How Do You Know If You Have Herpes?

 

Common Reasons To Get Tested

 

Trying To Visually Diagnose Genital Herpes Is Not Effective

Many people try to diagnose themselves visually. In fact, "herpes photos" is the third most popular phrase typed into search engines. "herpes" and "genital herpes" are the only phrases searched for more often.

Unfortunately, it is difficult to correctly diagnose genital herpes by visual inspection alone. This is difficult because the symptoms can be very mild and because many other conditions look like genital herpes. Other conditions which can look like genital herpes include:

Just how difficult is it to visually diagnose genital herpes? There was a study in the New England Journal Of Medicine where doctors were asked to diagnose genital herpes by visual inspection alone. A laboratory test was then performed to check the doctor's visual diagnosis. One out of five doctors was wrong. If a highly trained medical professional only gets it right 80% of the time then the chances that you can diagnose yourself by looking at some online photos are not very good at all.

 

How Accurate Is The Herpes Test?

It makes a huge difference which laboratory test you choose. Some tests are nearly 100% accurate. Some tests are strongly not recommended because they can confuse genital herpes with the common cold sore. That's right. Some of the tests out there can't even tell the difference between genital herpes and a cold sore. Imagine how you would feel if you were told you had genital herpes when what you really had was the very common cold sore. It is important to know how to choose the right test.

The most common way to test for herpes directly is through a viral culture. If you get a positive result from a viral culture then you can be very confident (>95%) that you have genital herpes. Unfortunately a negative result from a viral culture is not as reliable. If you are able to sample the sores when they are active then the viral culture is very accurate but this is not always possible. Sometimes the sores have started to heal and sometimes the viruses die on the way to the lab. It is a good idea to confirm a direct test with a blood antibody test.

All of the blood antibody tests listed below are very accurate (above 90%). One key factor which can influence your results is the amount of time you have been infected. Blood antibodies are produced by your body after weeks or months so if you have recently been infected then the blood antibody test may not detect anything.

 

Cost Of Herpes Test In Doctors Office

These tests are covered under most insurance plans. The only cost would be the co-pay charge. For those with no health insurance the cost will range from $150.00 to $300.00 depending on the type of test you choose.

 

Tests To Determine How Long One Has Had Herpes

You can use a combination of direct and indirect tests to learn if your infection was recently acquired. If you are suffering from your first outbreak you can request both a direct test (viral culture or PCR) and an indirect test (blood antibody test).

It will take your body anywhere from a couple of weeks to several months to begin producing antibodies against the herpes virus. If your viral culture comes back positive but your blood antibody test comes back negative this means that the virus was found but antibodies were not found. Your infection was most likely acquired very recently.

This is only possible if this is your first outbreak. If you have had more than one outbreak then it is no longer possible to determine when you acquired the virus.

 

What Is The Least Embarrassing Way To Call A Clinic And Request A Herpes Test?

Every part of dealing with genital herpes is uncomfortable and potentially humiliating or embarrassing. Even calling a local clinic to make an appointment can be intimidating. A good way to do this is to avoid using the words "genital herpes". Instead you could ask the following: "Hi. I need to schedule an appointment for an HSV blood test. Also, I would prefer an IgG type specific test." Just using different words makes a huge difference. The important thing is to get tested.

 

Direct Tests For Herpes

There are really only two choices when it comes to direct testing. Remember that direct testing means testing for the presence of the herpes virus whereas indirect testing checks for the presence of blood antibodies. Direct tests either detect the presence of the herpes virus or they don't.

