How Do I Get Tested For Herpes?

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Question: How Do I Get Tested For Herpes?

Considering how common the virus is, relatively few people know how to test for herpes. Oddly enough, that includes doctors. I've talked to more than a few people whose doctors did not know herpes blood tests existed. They do. Herpes blood tests may not be perfect, but they're very useful in certain situations. For example, they're the only way of getting a herpes test if someone wants to be screened after their partner becomes infected.

Herpes blood can't detect a very new infection. However, they can show if the person has been harboring an unrecognized infection for some time. Other testing could require waiting for an outbreak that might never appear. 

Answer: How To Test for Herpes Depends on Whether You Have Symptoms

Although a lot of doctors don't realize it, it is possible to get tested for herpes. However, the techniques for getting tested for herpes depend on whether or not someone is currently are having symptoms.

  • If you go to see your doctor during an outbreak:

    Your healthcare provider will look at the sores and see if they seem typical of a herpes outbreak. If they are, your provider may swab the sores to see if they contain virus. However, this swab test is not always accurate. It has a high risk of false negatives. An outbreak that looks like herpes, but that comes back with a negative test for virus, may still be a herpes infection. Testing a swab for virus is most useful in the first 48 hours of a first outbreak. After that, and during recurrent outbreaks, it becomes much less accurate. Visual inspection can actually give better results than a viral culture in such circumstances. Therefore, some doctors will diagnose herpes on appearance alone. 

    Herpes outbreaks usually appear as one or more blisters that then break open to become sores. If your doctor thinks you have herpes, but the test comes back negative, believe your doctor. The visual signs of infection are more accurate as a diagnosis. However, you can also get further testing. It just may take time for additional tests to be accurate. Most herpes blood tests can take up to several months to become reliable. 

  • If you go to see your doctor when you have no symptoms:

    There are commercial blood tests for herpes that looks for antibodies against both HSV1 and HSV2. However, they do not always give conclusive results. There are also type-specific blood tests that are more accurate. Unfortunately, these may be more difficult to find. Furthermore, even they're not perfect. That's one reason some doctors won't test for herpes when people don't have symptoms. They worry that the possibility of a false positive could be worse for that person than not knowing they're infected. 

    It is also important to know it can take a while before you test positive after you've been infected with herpes. The exact amount of time depends both on your immune system and the specific test you are given.

    How To Find Herpes Testing

    If your doctor doesn't know how to test you for herpes, or is reluctant to test you, you might try visiting an STD clinic. Practitioners there are usually better informed about the latest developments in STD testing and treatment. If that is not an option, online testing may be. You just want to look for several things. First, the online test should be sending you to a reliable, national lab chain like Quest or Lab Corps. Second, they should be selling you a type specific test for both HSV-1 and HSV-2. Third, they should ideally be offering to connect you to counseling or care when you receive your results. The last is the hardest to find. It's not absolutely necessary, but it can be helpful. That's particularly true when dealing with diseases like herpes and HIV, where there is a lot of stigma. 

    Next: Five reasons why everyone should get tested for STDs...

    Sources:

    Feltner C, Grodensky C, Ebel C, Middleton JC, Harris RP, Ashok M, Jonas DE. Serological Screening for Genital Herpes: An Evidence Review for the U.S. Preventive Services Task Force [Internet]. Rockville (MD): Agency for Healthcare  Research and Quality (US); 2016 Dec. Available from  http://www.ncbi.nlm.nih.gov/books/NBK409117/

    LeGoff J, Péré H, Bélec L. Diagnosis of genital herpes simplex virus infection in the clinical laboratory. Virol J. 2014 May 12;11:83. doi: 10.1186/1743-422X-11-83. 

    Van Der Pol B, Warren T, Taylor SN, Martens M, Jerome KR, Mena L, Lebed J, Ginde S, Fine P, Hook EW 3rd. Type-specific identification of anogenital herpes simplex virus infections by use of a commercially available nucleic acid amplification test. J Clin Microbiol. 2012 Nov;50(11):3466-71. doi: 10.1128/JCM.01685-12.

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