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Genital herpes – NHS

Genital herpes is a sexually transmitted infection (STI) passed on through vaginal, anal and oral sex. Treatment from a sexual health clinic can help. Symptoms clear up on their own but can come back.

Important:
Using sexual health clinics during coronavirus (COVID-19)

Call a sexual health clinic if you need help or advice. Only go to a clinic if you’ve been told to.

Find sexual health clinic contact details

Non-urgent advice: Go to a sexual health clinic as soon as possible if you have:

  • small blisters that burst to leave red, open sores around your genitals, anus, thighs or bottom
  • tingling, burning or itching around your genitals
  • pain when you pee
  • in women, vaginal discharge that’s not usual for you

These can be symptoms of genital herpes.

Go even if you have not had sex for a long time, as blisters can take months or years to appear.

See pictures of genital herpes on a vagina, penis and buttocks

Herpes blister on the vagina

Credit:

Herpes blisters on the penis

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Herpes blisters and sores on the buttocks

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Information:

Why you should go to a sexual health clinic

You can see a GP, but they’ll probably refer you to a sexual health clinic if they think you might have genital herpes.

Sexual health clinics treat problems with the genitals and urine system.

Many sexual health clinics offer a walk-in service, where you do not need an appointment.

They’ll often get test results quicker than GP practices and you do not have to pay a prescription fee for treatment.

Find a sexual health clinic

What happens at a sexual health clinic

The doctor or nurse at the sexual health clinic will:

  • ask about your symptoms and your sexual partners
  • use a small cotton bud (swab) to take some fluid from 1 of your blisters or sores for testing

The test cannot:

  • be done if you do not have visible blisters or sores
  • tell you how long you have had herpes or who you got it from

Symptoms might not appear for weeks or even years after you’re infected with the herpes virus.

If you have genital herpes, your previous sexual partners should get tested.

The doctor or nurse at the clinic can discuss this with you and help you tell your partners without letting them know it’s you who has the virus.

Treatment for genital herpes

There’s no cure. Symptoms clear up by themselves, but the blisters can come back (an outbreak or recurrence).

Treatment from a sexual health clinic can help.

Treatment the first time you have genital herpes

You may be prescribed:

  • antiviral medicine to stop the symptoms getting worse – you need to start taking this within 5 days of the symptoms appearing
  • cream for the pain

If you have had symptoms for more than 5 days before you go to a sexual health clinic, you can still get tested to find out the cause.

Treatment if the blisters come back

Go to a GP or sexual health clinic if you have been diagnosed with genital herpes and need treatment for an outbreak.

Antiviral medicine may help shorten an outbreak by 1 or 2 days if you start taking it as soon as symptoms appear.

But outbreaks usually settle by themselves, so you may not need treatment.

Recurrent outbreaks are usually milder than the first episode of genital herpes.

Over time, outbreaks tend to happen less often and be less severe. Some people never have outbreaks.

Some people who have more than 6 outbreaks in a year may benefit from taking antiviral medicine for 6 to 12 months.

If you still have outbreaks of genital herpes during this time, you may be referred to a specialist.

How to deal with outbreaks yourself

If you have been diagnosed with genital herpes and you’re having an outbreak:

Do

  • keep the area clean using plain or salt water to prevent blisters becoming infected

  • apply an ice pack wrapped in a flannel to soothe pain

  • apply petroleum jelly (such as Vaseline) or painkilling cream (such as 5% lidocaine) to reduce pain when you pee

  • wash your hands before and after applying cream or jelly

  • pee while pouring water over your genitals to ease the pain

Don’t

  • do not wear tight clothing that may irritate blisters or sores

  • do not put ice directly on the skin

  • do not touch your blisters or sores unless you’re applying cream

  • do not have vaginal, anal or oral sex until the sores have gone away

How genital herpes is passed on

Genital herpes is very easy to pass on (contagious) from the first tingling or itching of a new outbreak (before any blisters appear) to when sores have fully healed. You may also be able to pass on the virus even if you do not have any symptoms.

You can get genital herpes:

  • from skin-to-skin contact with the infected area (including vaginal, anal and oral sex)
  • when there are no visible sores or blisters
  • if a cold sore touches your genitals
  • by transferring the infection on fingers from someone else to your genitals
  • by sharing sex toys with someone who has herpes

You cannot get genital herpes:

  • from objects such as cutlery or cups – the virus dies very quickly when away from your skin

Protecting against genital herpes

You can reduce the chances of passing herpes on by:

  • using a condom every time you have vaginal, anal or oral sex – but herpes can still be passed on if the condom does not cover the infected area
  • avoiding vaginal, anal or oral sex if you or your partner has blisters or sores, or a tingle or itch that means an outbreak is coming
  • not sharing sex toys – if you do, wash them and put a condom on them

Why genital herpes comes back

Genital herpes is caused by a virus called herpes simplex. Once you have the virus, it stays in your body.

It will not spread in your body to cause blisters elsewhere. It stays in a nearby nerve and causes blisters in the same area.

If you can, avoid things that trigger your symptoms.

Triggers can include:

  • ultraviolet light – for example, from sunbathing or sunbeds
  • friction in your genital area – for example, from sex (lubricant may help) or tight clothing
  • smoking
  • drinking alcohol

Some triggers are unavoidable, including:

  • being unwell
  • stress
  • during the menstrual cycle
  • surgery on your genital area
  • a weakened immune system – for example, from having chemotherapy for cancer

Genital herpes and HIV

Genital herpes can be a more serious condition for people with HIV.

If you have HIV and herpes, you’ll be referred to a genitourinary medicine (GUM) specialist.

Genital herpes and pregnancy

Women with herpes before pregnancy can usually expect to have a healthy baby and a vaginal delivery.

If you have genital herpes during pregnancy, there’s a risk your baby could develop a serious illness called neonatal herpes.

This can be fatal, but most babies recover with antiviral treatment.

