they may do a spinal tap. […] If you don’t have sores, your provider can use a blood test to check for antibodies against HSV-1 or HSV-2. Antibodies are a sign you’ve been infected with the virus in the past. Test results help your provider plan treatment.

• #49 Herpes Test | HSV 1 & 2 Test | Herpes Blood Test | Quest®

  https://www.questhealth.com/product/herpes-hsv-1-2-test-17169M.html?srsltid=AfmBOoqh1iOvjZjSv9XeFNthG6y5B5SsxaP65k8wuJQPtHXxAKFVNljK

  If your HSV-2 test result is positive, the lab will perform an additional confirmation test on the sample you have already provided at no extra cost to you. This helps to validate the positive result before it is reported, per standard recommended guidelines. […] Testing is the only way to know for sure if you have herpes or any other sexually transmitted infection. […] While there is no cure for herpes, it can be treated with prescription medication. […] After your results are ready, you’ll have the option to talk with a healthcare provider at no additional cost to you to discuss next steps. […] If you have herpes, your healthcare provider may put you on medication as you get closer to your delivery date in order to protect both you and your baby. […] If you do have symptoms, or if you had sex with someone who has genital herpes, you may consider getting tested or talking to your healthcare provider. […] This test cannot tell whether you are having a flare-up. Positive results can be seen in persons who have never had symptoms. In addition, a negative result does not rule out infection with HSV.

• #50 Genital Herpes Simplex: Causes, Symptoms, and Treatment

  https://patient.info/doctor/genital-herpes-simplex

  Antiviral therapy as required (episodic treatment). […] Suppressive therapy. […] The suppressive effect takes five days of therapy to establish. […] The presence of genital ulceration in a child may be alarming and has a broad differential diagnosis as listed above. […] The presence of genital ulceration in children should prompt a screen for other STIs. […] HSV vaccines have been developed, but none has so far been very successful. […] Transmission of HSV may be reduced by the following: Reduction in the number of sexual partners. […] Use of condoms, which reduces but does not completely prevent transmission. […] Antiviral drugs, which may reduce transmission to partners. They are thought to reduce symptomatic and asymptomatic viral shedding by 80-90%.

• #51 Diagnosis of Herpes Simplex Virus: Laboratory and Point-of-Care Techniques

  https://www.mdpi.com/2036-7449/13/2/49

  Molecular diagnosis of the virus can be achieved by nucleic acid amplification using polymerase chain reaction (PCR) and loop-mediated isothermal amplification (LAMP). […] Immunological assays include enzyme-linked immunosorbent assays (ELISA) and Western blot assays for effective detection of antigens (HSV glycoproteins) or antibodies specific to HSV glycoproteins, which have proven to be an excellent marker for HSV infection. […] We also focus on the different POC devices for herpes diagnosis that are portable, cost-effective, and can be easily operated without the need for expert handling. […] The POC tests are usually based on microfluidic platforms and employ tests based on ELISA, immunofluorescence, PCR, and LAMP. […] Traditional diagnosis of HSV from lesions involves the direct detection of tissues or cells infected by the virus, viral proteins, whole virus, or genetic materials.

• #52 Herpes Simplex Virus – HSV | Choose the Right Test

  https://arupconsult.com/content/herpes-simplex-virus

  Clinical suspicion for genital herpes should be confirmed by laboratory testing. […] Virologic testing of samples from active lesions is the best way to confirm HSV diagnosis. […] NAAT has been shown to be more sensitive than culture and is the preferred diagnostic testing method. […] If there are no active lesions but exposure to HSV is suspected, serologic testing may be used. […] If suspicion is high but results are negative, testing should be repeated 6-12 months later, given that false-negative results can occur, especially early in the disease. […] A positive IgG result cannot determine the exact time of exposure or the site of infection. […] Serologic testing in neonates is not helpful, given that detected HSV IgG antibodies are most likely transplacentally acquired maternal antibodies. […] The recommended test for HSV encephalitis is NAAT on a CSF sample obtained by lumbar puncture. […] If NAAT is negative and there is clinical suspicion for HSV, a second lumbar puncture should be performed within 3-7 days and the CSF should be tested.

• #53 Core Concepts – Genital Herpes – Self-Study Lessons – National STD Curriculum

  https://www.std.uw.edu/go/comprehensive-study/genital-herpes

  Two types of tests are recommended for the detection of HSV in clinical samples: nucleic acid amplification test (NAAT) methods or viral culture. Among these tests, the NAAT is the preferred test for detecting HSV in clinical samples. […] Type-specific serologic tests are based on antigens specific for HSV-1 (gG1) and HSV-2 (gG2), and these tests are preferred since they can distinguish antibodies to HSV-2 from antibodies to HSV-1. […] The sensitivities of these tests for the detection of HSV-2 antibodies have been reported in studies to vary from 80 to 98%. […] For clinical purposes, serologic testing for HSV-2 should use type-specific assays, with a two-step process that consists of performing an initial test followed by a second confirmatory test for all positive results on the initial test; the confirmatory test should utilize a technology distinct from that used for the initial test.

• #54

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5177552/

  Valacyclovir is also a standard treatment for herpes genitalis in immunocompetent patients and studies have shown its efficacy for viral suppression and prevention of recurrent herpes genitalis. […] In such cases the pyrophosphate analogue foscarnet is recommended as alternative treatment. […] The detection of virus-specific antibodies for confirming HSV infection is widely used in clinical practice. […] The importance of HSV type-specific IgG is mostly that it allows rapid, reliable and economical identification of HSV-2 carriers and potential virus shedders. […] The question of possible immunisation is often raised not only by doctors but also by many patients affected by herpes genitalis. […] To date, however, there is no licensed vaccine against herpes genitalis, though research has been ongoing for a number of decades. […] Sound, comprehensive partnership counselling is an essential component of the medical management of herpes genitalis patients. […] The medical management of patients with herpes genitalis is often unsatisfactory.

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