Info on hsv

Testing with symptomsHow does herpes testing work? Check out the infographic to learn more.

If symptoms of herpes appear, they can vary widely from person to person. If a person does experience signs of infection, we recommend obtaining a culture test (a swab from the symptom) within the first 48 hours after a lesion appears. Results are usually available in about a week’s time.

The major advantage of the culture is its accuracy in giving a positive result—generally, if you test positive by viral culture, you can be sure you have the virus. A culture can also be “typed” to determine whether the infection is caused by HSV-1 or HSV-2.

The major disadvantage of the culture is its high rate of false negatives. Because a culture works by requiring virus that is active, if a lesion is very small, or is already beginning to heal, there may not be enough virus present for an accurate culture. Beyond 48 hours of the symptoms appearing, there is a risk of receiving a false negative test result. Viral culture is even less accurate during recurrences (positive in only about 30% of recurrent outbreaks).

Healthcare providers can also take a swab of an area that has symptoms and run DNA tests—known as Nucleic Acid Amplification Testing (NAAT). These newer tests are fast, accurate, and can tell if a person has HSV-1 or HSV-2. There is less chance of a false negative result with NAATs. NAAT methods are the preferred method, with PCR as the most-widely used NAAT method.

Testing with no symptoms

Blood tests can be used when a person has no visible symptoms but has concerns about having herpes. Blood tests do not actually detect the virus; instead, they look for antibodies (the body’s immune response) in the blood.

IgM vs. IgG

When an individual contracts herpes, the immune system responds by developing antibodies to fight the virus: IgG and IgM. Blood tests can look for and detect these antibodies, as the virus itself is not in blood. IgG appears soon after infection and stays in the blood for life. IgM is actually the first antibody that appears after infection, but it may disappear thereafter.

IgM tests are not recommended because of three serious problems:

Many assume that if a test discovers IgM, they have recently acquired herpes. However, research shows that IgM can reappear in blood tests in up to a third of people during recurrences, while it will be negative in up to half of persons who recently acquired herpes but have culture-document first episodes. Therefore, IgM tests can lead to deceptive test results, as well as false assumptions about how and when a person actually acquired HSV. For this reason, we do not recommend using blood tests as a way to determine how long a person has had herpes. Unfortunately, most people who are diagnosed will not be able to determine how long they have had the infection.In addition, IgM tests cannot accurately distinguish between HSV-1 and HSV-2 antibodies, and thus very easily provide a false positive result for HSV-2. This is important in that most of the adult population in the U.S. already has antibodies to HSV-1, the primary cause of oral herpes. A person who only has HSV-1 may receive a false positive for HSV-2.IgM tests sometimes cross-react with other viruses in the same family, such as varicella zoster virus (VZV) which causes chickenpox or cytomegalovirus (CMV) which causes mono, meaning that positive results may be misleading.

Hope this helps

the first study, the volunteers were randomly given a standard 400 mg, twice-daily dose of acyclovir or an inactive placebo pill for four weeks. After a one-week washout period, they switched to the active or placebo treatment for another four weeks.

The result: Swabs were 95% less likely to test positive for HSV-2 when a person was taking acyclovir. But even during treatment, people tested positive 3% of the time.

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In the second and third studies, the researchers selected volunteers who suffered frequent genital herpes outbreaks. In study two, they took either 800 mg three-a-day, high-dose acyclovir or standard 500 mg daily doses of valacyclovir. Study three compared standard-dose valacyclovir against high-dose valacyclovir (1,000 mg three times daily). As in the first study, volunteers switched treatments after a one-week washout period.

The result: None of these very high doses of active anti-herpes drugs completely prevented genital shedding of infectious herpes virus. Even with high-dose valacyclovir, 3% of swabs carried herpes virus -- and patients tested positive 7% of the time.

The findings show that herpes hiding in nerve roots doesn't sleep between outbreaks. Instead, it's frequently seeping out.

"The finding that treatment cannot fully prevent transmission should encourage patients to use condoms and adopt safe-sex practices," Philippe Van de Perre and Nicolas Nagot of the University Hospital of Montpellier, France, suggest in an editorial accompanying the Johnston report in the Jan. 5 online issue of The Lancet.

WebMD Health NewsReviewed by Laura J. Martin, MD on January 04, 2012

Neither meds nor condom can give 100% protection even when combined 😞