Primary Care Physician
Dr. Orrange received her BA in Biology at the University of California, San Diego, and a Masters Degree in Health Sciences at the Johns Hopkins University School of Public Health. She received her MD from the USC Keck School of…
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Is There a Blood Test That Will Detect Genital Herpes?
Posted in Sexually Transm... by Dr. Sharon Orrange on Jul 26, 2011
"Is there a blood test that can tell whether I have genital herpes?"

The answer is no and I’ll explain why. Yes, there are blood tests for Herpes Simplex Virus 1 and 2 (HSV1 and HSV2) but they are not recommended in adolescents or adults who are asymptomatic. In other words, if you don’t have a sore that you are worried may be herpes you don’t need a blood test.

Here is why all medical organizations recommend against routine blood tests for HSV1 and HSV2 in people not having symptoms, and why a culture of a sore is the only reliable way to see if you have genital herpes.
• First, the gold standard for diagnosing herpes is a test done on a sore (either a viral culture or PCR testing), not a blood test.

• The most sensitive test for genital herpes is a PCR test done from a lesion or sore and this is readily available now.

• If a PCR test from a swab of a sore is positive, you can be pretty sure herpes is the cause.
What’s the deal in a person who has no sore, but wants a blood test for herpes?

• Blood tests are tests for HSV 1 or HSV 2 antibody

• Both HSV 1 and 2 can cause genital lesions and in fact the incidence of HSV 1 genital infections has surpassed that of HSV 2.

• Antibodies to HSV 1 are very common and many people will test positive for HSV 1 antibodies who will never develop lesions. For HSV 2, twenty- two percent of adults who have never had genital lesions will have a positive blood test for HSV2

• What this means is that HSV 1 and HSV2 antibodies in the blood are frequently seen in people who have been exposed but will never develop either oral or genital lesions and may remain asymptomatic.

It is for this reason that we don’t recommend blood tests for herpes in asymptomatic (no evidence of lesions or sores) adolescents and adults.

Hope that helps.

Dr O.


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Hi doctor Orrange:

But what about all the findings saying that herpes can be spread via asymptomatic shedding for people who have or not have symptoms? So the studies found that herpes sheds in genital tract even without symptoms. Thanks

Neda
By neda333  Aug 12, 2012
4
Thanks for discussion about genital herpes.
By johnlasseter  Mar 14, 2012
3
Luckman Hep B/C and HSV have very different transmission. If one tests (+) on a blood test for HSV 1 or 2 but has never had a genital lesion they are not going to transmit HSV through sexual contact. While it is true there are "asymptomatic shedders" of HSV infection it is extremely rare, and those are people who have had sores and just dont have active ones at the time they transmit the virus. Dont confuse transmissiona and the issue of screening for Hep C with Herpes...two very very different things.
By DrOrrange  Jul 27, 2011
2
But that doesn't mean they don't have it. This is ridiculous advice. Most people with Hepatitis B or C don't show any symptoms either but can readily spread the disease.
By LuckMan  Jul 27, 2011
1
But that doesn't mean they don't have it. This is ridiculous advice. Most people with Hepatitis B or C don't show any symptoms either but can readily spread the disease.
By LuckMan  Jul 27, 2011
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