The risk of your baby getting neonatal herpes is low if you have had genital herpes before.

It’s higher if you get genital herpes for the first time in pregnancy.

Important

See your midwife or a GP if you think you have genital herpes in pregnancy.

Genital herpes treatment in pregnancy

You may be offered antiviral treatment:

  • to treat outbreaks in pregnancy
  • from 36 weeks to reduce the chance of an outbreak during birth
  • from diagnosis until the birth if you first get herpes after 28 weeks of pregnancy

Many women with genital herpes have a vaginal delivery. You may be offered a caesarean, depending on your circumstances.

Video: genital herpes – Marian’s story

In this video, Marian talks about the symptoms, treatment and issues surrounding herpes.

Media last reviewed: 13 January 2021
Media review due: 13 January 2024

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Page last reviewed: 16 September 2020
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What Should I Know About Genital Herpes?

Please note: This information was current at the time of publication. But medical information is always changing, and some information given here may be out of date. For regularly updated information on a variety of health topics, please visit familydoctor. org, the AAFP patient education website.

Information from Your Family Doctor

 

What is genital herpes?

Genital herpes is a viral infection. It is caused by the herpes simplex virus, which is called HSV for short. One form of the herpes virus causes “cold sores” around the mouth or lips. This kind can be passed around if someone touches the cold sore and then touches another person.

Genital herpes is caused by another form of the virus. It causes sores in the genital area and can be spread from person to person by direct skin contact (often during sex) with a person who has the infection.

What do genital herpes sores look like?

Herpes sores usually look like blisters or cold sores. In women, the sores can be inside the vagina and on the cervix, or on the skin outside the vagina. In men, the sores are on the penis and scrotum, and the skin around the genital area. The sores start off as itchy places and then change to blisters or ulcers. Ulcers are red sores that are filled with pus. Sometimes, blisters pop up and change to ulcers before you even notice you have them. Over a period of days, the sores change to crusted spots before they finally heal.

How common is genital herpes?

Genital herpes is very common. One of every five people in this country has genital herpes. People who have sex with many partners are most likely to get it. When women with genital herpes get pregnant, they can pass the infection to their baby during delivery. New babies can get really sick from herpes. If the infection is bad, the infant may even die.

What are genital herpes infections like?

The first herpes infection is usually the worst one. Genital herpes infections come back over and over again. The first time, you may have one sore or many sores. The sores are painful. Some may be hidden inside the urethra. The urethra is the tube that carries urine from your bladder. The sores make urination painful. Some people also have a fever, a sore throat, deep tiredness and body aches. These problems might last three weeks.

After the first infection, HSV sores can come back any time. They often come back when you are sick with something else and when your immune system isn’t strong enough. Genital herpes might come back 4 to 6 times a year at first. After a few years, the herpes sores hurt less. They come back less often.

Is genital herpes contagious?

Yes. When blisters or crusts are present, the virus can be passed by direct contact to others. But the virus can be just as contagious even when you cannot see any sores. Using condoms helps to prevent the spread of infection—but condoms cannot protect you completely. Because HSV also causes cold sores on the mouth, a person with cold sores can spread HSV through mouth contact with the genital area of another person. The virus can also be carried on hands from the mouth to another area. You can even spread the virus to yourself by touching cold sores on your mouth and then touching other areas of your body.

Will it ever go away?

No, genital herpes can’t be “cured.” You will have genital herpes for the rest of your life. As time goes by, many people have fewer and milder herpes sores.

Is there a treatment?

Yes, several medicines are used to treat HSV infection. Acyclovir (brand name: Zovirax), famciclovir (brand name: Famvir) and valacyclovir (brand name: Valtrex) are all used for genital herpes. Your doctor can prescribe one of these medicines for you. They don’t have many side effects, but they can be a little expensive.

How can I avoid getting genital herpes?

No vaccine can protect you from HSV infection, but you can do some things to prevent getting infected:

  • Limit the number of sexual partners you have in your lifetime.

  • Make sure that you and your sexual partner use condoms every time you have sex.

  • Consider sexual abstinence (not having sex until you’re in a deeply committed relationship).

  • Don’t have any kind of sex with someone who has herpes sores, itching or scabs, and remember that genital herpes can be spread even when there is no sign of a sore.

  • Always wash your hands after touching a cold sore.

Can you identify this condition?

Can Fam Physician. 2010 Dec; 56(12): 1304–1306.

Drs Arias-Santiago and Husein-El-Ahmed are dermatology residents at the San Cecilio University Hospital in Granada, Spain

Dr Girón-Prieto is a general medicine resident at the Virgen de las Nieves Hospital in Granada

Dr Fernández-Pugnaire is a dermatologist at the San Cecilio Clinical Hospital

Dr Naranjo-Sintes is chief of Dermatology at the San Cecilio Clinical Hospital.

Copyright © the College of Family Physicians of Canada

Answer to Dermacase continued from page
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4. Genital herpes

Genital herpes is a common, highly infectious disease caused by the herpes simplex virus (HSV). It is transmitted from one person to another by close personal contact, such as during sexual activity. There are 2 types of herpes: HSV-1 and HSV-2. The genital sores caused by either virus look the same. Most genital herpes infections are caused by HSV-2, and risk of infection is correlated with the number of lifetime sexual partners. Less often, HSV-1 can cause genital herpes infections through oral sexual contact. Up to 80% of HSV infections are asymptomatic. Symptomatic infections can be characterized by increased rates of morbidity and recurrence; in immunocompromised patients, infections can cause life-threatening complications.1

