Herpes Tests: How to Choose?

Penelope James Health Guide
  • Maybe your partner (or ex) has just told you he/she has herpes.  Or maybe you’ve recently noticed sores on your mouth or genitals.  In any case, now might be a good time to get tested for herpes.  Many people don’t realize that when they ask to be tested for all STDs, typically the doctor will test you for everything BUT herpes.  Why is that?  It seems pretty silly to me, especially given the large number of people who apparently carry the disease but do not know it, and the fact that those are the people who are probably most often spreading the disease.  My guess is that the test is expensive, and when it comes to health care in the US, the bottom line of a corporation is almost always more important than the well-being of a citizen.  Or maybe it’s because for a long time there was no test that determined which type of herpes one had. 

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    Because the majority of people in the US have at least been exposed to herpes type-1, the results of non type-specific tests would be overwhelmingly positive, and therefore not so valuable.  Whatever the reason, if you suspect you have, or have been exposed to, the herpes virus you should ask your doctor specifically to test you for it.  What kind of test should you get?  There are many types of ways to test for herpes, so let’s break them down into two categories: when sores are not present and when sores are present. 

     

    If you are not experiencing any sores, the only real way to be tested is by having a blood test.  This approach looks for herpes antibodies in the bloodstream, NOT herpes itself.  (Herpes does not live in the blood, which is why herpes carriers can still donate blood.)  The drawbacks about blood tests are that they may not be able to reliably detect antibodies for up to 4 months of infection.  So if you are tested too soon after a possible infection, you could get a false negative result.  Also, they do not tell you the location of the herpes infection, and some of the older blood tests cannot distinguish between HSV-1 and HSV-2.  So if you ask for a blood test, be sure to get one that can tell you specifically which type of herpes you have, like the Immunoblot, the POCkit, or the more reputable Western Blot.

     

    If you are experiencing sores, you have more options available.  One method is to have a viral culture, which takes a sample of cells from an active sore and determines if the virus is present there.  Currently this is known to be the most valid test available when the results come back positive.  However, the downside of this test is that it can often show a false negative result if the cells are taken from a sore that has already started to heal.  Another method is a viral antigen detection test, which is similar to the viral test in that it also requires taking a cell sample from an active sore and has a high false negative rate.  The differences between these two are that the latter method tests for antigens versus actual viral cells, and it is quicker to show results.  Neither test requires a waiting period, like blood tests, and both are excellent tests to determine which type of herpes you have.  Just remember to ask your doctor for a type-specific test.  Finally, there is a PCR (Polymerase Chain Reaction) test, which takes any sample of bodily fluid or active lesion and looks for the DNA of the herpes virus.  This method can also determine the type of herpes you have, but it is used less often.  It is most effective at testing spinal fluid for rare cases of herpes near the brain.  Of course, if you are experiencing symptoms, you can still have a blood test in addition to the other tests.  If you suspect you have herpes, and tested negative with the above methods, it is recommended you get tested again to be sure.  It is somewhat common to have false negative results, but not as common to have false positives.

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    Pap smears, simple clinical examinations, and the Tzanck test are not recommended methods of testing for herpes.  These are not herpes-specific tests, and because herpes symptoms are so similar to symptoms of other ailments, there is a much higher risk of misdiagnosis by using these approaches. 

     

    So if you think you may have herpes but aren’t sure, do yourself (and the world around you) a favor by getting tested soon.  It is a good idea to be tested for herpes regularly if you have an active sex life, or each time you change partners or have put yourself at risk.  Don’t be afraid, (as the old adage goes…) knowledge is power!

     

     

     

Published On: December 11, 2008