 

  Viral Culture Or Cell Culture Viral DNA Testing (PCR*)
How They Work These tests work by growing more copies of the virus in a cell culture and then looking for changes under a microscope These tests work by making lots of copies of the herpes virus DNA so that even very small numbers of the virus can be detected
Tissue Sampled
  • Ulcers, sores, lesions, or scabs
  • Ulcers, sores, lesions, or scabs
Accuracy
  • Positive results are very accurate
  • Negative results should be confirmed with an antibody test
  • Positive results are very accurate
  • Negative results should be confirmed with an antibody test
Advantages
  • Simplicity of sampling
  • Can tell difference between HSV-1 and HSV-2
  • Inexpensive ~ $50.00
  • Most sensitive method
  • Fast results
  • Can tell difference between HSV-1 and HSV-2
Disadvantages
  • Results take 2 to 7 days
  • More expensive ~ $100.00 - $200.00

 

*PCR stands for Polymerase Chain Reaction which is a scientific technique in molecular biology used to amplify a single or a few copies of a piece of DNA across several orders of magnitude, generating thousands to millions of copies of a particular DNA sequence.

Pap smears and Tsank tests are not recommended for direct testing due to a lack of accuracy. And don't even think about letting a doctor visually diagnose you with genital herpes.

 

What Is The Difference Between IgG and IgM Antibody Tests

IgM and IgG refer to different kinds of blood antibodies which your body produces to fight the herpes virus. IgM antibodies start to appear within a few days from exposure to the virus, reach a peak level within two to four weeks and slowly disappear within two to three months. IgM antibodies are not type specific meaning there is no way to know whether the antibodies come from HSV-1 or HSV-2. This is why an IgM test alone is not a good idea since by itself it will not tell you if you have HSV-1 or HSV-2. IgG antibodies on the other hand are type specific. They can be used to determine which type of herpes virus you have. They may appear within three to four weeks and are definitely present four to six months after exposure.

 

How To Choose A Herpes Blood Test

The table lists many IgG specific blood antibody tests. All of these tests are accurate, FDA approved, and relatively inexpensive. There have been many new tests introduced recently - you can see that four of the tests listed below were FDA approved within the last few years.

 

  Antibodies
Detected
Result
Time
FDA
Approved
More Information Comments
Captia ELISA HSV-1 & HSV-2 1 week 2004

trinity-biotech.com

888-291-0415

They offer both IgM and IgG tests - be sure to specify the IgG test

Biokit HSV-2 Rapid Test

Only HSV-2 10 minutes 1999

biokitusa.com

800-926-3353

This is the same test as the Fisher Sure-Vue HSV-2 Rapid Test
BioPlex HSV HSV-1 & HSV-2 1 week 2009

bio-rad.com

800-224-6723

 
Euroimmun
Anti HSV-1 &
Anti HSV-2 ELISA
HSV-1 & HSV-2 1 week 2007

euroimmunus.com

800-913-2022

They offer both IgM and IgG tests - be sure to specify the IgG test
HerpeSelect HSV-1
& HSV-2 ELISA
HSV-1 & HSV-2 1 week 2002

herpeselect.com

800-838-4548

 
HerpeSelect 1 & 2 Differentiation Immunoblot HSV-1 & HSV-2 1 week 2000

herpeselect.com

800-838-4548

 
Liaison HSV-2 HSV-1 & HSV-2 1 week 2008

diasorin.com

800-328-1482

 
Western Blot HSV-1 & HSV-2 2 - 3 weeks N/A

Western Blot

206-598-6066

This is the most accurate test currently available and is the test which all other tests are compared to
AtheNA MultiLyte HSV-1 & HSV-2 1 week 2008

invernessmedicalpd.com

800-257-9525

They offer both IgM and IgG tests - be sure to specify the IgG test

 

Anonymous Herpes Testing - Choosing An Online Herpes Test

Many people avoid getting tested because they feel embarrassed going to their private doctor or local clinic. For these individuals anonymous herpes testing is a great option.

These online testing services use the exact same blood tests administered by your local clinic. They use FDA-approved IgG tests which can distinguish between HSV-1 and HSV-2.