Description

The average incubation period after genital acquisition of HSV-1 or HSV-2 is approximately 4 days. Primary infection of genital herpes in men is characterized by a pattern of erosive balanitis, producing substantial pain; vesicles appear in the prepuce, the shaft of the penis, and sometimes on the scrotum. The perianal area and rectum might also be involved. Herpetic urethritis occurs in 35% to 45% of affected men and is characterized by severe dysuria and mucoid discharge. In women, herpetic vesicles can appear on the external genitalia (ie, labia majora, labia minora, or vaginal vestibule), and the cervix is involved in a high percentage of cases characterized by ulcerative or necrotic cervical mucosa. The ulcerative lesions persist for 4 to 15 days until crusting and re-epithelialization occur. Fever and locoregional lymphadenopathy distinguish greater local involvement from successive relapses. Most morbidity associated with genital herpes is due to its frequent reactivation rate, which is more common in HSV-2 and in patients who have had severe primary genital herpes. Recurrent genital herpes presents as 1 or more patches of grouped vesicles on the genitals and fever; constitutional symptoms are uncommon, pain is mild, and lesions heal in 7 to 10 days. The frequency and severity of recurrences decrease with time.2

Central nervous system complications of genital herpes include aseptic meningitis, sacral radiculopathy, transverse myelitis, and benign recurrent lymphocytic meningitis.

Diagnosis

When the medical history is incomplete, the lesions are atypical, or a quick diagnosis is needed because the patient is immunocompromised, has severe or disseminate disease, or has incurred serious repercussions from a previous incorrect diagnosis or treatment, additional tests should be ordered to confirm the diagnosis of herpesvirus ().

Table 1.

Laboratory tests available for the diagnosis of herpesvirus infections

TEST EFFICACY
Histology or Tzanck test Screens for herpesvirus in general, but is not useful in differentiating among different types of the virus
Antibody testing Useful in the diagnosis of primary, but not recurrent, herpes infections
Tissue culture The most specific test for diagnosis; however, it is not the most sensitive and often takes too long
Immunofluorescence Quick, sensitive, and economical; it can distinguish between HSV types 1 and 2
PCR Quick, sensitive, and expensive; it can distinguish between HSV types 1 and 2, but is rarely necessary in routine practice

In patients with HSV, histology will reveal intraepidermal blistering caused by keratinocyte necrosis and grayish nuclear inclusions with a ground-glass appearance, together with chromatin margination. Multinucleated giant cells and epithelial cells containing eosinophilic intranuclear inclusion bodies can be identified with the Tzanck test. Neither test is useful in differentiating between lesions caused by HSV-1 and those caused by HSV-2. Blood tests (ie, antibody tests) are only useful in the diagnosis of primary, but not recurrent, herpes infections. In the present case, the patient was positive for HSV-2 immunoglobulin M, confirming the diagnosis of primary infection.

The criterion standard for diagnosis of an HSV infection is the isolation of the virus in tissue culture; this method can yield positive results within 48 hours of inoculation. Characteristic cytopathic effects, with ballooning of cells and cell death, are observed; immunofluorescent staining of the tissue culture cells can quickly identify HSV and can help distinguish between types 1 and 2. Viral antigen detection by direct immunofluorescence of a specimen from a fresh vesicular lesion is an economical, rapid, and sensitive diagnostic tool. Other tests examine viral genetic material using in situ hybridization or polymerase chain reaction. These tests are quick and sensitive but rarely necessary in routine practice.

The differential diagnosis for genital herpes includes syphilis, candidiasis, herpes zoster, hand-foot-and-mouth disease, chancroid, and granuloma inguinale. Primary syphilis is characterized by one or more painless, indurated ulcers occurring at the site of inoculation; chancroid ulcerations, caused by Hemophilus ducreyi, are typically painful, tender, nonindurated lesions covered with gray or yellow necrotic purulent exudates. Noninfectious conditions that can mimic genital herpes include Reiter syndrome, contact dermatitis, Crohn disease, Behçet syndrome, trauma, erythema multiforme, and lichen planus.

Management

Treatment of HSV infection is centred on specific antiviral treatment. Although the same medications are active against both HSV-1 and HSV-2 infections, the location of the lesions and the chronicity of the infection (ie, primary or recurrent) dictate dosage and frequency. For initial treatment, 200 mg of oral acyclovir should be taken 5 times daily for 5 to 10 days, which should reduce the duration of viral shedding, time to crusting, and time to healing.3 In the present case, treatment with oral acyclovir for 5 days resolved the pain and the lesions.

For life-threatening HSV infections in immunocompromised patients or in patients with neurologic complications, intravenous acyclovir administered 3 times daily should be considered. Also, its derivatives—famciclovir (250 mg, 3 times daily for 5 to 10 days), penciclovir (1 topical application every 2 to 4 hours per day for 4 days), or valacyclovir (1000 mg, twice daily for 10 days)—have been shown to be safe and effective in the treatment of active disease. Acyclovir, valacyclovir, and famciclovir are all effective for the treatment or long-term suppression of recurrent episodes of genital herpes. However, topical acyclovir provides no benefit in the episodic treatment of genital herpes and is not recommended. If episodic therapy is used, it should be started at the first sign of recurrence, including during the prodromal period (if it is recognized). Several drugs, such as foscarnet, cidofovir, or trifluridine, can be used for the treatment of acyclovir-resistant cases of HSV.

Some approaches to preventing the transmission of HSV to uninfected persons are the use of condoms and antiviral suppressive therapy in the seropositive partner; however, the risk of transmission is not completely eliminated.

Footnotes

Competing interests

None declared

References

1. Kimberlin DW, Rouse DJ. Clinical practice. Genital herpes. N Engl J Med. 2004;350(19):1970–7. [PubMed] [Google Scholar]2. Benedetti JK, Zeh J, Corey L. Clinical reactivation of genital herpes simplex virus infection decreases in frequency over time. Ann Intern Med. 1999;131(1):14–20. [PubMed] [Google Scholar]3. Leung DT, Sacks SL. Current recommendations for the treatment of genital herpes. Drugs. 2000;60(6):1329–52. [PubMed] [Google Scholar]

Herpes Tests | Michigan Medicine

Test Overview

Herpes tests are done to find the herpes simplex virus (HSV). An HSV infection can cause small, painful sores that look like blisters on the skin or the tissue lining (mucous membranes) of the throat, nose, mouth, urethra, rectum, and vagina. A herpes infection may cause only a single outbreak of sores, but in many cases the person will have more outbreaks.

