LabCorp and its Specialty Testing Group, a fully integrated portfolio of specialty and esoteric testing laboratories.
To screen for or diagnose infection with the herpes simplex virus (HSV)
If you have symptoms of an infection with HSV, such as blisters in the genital area, or symptoms of viral meningitis; if you have certain risk factors
A swab or scraping from a blister or sore in the infected area or a blood sample drawn from a vein in your arm; for meningitis or encephalitis, a sample of cerebrospinal fluid
Herpes is a common viral infection caused by the herpes simplex virus (HSV). The virus exists as two main types, HSV-1 and HSV-2. Herpes simplex virus testing identifies the presence of the virus in a sample from a blister, sore or fluid to diagnose an acute herpes infection or detects herpes antibodies in the blood to determine previous exposure to herpes.
Both HSV-1 and HSV-2 are contagious and periodically cause small fever blisters (vesicles) that break to form open lesions. HSV-1 primarily causes blisters or "cold sores" around the mouth, while HSV-2 usually causes lesions around the genital area; however, either one can affect the oral or genital areas.
The herpes simplex virus can be passed from person to person through skin contact while the sores are open and healing and sometimes when there are no visible sores. HSV-2 is frequently a sexually transmitted disease, but HSV-1 also may be acquired during oral sex and found in the genital area. According to the American Sexual Health Association, about 50% of adults in the U.S. have HSV-1 and about 17% have HSV-2. Because symptoms may be mild, however, 90% of those who have HSV-2 may be unaware that they have been infected.
When someone is first infected, the person may have obvious and painful blisters at the site of infection, which usually appear within two weeks after the virus is transmitted. The lesions generally heal within two to four weeks. The blisters can appear in the vaginal area, on the penis, around the anus, or on the buttocks or thighs. This primary episode can include a second outbreak of blisters and even flu-like symptoms such as fever and swollen glands. However, not everyone develops blisters, and sometimes symptoms are so mild that they are unnoticeable or mistaken for something else, such as insect bites or a rash.
Once someone is infected and the initial infection resolves, the person will harbor the HSV in a latent form. During periods of stress or illness, the virus may reactivate.
People with conditions that cause their immune system to be suppressed, such as those with HIV/AIDS or those who have had an organ transplant, may have more frequent and serious outbreaks of HSV. While there is no cure for herpes, antiviral medications can suppress outbreaks and shorten the duration of symptoms and active shedding of virus.
Rarely, the virus can cause neonatal herpes when a woman transmits the virus to her baby during a vaginal delivery. Neonatal herpes symptoms appear during the first month of life and, if left untreated, can cause long-term damage to a baby's health. A pregnant woman who has been diagnosed with herpes may be monitored regularly prior to delivery to identify a reactivation of her infection, which would indicate the necessity for a caesarean section to avoid infecting the baby.
The herpes simplex virus can be transmitted to the brain, causing encephalitis. This illness can be fatal or cause serious, permanent neurological problems in those who survive.
A healthcare practitioner will take a swab or scraping from a blister or sore in the genital area. A sample of cerebrospinal fluid (CSF) may be collected from the spinal column (spinal tap) when meningitis or encephalitis is suspected. For antibody testing, a blood sample is obtained by inserting a needle into a vein in the arm.
Herpes simplex virus (HSV) testing is used to diagnose an active herpes infection in those who have genital sores or encephalitis. It is also used for newborns suspected of having neonatal herpes, a rare but serious condition in which herpes is contracted during vaginal birth.
HSV testing may also be used to identify a previous infection. In people with symptoms, testing may be used to distinguish between a primary, active infection and a recurrent infection.
Direct detection of the virus
In people with active genital sores, the preferred methods of testing for the virus are the herpes culture and HSV DNA testing (PCR). PCR testing is preferred if encephalitis or neonatal herpes are suspected.
HSV antibody testing detects immune proteins that the body produces in response to a herpes infection. The body produces two classes of antibody. It begins to produce the IgM class antibody of several days after a primary (initial) HSV infection and these antibodies may be detectable in the blood for several weeks. It then begins to produce HSV IgG antibody after HSV IgM. IgG levels rise for several weeks, slowly decline, and then stabilize in the blood. Once someone has been infected with HSV, that person will continue to produce small quantities of HSV IgG.
