Most women are familiar with the Pap smear, which is used to detect cervical cancer. There is a new test, dubbed the "silver pap" that includes a herpes PCR swab test in addition to the GC (gonorrhea and Chlamydia) tests that are performed at this time. However, the test is done at the time of a Pap, and not necessarily at the time of an outbreak. Therefore, a negative test doesn't mean that you don't have herpes. You just didn't have active infection at the time of the Pap.
Blood Tests
Blood tests look for antibodies to the herpes virus. Therefore, a positive antibody test means that a person definitely has herpes. However, it can take 3-4 months after a possible exposure to produce enough antibodies, therefore if you can identify the exposure, you should wait that long to have the test.
Some older herpes blood tests (called crude antigen tests) can detect the herpes virus, but can't differentiate between types 1 and 2. It's still done, but it's pretty worthless.
Newer tests are called type-specific serologic tests. They can distinguish between HSV 1 and 2. The best tests measure a type of antibody called IgG, which is present a few months after infection.
You can also test for IgM antibodies, but they can erroneously pick up other herpes viruses like chicken pox or mono. These tests should be avoided.
At last count, there were five of IgM antibody blood tests available:
HerpeSelect tests currently are the most accurate tests available for most physicians. They test for IgG, and are very sensitive and specific for herpes. When your physician has your blood drawn for herpes testing and sent off to a lab, chances are, this is usually what they are ordering. The two largest laboratories, Quest and LabCorp use this test, as well as most smaller community labs.
The Biokit HSV-2 (SureVue HSV-2) test is an in-office blood test. The blood is collected via finger prick - like a blood sugar test. It takes five- ten minutes to run. It's highly sensitive for diagnosing HSV2, but it can only be performed in a nationally certified lab - and most physician's offices are not. It used to be called POCkit HSV-2.
The Captia test is a newer FDA approved test, but it's not widely available.
The best test, the Western Blot, is only available at the University of Washington where it was developed. It's expensive and takes awhile to perform. It is not FDA approved. However, if your HerpeSelect test is indeterminate (not definitely positive or negative) or weakly positive, it may be worth it to you to send a blood sample to the University. They accept samples from anyplace in the U.S.
Interpreting the results of your IgG test.
HSV-2 Antibodies present - this means that you have HSV-2 infection.
HSV-2 Antibodies NOT present: With 95-98% accuracy, you do NOT have genital herpes, unless you acquired it very recently.
HSV-1 Antibodies present: this means you have HSV-1 infection. Usually the virus is normant in the nerves of the mouth and eye, though some people do have genital HSV-1 infection
Neither HSV-1 or HSV-2 Antibodies present: you are not infected with either HSV-1 or HSV-2. Note that there is a small chance that have been recently infected and have not made antibodies yet.
CONCLUSION
Timing is EVERYTHING
If you are going to go to the trouble of having herpes testing, be sure that you time the testing right. Know that it can take 3 months (or up to 6 months!) for the IgG antibody to be detected, therefore a test drawn to soon after an exposure may be falsely negative. Have it redrawn after 3-4 months to be safe.
ASK Questions and be prepared! Some people feel weird questioning their doctor about which test is being ordered. DON'T. It's your health. NEVER settle for ambiguous results and misinformation. Perservere in getting the best answers.