There are two types of HSV.

  • HSV type 1 causes cold sores (also called fever blisters) on the lips. HSV-1 is generally spread by kissing or by sharing eating utensils (such as spoons or forks) when sores are present. HSV-1 can also cause sores around the genitals.
  • HSV type 2 causes sores in the genital area (genital herpes), such as on or around the vagina or penis. HSV-2 also causes the herpes infection seen in babies who are delivered vaginally in women who have genital herpes. HSV-2 is generally spread by sexual contact. HSV-2 can sometimes cause mouth sores.

In rare cases, HSV can infect other parts of the body, such as the eyes and the brain.

Tests for HSV are most often done only for sores in the genital area. The test may also be done using other types of samples, such as spinal fluid, blood, urine, or tears. To see whether sores are caused by HSV, different types of tests may be done.

  • Herpes viral culture. This is a test to find the herpes virus. Fluid from a fresh sore is added to certain cells used to grow HSV. If no virus infects the cells, the culture is negative. If the herpes virus infects the cells, the culture is positive. The culture often fails to find the virus even when it is present (false-negative results).
  • Herpes virus antigen detection test. Cells from a fresh sore are scraped off and then smeared onto a microscope slide. This test finds markers (called antigens) on the surface of cells infected with the herpes virus. This test may be done with or in place of a viral culture.
  • Polymerase chain reaction (PCR) test. A PCR test can be done on cells or fluid from a sore or on blood or on other fluid, such as spinal fluid. PCR finds the genetic material (DNA) of the HSV virus. This test can tell the difference between HSV-1 and HSV-2. Using the PCR test on skin sores isn’t common. PCR is used mainly for testing spinal fluid in rare cases when herpes may have caused an infection in or around the brain.
  • Antibody tests. Blood tests can find antibodies that are made by the immune system to fight a herpes infection. Antibody tests are sometimes done but are not as accurate as a viral culture at finding the cause of a specific sore or ulcer. Antibody tests cannot always tell the difference between a current active herpes infection and a herpes infection that occurred in the past. Because antibodies take time to develop after the first infection, you may not have a positive antibody test if you have just recently been infected. Some blood tests can tell the difference between HSV-1 and HSV-2.

About 1 out of 6 adults in the United States have antibodies to HSV-2, the virus typically linked to genital herpes.footnote 1

A herpes infection cannot be cured. After you become infected with HSV, the virus stays in the body for life. It “hides” in a certain type of nerve cell and causes more outbreaks of sores in some people. Recurring infections can be triggered by stress, fatigue, sunlight, or another infection, such as a cold or flu. Medicine can relieve symptoms and shorten the length of the outbreaks, but medicine cannot cure the infection.

A different herpes virus (called varicella zoster) causes chickenpox and shingles.

Why It Is Done

A test for herpes may be done to:

  • Find out whether HSV is causing sores around the mouth or in the genital area.
  • Find out which virus type (HSV-1 or HSV-2) is causing sores around the mouth or in the genital area.
  • Find out whether the sex partner of a person with genital herpes may be infected with HSV.
  • Diagnose a herpes infection in a newborn baby whose mother has genital herpes.

How To Prepare

If you may have genital herpes, do not have sexual contact until your test results are back. You can lower the chance of spreading the disease to your partner(s).

How It Is Done

For a viral culture, viral antigen test, or PCR test, a clean cotton swab is rubbed against a herpes sore to collect fluid and cells for examination. Samples may be collected from the vagina, cervix, penis, urethra, eye, throat, or skin. Doctors usually collect a sample from small sores that are only a few days old. Viruses are more likely to be found in small newly formed sores.

For an antibody test, the health professional drawing blood will:

  • Wrap an elastic band around your upper arm to stop the flow of blood. This makes the veins below the band larger so it is easier to put a needle into the vein.
  • Clean the needle site with alcohol.
  • Put the needle into the vein. More than one needle stick may be needed.
  • Attach a tube to the needle to fill it with blood.
  • Remove the band from your arm when enough blood is collected.
  • Put a gauze pad or cotton ball over the needle site as the needle is removed.
  • Put pressure on the site and then put on a bandage.

How It Feels

You are likely to feel some mild discomfort or pain when the sores are scraped to collect a sample for testing.

The blood sample is taken from a vein in your arm. An elastic band is wrapped around your upper arm. It may feel tight. You may feel nothing at all from the needle, or you may feel a quick sting or pinch.

Risks

If an antibody test is done, there is very little chance of problems from having a blood sample taken from a vein.

  • You may get a small bruise at the site. You can lower the chance of bruising by keeping pressure on the site for several minutes.
  • In rare cases, the vein may become swollen after the blood sample is taken. This problem is called phlebitis. A warm compress can be used several times a day to treat this.

Results

Herpes tests are done to find the herpes simplex virus (HSV). Results for a rapid viral culture may take 2 to 3 days, while results for a standard culture can take up to 14 days. Antigen detection test results are ready in a day. Polymerase chain reaction (PCR) test results are ready in 1 to 3 days. Results from an antibody blood test are ready in 2 days. The results from an antibody test called an enzyme-linked immunosorbent assay (ELISA, EIA) may be ready in about 2 hours.

Herpes tests

Normal:

Normal results are called negative.

No HSV grows in the viral culture.

No viral antigens or DNA are found.

No herpes antibodies are present in the blood.

Abnormal:

Abnormal results that show HSV are called positive.

HSV grows in the viral culture.

HSV antigens or DNA are found.

Antibodies to the herpes virus are present in the blood.

Samples taken from newly formed sores containing fluid (blisters) are generally better than samples collected from older, crusted sores.

Rapid tests are available at some clinics that check blood from a finger stick for antibodies to HSV-2. The results are generally ready in about 10 minutes. These tests are more expensive than other tests and may not be available everywhere.

