Table of ContentsView AllTable of ContentsSelf-ChecksLabs and TestsIn NewbornsDifferential DiagnosesTreatmentNext in Herpes GuideTreatments That Heal Herpes Sores Faster
Table of ContentsView All
View All
Table of Contents
Self-Checks
Labs and Tests
In Newborns
Differential Diagnoses
Treatment
Next in Herpes Guide
Herpes simplex virus (HSV)types 1 and 2 can be diagnosed based on the appearance of lesions (if present), as well as with laboratory tests.
In general, if you do not have symptoms, there is no need for you to have any diagnostic testing for HSV type 1—the type that causes cold sores. However, if you may have been exposed to HSV type 2, a sexually transmitted infection (STI) that causes genital sores, you may need to be tested even if you do not have lesions.
This article explains the tests used to diagnose herpes, including why a urine test is not typically used to detect herpes. It also discusses how you can monitor for signs of herpes at home.
Both HSV-1 and HSV-2 can causevisible skin lesions.It is important that you see a healthcare provider, especially if you’ve never had an outbreak before. Most healthcare providers do not routinely test for herpes unless you specifically ask.
Cold sores in and around the mouth usually are due to HSV-1. If you are concerned about HSV-2 symptoms due to an STI, or think you may have been exposed, watch for:
Additional symptoms typically linked to a first episode of HSV-2 infection can include:
Once you’ve had herpes, you can learn to recognize recurrences of the lesions. But if your recurrences are more severe or if the lesions look different than usual, then you should seek an evaluation.
If you or your child experience pain or tingling around or inside the mouth or on the tongue, you can feel and look for bumps and blisters around the painful area, which may indicate HSV-1.
If you have pain in or around the genital area, or if you havepain with urinationor sexual activity, it may indicate HSV-2. Check for lesions if you think you could have been exposed to the infection. Know, though, that genital herpes infections are oftenasymptomatic.
If you do not have obvious symptoms, a blood test can help determine whether you have an infection.
Urine tests are typically not used to diagnose HSV-1 or HSV-2 infections. Lab tests rely on swabs of cells found in vaginal tissue or sores, or vesicular fluid. Some labs reject urine specimens for herpes tests.Urine tests are not considered accurate enough for herpes, though many urine STI screenings test for chlamydia and gonorrhea.
Can a Urine Test Detect STIs?
Swab Testing
The gold standard for herpes diagnosis is a viral culture test ornucleic acid amplification test(NAT) of a sample of skin, crust, or fluid from a lesion. This is usually obtained with a gentle swab of the area.
A viral culture is a test that allows the virus to grow in a laboratory setting. The NAT tests for the genetic material of the virus in the sample.
These tests should only come back positive if you have the virus present in the lesion. In general, the results of the test are reliable if you have active lesions.
Herpes Blood Tests
It is possible to screen forasymptomaticherpes infections using a blood test. Herpes blood tests can detectantibodiesto the herpes virus.
You form these proteins when you need to fight an infection. Generally, it takes about two weeks for your body to produce enough antibodies against herpes to be detectable.
The presence of antibodies is evidence that your body has confronted an infection, either recently or in the past. There are two kinds ofblood testsfor herpes:
Several different brands of blood tests are used to detect viral proteins, and there are pros and cons for each.Sensitivity and specificityof tests refer to the accuracy with which a condition is detected when present (sensitivity) and reliability of a negative test result (specificity).
The accuracy of various HSV-2 tests includes:
It is difficult to know how long it takes for blood tests to become positive after infection with HSV-1, and the tests are associated with a high false positive rate. However, testing before antibodies develop can lead to false negative results.
In general, it usually takes around two weeks for symptoms to appear after you have been infected with HSV type 1 or 2.If you do not have lesions that can be swab tested, it is a good idea to wait at least a month or two after your exposure before getting an HSV-2 antibody test. This is because it takes time for your body to make antibodies that can be detected in the blood.
There is some possibility that herpes blood tests may detect antibodies to similar viruses. This result would lead to a false-positive result, suggesting you have the infection when you don’t.
If you have a strong reason to believe that you have been infected, consider getting retested after six months because some of the tests take longer to yield a positive result.
The diagnosis of neonatal herpes—an infection passed to a child during or after childbirth—is challenging.
Generally, babies are not screened for herpes infection. Symptoms such as lesions around the mouth or eye may alert caregivers that there is a problem.This should prompt diagnostic testing, which can be done using a swab sample.
However, more complicated neonatal herpes infections, such asencephalitis(infection of the brain), require specific tests such as aspinal tap.
There are a few other conditions that can be confused with cold sores or genital herpes. Some of these are quite serious, and it is not safe for you to self-diagnose.
Typically, these conditions can be distinguished from herpes with a medical examination or with laboratory tests.
Most healthcare providers do not routinely test for herpes unless you specifically ask or have symptoms including genital pain, redness, swelling, sores, or blisters. If you have been exposed to genital herpes or would like to be tested, talk to your healthcare provider.
How Is Herpes Treated?
Herpes is a viral infection that affects your body for a lifetime, and it can be managed but not cured.Options include over-the-counter treatment for oral cold sores, like Abreva (docosanol) cream.Pain relief medications like Advil (ibuprofen) can help. Antiviral medications like acyclovir can be used to treat genital herpes.
Keep in mind that treatment drugs and doses can change depending on whether it’s your first herpes outbreak, or whether it’s a recurrence of HSV-1 rather than HSV-2. For example, 400 milligrams (mg) of acyclovir given three times per day, for seven to 10 days, is recommended for a first HSV-2 outbreak; treatment for a recurring HSV-2 episode can be doubled to 800 mg, twice a day for five days instead.
Your healthcare provider will choose a treatment plan based on your specific infection and medical history.
Treatments That Heal Herpes Sores Faster
Summary
Herpes infections are typically diagnosed based on test results, often but not always in the presence of skin lesions like cold sores or other symptoms. HSV-1 and HSV-2 infections can have different causes and presentations, so it’s important to see a healthcare provider if you suspect infection or exposure.
16 Sources
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