These testing services all work in pretty much the same way. You go to a local testing center to provide a blood sample. Your blood sample is then mailed to a testing laboratory. After a couple of days, you call the testing service for your results. Nobody at the local testing center will ever know why you gave a blood sample. For all they know you were just having some routine blood work done.

There is one group of people for whom online testing is not appropriate. If you are experiencing your first outbreak and still have active sores then a direct test like cell culture is a better option. There are a couple of reasons for this. First, a positive cell culture test is very reliable and will let you know which type of virus you have and the site of infection. Remember that this is only possible if you still have active sores from which to sample. Second, if you have recently been infected then your body has not had sufficient time to develop antibodies and the blood test will not be able to determine your status. But if you no longer have active sores and if you have been infected for more than a couple of months then online herpes testing is a great option.

Below you will find a list of companies which provide anonymous herpes testing. Compared to your local clinic, it is actually cheaper to get tested through one of these services and you will get your results back sooner as well. Another nice thing about using these services is that your test results will never become part of your permanent medical record. Not even your insurance company will know.

 

Herpes Testing Services Cost Comments
StdTestExpress.com $149.00
  • 1800 testing centers nationwide
  • 200,000 tests administered & 55,000 satisfied customers
  • FDA-approved Type-specific IgG test (Captia ELISA Test)
  • Test distinguishes between HSV-1 & HSV-2
  • Get results in 3 days or less
GetStdTested.com $150.00
  • FDA-approved Type-specific IgG blood test
  • Test distinguishes between HSV-1 & HSV-2
  • Results in 3 days
StdWeb.com $129.00
  • FDA-approved Type-specific IgG blood test
  • Test distinguishes between HSV-1 & HSV-2
  • Results in 3 days
RequestaTest.com $129.00
  • FDA-approved Type-specific IgG blood test
  • Test distinguishes between HSV-1 & HSV-2
  • Founded in 2002

 

Interpreting Herpes Test Results

So now that you have your test results back what do they mean? Your blood antibody test can return three results: negative, positive, or equivocal. You may also be given a number called the index, cut-off index, or antibody index. A negative result is an index significantly less than 1. A positive result is an index significantly greater than 1. An equivocal result is an index value between 0.9 and 1.1.

 

Test Result Interpretation
< 0.9 Negative: No significant level of detectable IgG antibody to HSV.
0.9 - 1.1 Equivocal: Questionable presence of IgG antibody to HSV. Repeat testing or alternative testing may be helpful.
> 1.1 Positive: IgG antibody to HSV detected. This may indicate a current or recent HSV infection.

 

If you receive an equivocal result you will probably be encouraged to repeat the test after a few weeks. You will also be encouraged to retest if viral culture and antibody tests give conflicting results.

 

Herpes Dating Guide

Feel free to look around the other sections of this website for information on topics such as preventing the Transmission Of Herpes, finding Herpes Support Groups, and How To Tell Someone You Have Herpes. Also, be sure and check out the Herpes Dating eBook. It is the best available resource on the subject. You will find lots of great information inside including the following:

  • Have you ever wondered why a routine STD exam doesn't check for genital herpes? And did you know that although other std's are tested for during pregnancy that genital herpes is not? You might think that with so many millions of American adults not knowing they are carrying the virus it would be a good idea to test everybody. The answer actually makes a lot of sense once you learn something very surprising about the accuracy of laboratory tests.
  • Learn the advantages and disadvantages of anonymous testing. The fact that these tests are discreet is a definite plus but you should also be aware of the disadvantages.
  • IgM antibody tests have received a lot of negative press recently because of their inability to tell the difference between HSV-1 and HSV-2. But very few people know that they can actually be used as a tool in determining how recently you acquired the herpes virus. Learn about the IgM test and how it can be of use to you.
  • How to reduce the chances of infecting your partner down to as low as 1% to 2% per year.
  • How to tell someone you have herpes.
  • Which precautions to take during pregnancy which can reduce the chances of infection down to as low as 1 in 6000.