A normal (negative) test result does not mean you do not have a herpes infection. If the first test is negative but you have symptoms of herpes, more tests may be done.

What Affects the Test

Reasons you may not be able to have the test or why the results may not be helpful include:

  • If a culture sample is taken from a crusted, older sore.
  • If a blood sample is taken before antibodies against HSV have formed. This period is called the window period or seroconversion period.
  • If you are taking antiviral medicines, such as acyclovir, famciclovir, ganciclovir, or valacyclovir.

What To Think About

  • Normal test results do not mean you do not have a herpes infection.
  • Herpes is often diagnosed by symptoms and by knowing whether the person has had contact with an infected person. Sometimes a test is not needed. A person who has genital herpes needs to learn how to avoid spreading the disease, because the disease is more likely to be spread when he or she has sores. If you have recurrent outbreaks, especially during times of stress or illness, you can also spread the disease.
  • You may want to know whether a herpes infection is due to HSV-1 or HSV-2 so you can take steps to prevent or treat outbreaks.
  • A genital herpes infection can be spread from a mother to her baby during vaginal delivery. In a newborn, herpes can cause organ failure, brain infection, and death. If active herpes is present near the time of delivery, a cesarean delivery (C-section) may be done to prevent infecting the baby.

References

Citations

  1. Centers for Disease Control and Prevention (2010). Seroprevalence of herpes simplex virus type 2 among persons aged 14–49 years—United States, 2005–2008. MMWR, 59(15): 456–459. Also available online: http://www.cdc.gov/mmwr/pdf/wk/mm5915.pdf.

Other Works Consulted

  • American College of Obstetricians and Gynecologists (2007, reaffirmed 2009). Management of herpes in pregnancy. ACOG Practice Bulletin No. 82. Obstetrics and Gynecology, 109(6): 1489–1498.
  • Chernecky CC, Berger BJ (2013). Laboratory Tests and Diagnostic Procedures, 6th ed. St. Louis: Saunders.
  • Fischbach F, Dunning MB III (2015). A Manual of Laboratory and Diagnostic Tests, 9th ed. Philadelphia: Wolters Kluwer Health.
  • Pagana KD, Pagana TJ (2014). Mosby’s Manual of Diagnostic and Laboratory Tests, 5th ed. St. Louis: Mosby.

Credits

Current as of:
February 26, 2020

Author: Healthwise Staff
Medical Review:
Sarah Marshall MD – Family Medicine
E. Gregory Thompson MD – Internal Medicine
Adam Husney MD – Family Medicine
Martin J. Gabica MD – Family Medicine
Kevin C. Kiley MD – Obstetrics and Gynecology

Current as of: February 26, 2020

Author:
Healthwise Staff

Medical Review:Sarah Marshall MD – Family Medicine & E. Gregory Thompson MD – Internal Medicine & Adam Husney MD – Family Medicine & Martin J. Gabica MD – Family Medicine & Kevin C. Kiley MD – Obstetrics and Gynecology

The Difference Between Cold Sores and Herpes

A lot of people want to know how to tell the difference between a cold sore vs. herpes, but the truth is it’s all herpes.

Throwing around the word “herpes” tends to worry people, which is likely why we’ve developed euphemisms like “fever blisters.” But, herpes is way more common than the stigma surrounding it makes it seems. There’s a huge stigma attached to the disease, eclipsed only by the lack of general knowledge about what exactly is herpes. This is frustrating since it affects so many people. According to the World Health Organization, an estimated two-thirds of the global population under the age of 50 have herpes simplex virus type 1, otherwise known as HSV-1, most commonly referred to as oral herpes. Meanwhile, its counterpart, HSV-2, or genital herpes, affects more than one out of every six people aged 14 to 49, according to the CDC. This begs the question: Why are we so scared of something so common?

Most of the answer lies, again, in misinformation. The general gist of herpes is pretty misunderstood. Both types of herpes are spread through physical contact, and both can be transmitted by kissing, oral sex, and bodily fluids. Far too many people remain in the dark about their chances of having herpes, and they are unnecessarily judgmental of those who have it. The truth is, the disease is only visible during a breakout, which may only happen once during the lifetime of someone who is infected. It’s similar to acne in that there are certainly ways to prevent it, but it affects most people at some point in their lives, so there’s no reason to see it as a moral shortcoming. If you’re affected by either HSV-1 or HSV-2, get treatment immediately, but don’t feel like your life is over.

Here’s more information on a cold sore vs. herpes:

Are Cold Sores Herpes?

In short, yes — and that’s OK! According to Cedars Sinai, cold sores are “small blisters around the mouth … caused by the herpes simplex virus. ” While the herpes simplex virus causes cold sores, an outbreak can be triggered by things like stress, a weak immune system, an illness like a cold, or even weather conditions like hot sun or cold wind.

HSV-1 = Oral herpes (usually)

Unlike HSV-2, which is almost entirely transmitted through skin-to-skin contact, HSV-1 is transmitted via oral-to-oral contact, usually resulting in orolabial herpes, or cold sores around the mouth. These cold sores, which are also known as fever blisters, can be extremely painful and take two to three weeks to heal completely.

They’re contagious, obviously, but it’s not just through mouth-to-mouth contact. If you’re experiencing a cold sore, it’s best not to touch the affected area with your hand since the infection could spread via your fingertips (in general, it’s a good idea to always be extra-vigilant and wash your hands when you have any sort of open wound). The cold sores can also appear on other parts of your body, like the inside of your mouth, on your face, or inside your nose.

HSV-2 = Genital herpes

HSV-2, meanwhile, is transmitted via genital-to-genital contact and might never produce symptoms. However, those symptoms can range in severity if you do experience them. They include small blisters around the genitals, which eventually break open, producing a painful sore, and might be accompanied by flu-like symptoms; cracked, raw, or red areas around the genitals without pain or itching; itching or tingling in the genital or anal region; pain when urine passes over the sores; and headaches and backaches.

