• Diagnosis of Genital Herpes

    Your doctor will ask about your symptoms and medical history. A physical exam will be done.
    It is important for you to be open and honest with your doctor about your symptoms and your sexual history. Your doctor needs this information so that he can properly diagnose you and provide you with the proper treatment. Your doctor will not judge you or your behavior.
    Sometimes genital herpes is easy to diagnose because the blisters or open sores are easily visible. However, just examining the sores or the rash is not enough. Also, you can have genital herpes even if the sores are not visible.
    There are a number of lab tests available to diagnose genital herpes.

    Viral Culture

    If your infection is visible, your doctor will rub a swab over an open sore or blister to collect some cells. The cells are then tested to see if the virus is present in those cells. It is recommended that this culture test be taken soon after symptoms appear.
    This type of test is not always reliable, though. If the sore is healing or if you have recurrent outbreaks, the test may give a false-negative. This means that the test reports that you do not have herpes, when you really do have the virus.

    Polymerase Chain Reaction (PCR)

    PCR is a molecular diagnostic test. It can identify the virus if it has been damaged by the body’s immune system and may not grow in a standard culture. Like the viral culture, you could get a false-negative with this test, as well. But, the PCR test is much more accurate.

    Blood Tests

    Your doctor may choose to do a blood test. These blood tests are also called antibody tests because they measure herpes simplex virus (HSV) antibodies—the disease-fighting substances in the blood. If the blood tests show HSV antibodies, you are most likely infected with the virus.
    Tests can distinguish between HSV-1 and HSV-2. This is done by assessing glycoproteins that are specific to the two kinds of viruses. It is important that your doctor finds out if you have HSV-1 or HSV-2 because your treatment and counseling may be different depending on which virus you have.

    References

    Ashley RL, Wald A. Genital Herpes: Review of the epidemic and potential use of type-specific serology. Clinical Microbiology Reviews. 1999;12(1):1-8.

    Gardella C, Huang ML, Wald A, et al. Rapid polymerase chain reaction assay to detect herpes simplex virus in the genital tract of women in labor. Obstet Gynecol. 2010;115(6):1209-1216.

    Genital herpes diagnosis. National Institute of Allergy and Infectious Diseases website. Available at: http://www.niaid.nih.gov/topics/genitalHerpes/understanding/Pages/diagnosis.aspx. Update January 26, 2011. Accessed February 25, 2013.

    Genital herpes—CDC fact sheet. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/std/herpes/STDFact-herpes.htm. Updated February 11, 2013. Accessed February 25, 2013.

    Herpes genitalis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what. Updated September 4, 2012. Accessed February 25, 2013.

    Strick LB, Wald A. Diagnostics for herpes simplex virus: is PCR the new gold standard? Mol Diagn Ther. 2006;10(1):17-28.

    Workowski KA, Berman S, Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines, 2010. MMWR. 2010;59(No. RR-12):1-110.

    Revision Information

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