Viral culture is the gold standard test for detecting herpes simplex virus in new lesions3. A positive culture result is generally reliable; however, culture testing alone is often unreliable in patients with recurrent infection or healing lesions. In some cases, patients have only a history of herpes lesions; a serology test would be useful in these cases.
A Herpes Infection is Lifelong and Commonly Misdiagnosed
A visual examination of herpes simplex virus is insensitive, nonspecific, and can yield inaccurate results. Culture tests are the gold standard method of testing for HSV-1 and HSV-2. Although positive culture results are generally reliable, 50 to 70 percent of non-positive results are falsely negative with healing lesions. Type-common (crude antigen) serology tests measure HSV antibodies in the blood but are unable to distinguish between HSV-1 and HSV-2 infection. Most adults have HSV-1 antibodies, so crude antigen tests ability to detect HSV-2 infections is unreliable.
When diagnosing a patient with a lifelong infection, result accuracy is of the upmost importance.
Sometimes, symptoms of genital herpes are mistaken for:
HerpeSelect has been a trusted type specific serology for the last decade. CDC guidelines state that serologic type-specific glycoprotein G (gG)-based assays should be specifically requested when serology is performed.*
Who Should Be Tested?
The ASHA Herpes Testing Toolkit7 suggests that any person who has been sexually active may have been exposed to genital herpes and testing should be strongly considered for those individuals with:
HerpeSelect assays are designed to aid in the diagnosis of:
HerpeSelect is not indicated for testing the general population.
How Often Should Someone Be Tested?
Testing for HSV-1 and HSV-2 should be considered for expectant mothers and sexually active adults. The patient's risk of acquiring or transmitting the viruses should be factors when considering the frequency of testing. CDC and ACOG recommend discussing sexual history with expectant mothers to decrease the risk of transmission to infants.*
The HerpeSelect products from Focus Diagnostics are offered by many commercial laboratories in the United States. If you are a Quest Diagnostics client, you have HerpeSelect available on the OB/GYN requisition form and on Cre360.
* This does not imply an endorsement of the HerpeSelect assays by CDC