You can get genital herpes from someone who has oral herpes

While the two types of herpes generally stay in their genital or oral place, oral-to-genital transmission of HSV-1 is possible. To prevent spread, the American Sexual Health Association (ASHA) recommends abstaining from oral contact, like kissing and oral sex, while experiencing an HSV-1 outbreak, aka cold sores or fever blisters. Otherwise, using a barrier, like a dental dam or a condom, can limit exposure as well.

If you already have oral herpes, it’s harder to get genital herpes

It’s more difficult for someone with HSV-1 to become infected with HSV-2 than someone without HSV-1, which is pretty good news, since the ASHA points out that most adults already have HSV-1.

There is no cure for either, but both can be treated

Neither form of herpes has a cure, but the discomfort can be treated with medication. Genital herpes can reach a severe level of discomfort in people with a suppressed immune system and should not go untreated. Sore close to the mouth, vagina, or rectum can also increase the risk of giving or getting HIV if one partner has it, so monitoring these symptoms is key.

How to test for herpes: What you should know – Blog

Medically reviewed by William Ross Perlman, PhD, CMPP on December 14, 2019. Written by Kathryn Wall. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.


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Signs and symptoms of herpes | How to test for herpes | Common questions


There are many different types of STDs (or STIs) that can affect men and women, and being informed about sexually transmitted infections is important for caring for your health. If you think you’ve possibly been exposed to herpes or are experiencing symptoms you think could be related, don’t fret. You’re not alone, and we’re here to help. The first place to start is knowing your STI status.

You’re most likely wondering what herpes is and how to test for it. There are two types of herpes [1]: herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2).

HSV-1 causes common cold sores and chancres at or around the mouth, and it’s also commonly known as oral herpes. HSV-2 occurs more often at or near the genitals and is more commonly referred to as genital herpes. Like gonorrhea and chlamydia and other infections, genital herpes is a sexually transmitted infection (STI) that can be spread through close personal contact, such as kissing or sexual intercourse.

So if you’re wondering, “How do you test for herpes?”, you can take a genital herpes test to help determine whether you’re infected.

Test for 6 other common STIs like chlamydia, gonorrhea, hepatitis C, HIV, syphilis, and trichomoniasis, with Everlywell STD testing for women or STD testing for men—which allows you to test for STIs from the privacy of your own home.

Signs and symptoms of herpes

Oral herpes is an infection in the mouth, caused by HSV-1 [2]. Symptoms often include cold sores or fever blisters, but you can have oral herpes without any symptoms. (Related: STDs in women)

The herpes simplex virus can be dormant until an active outbreak occurs. The initial infection typically has the worst symptoms, ranging from flu-like symptoms and swollen lymph nodes to headaches. Sores may occur in and around the lips and mouth. Recurring infections are usually milder, and may include redness, itching, or swelling. Painful, fluid-filled blisters can occur and are highly contagious. These blisters often turn into sores (or lesions), which will then scab over and typically heal in a few days.

Symptoms of genital herpes range from none to more severe manifestations [3]. The majority of genital HSV infections are mild, with little to no symptoms following the initial outbreak. For people who do experience symptoms, the usual course begins with genital inflammation, where the skin may itch or burn. Blister-like sores may appear. The sores may open, scab over, and heal.

Other indirect symptoms that can occur during an active herpes virus infection include fever, headaches, muscle aches, and a burning sensation during urination. (Related: How do you know if you have an STD?)

Genital herpes virus infections are highly contagious and spread through sexual contact. The first outbreak of herpes can last several weeks and usually affects the genital area. The virus then typically becomes inactive, but outbreaks may continue in the future. Fortunately, suppressive therapy—through the prescription of antiviral medication—is available for those who suffer from chronic, recurrent outbreaks.

If you think you may have a herpes infection, home testing could be a convenient option for you. If you’re wondering how to get tested for herpes at home, there’s good news: testing for HSV-2 is easy with the Everlywell female STD Test or male STD Test.

How to test for herpes

If you suspect you have herpes, the first thing you should do is contact your healthcare provider. Your healthcare provider can examine your blisters or sores to check for herpes. If you do have an HSV infection, your healthcare provider may recommend a treatment plan for you.

The Center for Disease Control (CDC) recommends a genital herpes test if you have symptoms of herpes or a sexual partner who has genital herpes [4]. Note that some people have asymptomatic herpes and don’t show symptoms, but the CDC does not recommend asymptomatic screening for herpes [5].

If you would like an easy at-home option to test for 6 other common STIs, try the Everlywell home STD Test for women or the STD Test for men which checks for chlamydia, gonorrhea, hepatitis C, HIV, syphilis, and trichomoniasis. Once your sample is received and analyzed at the lab, the test results are sent to you quickly and discreetly via our secure, online platform.

Common questions

How do healthcare providers test for herpes?

How are you tested for herpes at a clinic or healthcare provider’s office? Healthcare providers will examine the location and severity of any active blisters or sores around the mouth or genital area. They may take a tissue sample of the sores to send to a laboratory for examination. A blood sample will be needed if an antibody test is used to check whether you have been infected with the herpes virus.


How to diagnose herpes?

Genital herpes is typically diagnosed through examination by a medical professional and a blood test. If you suspect you have genital herpes (which is primarily caused by HSV-2), you can take an antibody test.

To test for 6 other common STIs like chlamydia, gonorrhea, hepatitis C, HIV, syphilis, and trichomoniasis, try the Everlywell home STD Test for women or the STD Test for men. After you collect your sample at home, it is received and analyzed at the lab, and the test results are sent to you quickly and discreetly via our secure, online platform.

Herpes : I Wanna Know

What is herpes?

Herpes is a very common skin disease. It’s caused by a virus and can affect your mouth (oral) and/or the area around the penis or vagina (genital), upper thighs or buttocks. Most of the time, it is hard to notice herpes, so most people don’t know they have it. Cold sores and fever blisters are an example of herpes in your mouth.

