Diagnosis Guidelines

Any person who has been sexually active may have contracted genital herpes. Diagnosis should be strongly considered in those with:

• More than five lifetime sexual partners
• A partner with known genital herpes
• Any recurrent lesions or symptoms in the area of the sacral dermatomes
• A history of STD or HIV infection.

2006 CDC STD Treatment Guidelines excerpt:

"Both virologic and type-specific serologic tests for HSV should be available in clinical settings that provide patient care for patients with STDs or those at risk for STDs."

> Click here to print the Diagnostic Algorithm chart below.

CDC Sexually Transmitted Diseases Treatment Guidelines
(as printed in the Morbidity and Mortality Weekly Report)

CDC Guidelines excerpts*:

"... the clinical diagnosis of genital herpes should be confirmed by laboratory testing. Both virologic tests and type-specific serologic tests for HSV should be available in clinical settings ..."

"Because false-negative HSV cultures are common, especially in patients with recurrent infection or with healing lesions, type-specific serologic tests are useful ..."

"... older assays that do not accurately distinguish HSV-1 from HSV-2 antibody, despite claims to the contrary remain on the market."

"... serologic type-specific gG-based assays should be specifically requested when serology is performed."

The MMWR series of publications is published by the Epidemiology Program Office, Centers for Disease Control and Prevention (CDC), US Department of Health and Human Services, Atlanta GA 3033.

*Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines 2006. MMWR 2006;55(No. RR-11):[page 16].

To view the complete report, please go to:
> http://www.cdc.gov/STD/treatment/2006/rr5511.pdf

Summary Guidelines for the Use of Herpes Simplex Virus (HSV) type-2 Serologies
(published by the California STD Controllers Association and California Department of Health Services, 2004)

California Guidelines Summary:

Recommended Use of HSV-2 Serologies For Diagnosis and Screening

• Diagnosis of genital lesions/symptoms: type-specific serology tests should be available for diagnostic purposes in conjunction with virologic tests at any setting where patients are evaluated for STDs.
• Screening in patients at-risk for STD/HIV (Current STD, recent STD, high-risk behaviors): shoud be offered to select patients. 
• Screening in HIV-positive patients: should be generally offered.
• Universal screeing in pregnancy: should generally not be offered.
• Screening in general population: should generally not be offered.
• Herpes education and prevention/transmission counseling is necessary for all people being tested or screened for HSV-2.