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Sensitivity/Specificity
Other Testing Options
Limitations of Testing
Herpesblood tests are highly accurate. They have a sensitivity level of 96% to 100% in detecting whether you’ve been infected with the herpes simplex virus (HSV).
While herpes blood tests offer a high level of accuracy, they are not infallible. Moreover, if you havesymptoms, they may not be as useful or informative as an HSV viral culture orPCR test(both of which can detect HSV in a swab of fluid from a herpes sore).
This article explores the accuracy of herpes blood tests and outlines the current recommendations for herpes testing in the United States.
How Test Accuracy Is Measured
The accuracy of all medical tests, including herpes tests, is measured based on two values: sensitivity and specificity.
Sensitivityis how often a test correctly identifies someone with a disease. A test that is 90% sensitive will correctly identify 90 people out of 100 who have the disease. Ten people will have afalse-negativeresult.
Specificity, on the other hand, refers to a test’s ability to correctly identify someone who doesn’t have the disease. If a test is 90% specific, that means that 90 people out of 100 will be correctly diagnosed asnothaving a disease and that 10 people will have a false-positive result.
The higher the sensitivity and specificity, the lower the chances of a false (incorrect) result.
Sensitivity and Specificity in Medical Testing
Two blood tests are used to screen for herpes:
To ensure that an initial positive result is correct, a second test using a different method of detection is used to confirm the results.
If the ELISA result is positive, your healthcare provider may administer a Western blot assay. This second test looks for proteins on the surface of the virus, calledantigens, which serve as the viruses' “ID tag.” HSV antibodies produced in response to these antigens help the immune system target its attack.
According to the U.S. Preventive Services Task Force, the accuracy of the two blood tests used to diagnose herpes breaks down as follows:
The Western blot is considered the most accurate way to test for herpes.
Can You Still Have Herpes if the Result is Normal (Negative)?
Testing too early during the so-calledwindow periodcan end up causing a false-negative result (in which the test says you don’t have HSV even if you do).
Window Period for Genital Herpes
When an ELISA is confirmed with a Western blot, it is unlikely for a herpes diagnosis to be wrong. But, other tests may be more useful and/or reliable in certain situations. These tests rely on the direct detection of HSV using fluids obtained from a swab of a herpes sore.
Polymerase Chain Reaction (PCR)
PCR is considered the gold standard of testing in cases where herpes has invaded the brain or spinal cord (typically in people with advanced HIV infection).
Viral Culture
An HSV viral culture is a process in which the virus is “grown” in the lab using a swab of fluid. Compared to all other methods of HSV detection, viral culture is considered the gold standard of testing.
Even so, an HSV viral culture is more time-consuming, taking between three to eight days to return results.Moreover, user error can affect the results. For instance, the test is likely to be less accurate if the healthcare provider swabs the scab rather than the sore itself. Delays in transport or improper refrigeration can also weaken the accuracy of the test.
Can a regular blood test detect herpes?Routine blood tests do not look for herpes. Herpes is also not typically part of a regular screening test that looks for other types of sexually transmitted infections.
Can a regular blood test detect herpes?
Routine blood tests do not look for herpes. Herpes is also not typically part of a regular screening test that looks for other types of sexually transmitted infections.
As accurate as herpes tests are, they are not used for routine screening. This is because, in the absence of symptoms, a positive result doesn’t mean you will ever have symptoms or require treatment.On the other hand, knowing your HSV status may reinforce safer sex practices if you are in a relationship.
Herpes Screening RecommendationsCurrently, the U.S. Preventive Service Task Force advises against herpes screening in people without herpes symptoms, including those who are pregnant.
Herpes Screening Recommendations
Currently, the U.S. Preventive Service Task Force advises against herpes screening in people without herpes symptoms, including those who are pregnant.
This doesn’t mean that you shouldn’t get tested under certain circumstances. According to the Centers for Disease Control and Prevention, HSV testing can be used in asymptomatic (symptom-free) people who:
Can a herpes test return a false-positive result?Yes, a herpes test result can be false-positive, especially if you are not showing any symptoms.For this reason and others, the CDC does not recommend routine testing of herpes for people who do not have symptoms.
Can a herpes test return a false-positive result?
Yes, a herpes test result can be false-positive, especially if you are not showing any symptoms.For this reason and others, the CDC does not recommend routine testing of herpes for people who do not have symptoms.
Summary
Herpes can be diagnosed with blood tests. This includes the ELISA test that detects herpes antibodies and a Western blot test used to confirm the results. Herpes testing is generally recommended for people with herpes symptoms only.
Although the ELISA and Western blot tests are highly accurate when used together, other direct testing methods may be used, particularly if you have symptoms. This includes a PCR test that can detect the genetic material of the virus and a viral culture that can “grow” the virus in the lab. Both rely on a swab of fluid from a herpes sore.