How do I get herpes?

Herpes is transmitted through direct skin-to-skin contact.

You can get herpes from touching someone else’s skin that has herpes, including:

  • Kissing someone with a cold sore
  • Oral, anal and vaginal sex
  • Touching any area infected with herpes

You can get herpes even if you can’t see it. Genital herpes can be transmitted sexually both when a person has noticeable symptoms and when they don’t.

What does herpes do to my body?

Most people don’t know they have herpes. You can find out that you have herpes a few days or as late as years after getting it. Herpes usually affects the mouth and the area around the penis or vagina, buttocks or upper thighs.

Some signs of herpes are:

  • Blisters, bumps, or pimples on the infected area that crust over
  • Fever
  • Headache
  • Pain while peeing

Herpes sometimes looks like bug bites, rash, jock itch, zipper burn, razor burn, irritation from sex, or yeast infection. It is easy to confuse the symptoms of herpes with these types of symptoms. The only way to know if you have herpes is to get tested.

How do I find out if I have herpes?

If you have symptoms that you think might be herpes, you should see a healthcare provider no later than 48 hours after noticing the symptom. If you don’t have symptoms, you can ask for a “herpes type-specific IgG ” blood test.

Is there a cure for herpes?

No, herpes can’t be cured. Once the virus enters your body, you can’t get rid of it. But there are  ways to treat herpes that can lower the number of herpes outbreaks you have. Herpes is usually not harmful, but it can make it easier for you to receive HIV if you’re exposed. ASHA’s website has more information about herpes treatment.

How can I reduce my risk of getting herpes?

There are many ways to reduce your risk.

The best way to avoid herpes or any STI is to not have sex. And since herpes is transmitted by skin-to-skin contact, you can contract herpes even if you don’t have intercourse.

You can protect yourself by using a latex condom every time you have sex. Condoms don’t provide complete protection against herpes, but they can help. Since herpes can be transmitted during oral sex, using condoms or a dental dam during oral sex can also help reduce your risk. Learn more about reducing your risk for STIs.

Analysis for herpes: ELISA method and PCR diagnostics

Author

Timofeeva Veronika Leonidovna

Leading physician

Gynecologist

Herpes test allows you to determine the presence of the herpes virus in the body.

Several types of herpes virus are known today. The most common herpes simplex virus (HSV) type I, manifested in the form of characteristic rashes on the face and oral mucosa (the so-called “cold on the lip”), HSV type II (genital herpes, which is characterized by a rash on the genital mucosa organs), as well as herpes zoster (herpes III type).

Herpes can be transmitted in various ways – by direct contact (household), by airborne droplets; intrauterine infection is possible.At the same time, herpes infection during sexual intercourse is typical, therefore herpes is included in the number of STDs (sexually transmitted diseases). Herpes is also one of the ToRCH infections that combine diseases that can harm the fetus during pregnancy.

The herpes virus is not always active. It can be present in the body for years without leading to the manifestation of any obvious symptoms and is activated only with a decrease in immunity.

It is believed that the majority of the world’s inhabitants are infected with the herpes virus (according to some estimates, up to 90%). Therefore, it is so important to determine whether you are a carrier of the virus. If not, you should be especially attentive to the threats of possible infection – this will allow you to maintain the health potential that you have.

An analysis for herpes is carried out for each specific type of virus. Knowing whether this type of herpes virus is present in the body or not, the doctor receives the necessary information to diagnose diseases and assess the general condition of the body.

To date, medicine does not yet have the means that can completely defeat herpes.But it is quite possible to suppress the activity of the virus or prevent its transition to an active state. Therefore, the analysis for herpes is a component of many comprehensive examinations, and in case of suspicion of herpes, it is necessary for accurate diagnosis and the appointment of an adequate course of treatment.

When an analysis for herpes is prescribed

An analysis for herpes is usually prescribed:

  • in the presence of symptoms characteristic of herpes infection – in order to confirm their herpes nature, as well as in order to determine what type of virus they are caused by;
  • when planning a pregnancy – to both partners;
  • 90,031 during pregnancy;

    90,031 newborns with maternal infection;

  • in order to establish whether herpes infection was transmitted through contact with an infected partner.

Methods of conducting

The main methods of analysis for herpes are enzyme-linked immunosorbent assay (ELISA) and PCR diagnostics.

Blood test for herpes by enzyme immunoassay (ELISA)

For the enzyme immunoassay for herpes, the biological material is blood.

The body responds to the penetration of the virus by developing specific immune bodies to fight it. These bodies can be found in the blood by serological testing.An enzyme-linked immunosorbent assay shows the presence of antibodies to the herpes virus (Ig G and Ig M) in the blood.

PCR diagnostics of herpes

The PCR (polymerase chain reaction) method is based on the analysis of DNA in a sample of biological material. Fragments of DNA characteristic of this type of virus are isolated and reproduced many times. Multiplication reveals a virus that is present even in small quantities.

Biological material for PCR diagnostics is usually scraping (a sample taken directly from the site of the rash), urine, blood or saliva.

Preparation for analysis for herpes

It is necessary to donate blood for an enzyme immunoassay for herpes on an empty stomach. It is advisable to do this in the morning, since you cannot eat or drink for 8 hours before taking the test. 1-2 days before the analysis, it is necessary to exclude alcohol, fatty and fried foods. You should not take any medications. If you cannot stop taking medications, tell your doctor.

Where to get tested for herpes in Moscow

You can make an analysis for herpes at the Family Doctor JSC.You can get tested where it is most convenient for you by choosing a polyclinic located in the district of Moscow you need. In our clinics you can get tested on weekends and holidays.

Do not self-medicate. Contact our specialists who will correctly diagnose and prescribe treatment.