HSV antibody testing can detect both viral types (HSV-1 and HSV-2) and tests are available that can detect the early IgM antibodies as well as the IgG antibodies that remain forever in those who have been exposed.
Although it is not as sensitive as PCR or culture, HSV antibody testing can be used to help diagnose an acute HSV infection if blood samples are collected several weeks apart (acute and convalescent samples). The HSV IgG antibody levels are compared to see if they have risen significantly, indicating a current infection.
Antibody testing may also be used to screen certain populations, such as sexually active people, potential organ transplant recipients, and those with HIV infection, for a previously contracted HSV infection.
The U.S. Centers for Disease Control and Prevention (CDC) does not recommend screening for herpes in the general population. However, it may be useful in testing those at increased risk, such as:
A herpes culture (or HSV DNA testing) may be ordered when someone has a blister (vesicle) on the genitals.
HSV DNA testing may be ordered when a person has signs and symptoms of encephalitis that a healthcare practitioner suspects may be caused by a virus. Examples of these signs and symptoms include:
HSV testing may be ordered on a regular basis when a pregnant woman has herpes. A mother and newborn may be tested for HSV when a baby shows signs of HSV infection, such as meningitis or skin lesions that could be caused by the herpes virus.
HSV antibody testing is ordered primarily when someone is being screened for a previous exposure to HSV. Occasionally, acute and convalescent HSV antibody testing may be ordered when a current infection is suspected.
A healthcare practitioner may also order an HSV antibody test when someone has another STD and is at risk for the infection. Risk factors include having multiple sex partners, having a sex partner with herpes, being infected with HIV, or being at risk for HIV because the person is a man who has sex with men.
Direct detection of the virus
Antibody blood tests
The most serious, or life-threatening, HSV infections can occur in newborns who are infected during birth and in individuals with weakened immune systems (immunocompromised). The lesions tend to be more extensive and persist longer than in individuals who have healthy immune systems.
Herpes can make people more susceptible to HIV infection. Likewise, it can make HIV-infected individuals more infectious. Infection with HSV can also increase HIV viral load. HSV-2 infection is a significant opportunistic infection in HIV-infected individuals; up to 90% of HIV-infected individuals are co-infected with HSV-2.
Oral herpes (mouth sores, skin lesions in non-genital sites) can't be prevented. Exposure occurs during everyday life.
The most reliable ways to avoid genital infection with herpes or any sexually transmitted disease (STD) are to abstain from oral, vaginal, and anal sex or to be in a long-term, mutually monogamous relationship with an uninfected partner. People who are sexually active should correctly and consistently use condoms to reduce the risk of infection with herpes and other STDs.
Yes. There are over 25 viruses in the herpes family and at least 8 types that infect humans. These include herpes simplex virus types 1 and 2 discussed in this article as well as varicella zoster virus (VZV, HHV-3), associated with chickenpox and shingles, Epstein Barr virus (EBV, HHV-4), which can cause infectious mononucleosis, cytomegalovirus (CMV, HHV-5), human herpes virus 6 (HHV-6) and human herpes virus 7 (HHV-7), both associated with roseola in young children, and human herpes virus 8 (HHV-8), which has been found in tumors in people with Kaposi's sarcoma (KS). KS primarily affects people with weakened immune systems, such as those with HIV/AIDS and organ transplant recipients.
This will depend on where the lab testing is done and the method used for testing. HSV DNA PCR tests and antibody blood tests may be reported in one day but can sometimes take longer. Cultures usually take longer and may be reported in two or more days.
To find out where you can get tested for sexually transmitted diseases, visit the U.S. Centers for Disease Control and Prevention (CDC) site Get Tested. You can input your zip code and find a local testing site.
Herpes cannot be cured, but it can be managed. Medications are available that can prevent or shorten the duration of herpes outbreaks. There is a medicine that you can take on a daily basis that can help prevent outbreaks and also lower your risk of spreading the virus to others. Talk to your healthcare provider about your options.
Yes, you should tell your sexual partner(s) that you have herpes so that you can follow preventive measures during sex. They may also wish to get tested.
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