Genital And Oral Herpes Testing

About Our Genital Herpes & Oral Herpes Test

Purpose of the test

The purpose of testing for genital and oral herpes is to identify evidence of an HSV infection. Testing for genital and oral herpes may be ordered for several reasons, including:

• Confirming a diagnosis of HSV infection in symptomatic patients
• Diagnosing patients with a history of genital sores who don’t have symptoms
• Identifying a potential HSV infection in pregnant women without symptoms
• Understanding if a sexual partner of a person with HSV is susceptible to infection
• Estimating the frequency of future symptom outbreaks

Testing can also determine the type of HSV causing an infection. There are two main types of HSV:

• Herpes simplex virus type 1 (HSV-1): HSV-1 is the cause of most cases of oral herpes and is often contracted during childhood. HSV-1 can also be spread to the genitals during oral sex.
• Herpes simplex virus type 2 (HSV-2): HSV-2 is the most common cause of genital herpes. HSV-2 can also be spread to the mouth during oral sex, causing infections of the mouth or lips. HSV-2 is typically spread through sexual contact, including vaginal, oral, or anal sex.

What does our genital herpes & oral herpes test measure?

Testing for genital and oral herpes detects evidence of an HSV infection. Several laboratory tests can be used to detect herpes simplex virus (HSV). The most appropriate test depends on whether symptoms are present.

Polymerase chain reaction (PCR) testing: PCR testing, also called nucleic acid amplification testing (NAAT), detects HSV genetic material from a sample taken from a sore. PCR is the most sensitive and accurate test for diagnosing herpes when active lesions are present and is now the preferred diagnostic method. PCR is also used to test cerebrospinal fluid when HSV infection of the brain or spinal cord is suspected.

Viral culture: Viral culture involves collecting fluid from a sore and attempting to grow the virus in a laboratory. While viral culture can identify HSV and determine the virus type, it is less sensitive than PCR, especially once sores begin to heal.

Antibody (serologic) testing: Blood tests can detect antibodies your immune system produces in response to HSV-1 or HSV-2. These tests can identify prior exposure to HSV, even without symptoms. However, antibody tests cannot determine when the infection occurred or where it is located, and false-positive results are possible, particularly in people without symptoms.

Tzanck smear: The Tzanck smear is an older test that examines cells scraped from a sore under a microscope. Because it cannot reliably distinguish between HSV types and has low accuracy, it is rarely used in modern clinical practice.

The accuracy of herpes testing depends on the type of test used and when it is performed:

• PCR testing from an active sore is the most accurate method and works best when sores are new.
• Viral culture is less sensitive and may miss infections once sores begin healing.
• Antibody testing is most reliable when performed at least 12 weeks after potential exposure, allowing time for antibodies to develop.

A healthcare provider can help determine which test is most appropriate based on your symptoms and timing of exposure.

When should I get a genital or oral herpes test?

Testing for the viruses that cause genital and oral herpes may be ordered if you have signs and symptoms of a herpes infection. Many people who contract HSV never develop noticeable symptoms. When symptoms do occur, they may appear within days or weeks after exposure, but in some cases, symptoms may not appear for months or may never occur at all.

When signs and symptoms of an initial infection occur, they may include:

• Small sores on the skin
• Blisters on the lips, penis, vagina, buttocks, anus, or around the mouth.
• Tingling, itching, or burning on the skin
• Fever, headache, or body aches
• Swollen lymph nodes

After the initial infection, HSV remains dormant inside the body. HSV can reactivate throughout your life, causing symptoms of genital or oral herpes to reappear. While the trigger for an HSV outbreak is often unknown, potential triggers include fever, stress, physical trauma, and a suppressed immune system.

Routine herpes testing is not recommended for people without symptoms.

According to public health guidelines, routine blood testing for herpes simplex virus (HSV) is not recommended for people who do not have symptoms, even if they are sexually active. This is because blood tests can produce false-positive results and cannot determine when or where the infection occurred.

Testing may still be appropriate in certain situations, including:

• People with symptoms suggestive of herpes, such as blisters or sores
• People with a sexual partner who has a confirmed HSV diagnosis
• People with weakened immune systems
• Newborns exposed to HSV during childbirth

If you are unsure whether testing is appropriate for you, a healthcare provider can help determine the most useful testing approach based on your symptoms and risk factors.