7 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.US Preventive Services Task Force.Serologic screening for genital herpes infection: US Preventive Services Task Force recommendation statement.JAMA. 2016;316(23):2525-2530. doi:10.1001/jama.2016.16776Maxim LD, Niebo R, Utell MJ.Screening tests: a review with examples.Inhal Toxicol. 2014;26(13):811–28. doi:10.3109/08958378.2014.955932Arshad Z, Alturkistani A, Brindley D, Lam C, Foley K, Meinert E.Tools for the diagnosis of herpes simplex virus 1/2: systematic review of studies published between 2012 and 2018.JMIR Public Health Surveill. 2019;5(2):e14216 doi:10.2196/14216University of California, San Francisco.Serum herpes simplex antibodies.Centers for Disease Control and Prevention.Genital herpes – CDC fact sheet (detailed).Connolly KL, Bachmann L, Hiltke T, et al.Summary of the Centers for Disease Control and Prevention/National Institute of Allergy and Infectious Diseases Joint Workshop on Genital Herpes: 3-4 November 2022.Open Forum Infect Dis. 2024;11(5):ofae230. doi:10.1093/ofid/ofae230Centers for Disease Control and Prevention.Screening for genital herpes.
7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.US Preventive Services Task Force.Serologic screening for genital herpes infection: US Preventive Services Task Force recommendation statement.JAMA. 2016;316(23):2525-2530. doi:10.1001/jama.2016.16776Maxim LD, Niebo R, Utell MJ.Screening tests: a review with examples.Inhal Toxicol. 2014;26(13):811–28. doi:10.3109/08958378.2014.955932Arshad Z, Alturkistani A, Brindley D, Lam C, Foley K, Meinert E.Tools for the diagnosis of herpes simplex virus 1/2: systematic review of studies published between 2012 and 2018.JMIR Public Health Surveill. 2019;5(2):e14216 doi:10.2196/14216University of California, San Francisco.Serum herpes simplex antibodies.Centers for Disease Control and Prevention.Genital herpes – CDC fact sheet (detailed).Connolly KL, Bachmann L, Hiltke T, et al.Summary of the Centers for Disease Control and Prevention/National Institute of Allergy and Infectious Diseases Joint Workshop on Genital Herpes: 3-4 November 2022.Open Forum Infect Dis. 2024;11(5):ofae230. doi:10.1093/ofid/ofae230Centers for Disease Control and Prevention.Screening for genital herpes.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
US Preventive Services Task Force.Serologic screening for genital herpes infection: US Preventive Services Task Force recommendation statement.JAMA. 2016;316(23):2525-2530. doi:10.1001/jama.2016.16776Maxim LD, Niebo R, Utell MJ.Screening tests: a review with examples.Inhal Toxicol. 2014;26(13):811–28. doi:10.3109/08958378.2014.955932Arshad Z, Alturkistani A, Brindley D, Lam C, Foley K, Meinert E.Tools for the diagnosis of herpes simplex virus 1/2: systematic review of studies published between 2012 and 2018.JMIR Public Health Surveill. 2019;5(2):e14216 doi:10.2196/14216University of California, San Francisco.Serum herpes simplex antibodies.Centers for Disease Control and Prevention.Genital herpes – CDC fact sheet (detailed).Connolly KL, Bachmann L, Hiltke T, et al.Summary of the Centers for Disease Control and Prevention/National Institute of Allergy and Infectious Diseases Joint Workshop on Genital Herpes: 3-4 November 2022.Open Forum Infect Dis. 2024;11(5):ofae230. doi:10.1093/ofid/ofae230Centers for Disease Control and Prevention.Screening for genital herpes.
US Preventive Services Task Force.Serologic screening for genital herpes infection: US Preventive Services Task Force recommendation statement.JAMA. 2016;316(23):2525-2530. doi:10.1001/jama.2016.16776
Maxim LD, Niebo R, Utell MJ.Screening tests: a review with examples.Inhal Toxicol. 2014;26(13):811–28. doi:10.3109/08958378.2014.955932
Arshad Z, Alturkistani A, Brindley D, Lam C, Foley K, Meinert E.Tools for the diagnosis of herpes simplex virus 1/2: systematic review of studies published between 2012 and 2018.JMIR Public Health Surveill. 2019;5(2):e14216 doi:10.2196/14216
University of California, San Francisco.Serum herpes simplex antibodies.
Centers for Disease Control and Prevention.Genital herpes – CDC fact sheet (detailed).
Connolly KL, Bachmann L, Hiltke T, et al.Summary of the Centers for Disease Control and Prevention/National Institute of Allergy and Infectious Diseases Joint Workshop on Genital Herpes: 3-4 November 2022.Open Forum Infect Dis. 2024;11(5):ofae230. doi:10.1093/ofid/ofae230
Centers for Disease Control and Prevention.Screening for genital herpes.
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