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90,000 KDL. Herpetic infections (herpes viruses). Analyzes and prices

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Herpes Simplex Virus 2, IgG

Determination of specific antibodies to the herpes simplex virus (HSV) type 2 in the blood, used to diagnose and prevent the transmission of genital herpes.

Synonyms Russian

Antibodies to herpes simplex virus type 2;

Specific antibodies to HSV 2.

Synonyms English

Herpes Simplex Virus Type 2, Abs;

HSV 2, Specific serologic test.

Research method

Immunochemiluminescence analysis.

What biomaterial can be used for research?

Venous blood.

How to properly prepare for the study?

  • Do not smoke for 30 minutes prior to examination.

General information about the study

Herpes simplex virus (HSV) is a large DNA-containing virus, a distinctive feature of which is tropism to nerve cells and the ability to establish a latent infection. There are two types of virus that are similar in antigenic composition and virulent properties: HSV type 1 (more often detected in labial herpes) and HSV type 2 (more often detected in genital herpes).Herpes infection is extremely common and contagious: it is estimated that 65-90% of the world’s people are infected with one or two types of HSV. Despite the fact that the clinical picture of herpes infection is quite typical, the diagnosis cannot be made on the basis of symptoms alone. The basis of HPV diagnostics is laboratory tests. Various laboratory tests and their combinations can be used to identify HSV, including the Tzank test, virus isolation in cell culture, molecular diagnostics (PCR) methods, and serological tests.At the moment, specific serological tests have appeared that can not only detect the presence of HSV, but also determine its type, which is of particular importance for the diagnosis and prevention of the transmission of genital herpes.

Specific serological tests are based on the determination in the patient’s blood of type-specific antibodies to glycoprotein G, one of the few antigens that differ in HSV types 1 and 2. So, in the blood of patients infected with HSV type 1, it is possible to detect antibodies to glycoprotein G1, and in those infected with HSV type 2, antibodies to glycoprotein G2.The sensitivity of the test for specific antibodies to HSV is 80-95% (for comparison: the sensitivity of the culture method is about 75%), the specificity is 96-100% (comparable to the specificity of the culture method and PCR).

It should be noted that a specific serological test for HSV type 2 is an additional method for diagnosing herpes infection, but it can be especially useful in the following situations:

  1. For the detection of asymptomatic genital herpes.

Detection of antibodies to HSV 2 almost always indicates the presence of genital herpes (or a combination of genital and labial herpes), since isolated labial herpes caused by HSV type 2 is extremely rare. It should be noted that antibodies to HSV type 2 can be detected in about 30% of adults, while only 10-25% of them show clinical signs of herpes infection. Thus, in most cases, genital herpes is asymptomatic and does not cause any concern in an infected person.On the other hand, patients with asymptomatic genital herpes are the source of the spread of herpes infection. Moreover, in some groups of patients, genital herpes, including those with asymptomatic course, can pose a serious danger (for example, the risk of neonatal herpes if the mother is infected). Patients who test positive for HSV type 2 antibodies should be counseled about the need for protected sexual intercourse, which will reduce the risk of infection for their sexual partners.

  1. To assess the prognosis of genital herpes.

Although studies have shown that the severity of exacerbation of genital herpes does not differ between HSV types 1 and 2, it is known that relapses of the disease are observed 6-10 times more often with HSV 2.

  1. To assess the risk of HSV type 2 infection in the presence of HSV type 1.

Cases of HSV type 2 infection in the presence of genital herpes caused by HSV type 1 have been described. In this case, genital herpes takes on a course more characteristic of HSV type 2, that is, it recurs more often.This is of particular importance if genital herpes without determining the type of HSV has been diagnosed in each of the sexual partners. Such couples are often told that, given that both partners are already infected, there is no need to use a barrier method of contraception in terms of preventing genital herpes. This, however, is not entirely true. If partners are infected with different types of HSV, there is a possibility of transmission of HSV type 2 in the presence of HSV type 1 and worsening of the course of genital herpes.Interestingly, the opposite situation (transmission of HSV type 1 in the presence of HSV type 2) is extremely rare. If both partners are infected with the same type of HSV, the risk of infection with the new type of HSV and its consequences are not clinically relevant. In this case, from the point of view of preventing genital herpes, there is really no need to use a barrier method of contraception.

  1. To confirm the diagnosis of genital herpes in a typical clinical picture.

Isolation of HSV in cell culture is currently the “gold standard” for the diagnosis of genital herpes.This method, however, has its drawbacks: the test does not always give a positive result in primary herpes and is usually negative in relapse or if a smear was performed 5 or more days after the onset of symptoms. The high rate of false negative test results generally negatively affects how seriously patients take the diagnosis of genital herpes and adhere to the prescribed treatment. Without a doubt, many patients are convinced that the diagnosis is incorrect if, after the clinical diagnosis of the doctor, a negative response comes from a confirmatory HSV test.This scenario can be avoided by using serological tests. Interpretation of serological tests, including for HSV 2, should be carried out taking into account the time elapsed since the moment of infection. IgG immunoglobulins begin to be produced and can be determined in the blood no earlier than 4 weeks after infection. The increase in antibody titer is of the greatest importance: an increase of 4 times or more is considered diagnostic (compared to zero value in primary infection or compared to basal value in case of recurrence of infection).

  1. To confirm the diagnosis of genital herpes in atypical clinical presentation.

In some cases, genital herpes, even HSV type 2, proceeds with minimal symptoms and rare relapses, and it is difficult to isolate HSV using cell culture or determine it in a PCR reaction. In such a situation, you can ask the patient to go to the clinic immediately when a “fresh” rash occurs, or, more conveniently, to perform a test for antibodies to HSV type 2.

  1. When genital herpes is detected in one of the sexual partners.

Quite often, when clinical signs of genital herpes are detected in one of the partners, it turns out that the second sexual partner does not have such signs and has never had genital herpes. This situation creates significant psychological stress in such “discordant couples”. In fact, “discordance” can only be established after a specific test for HSV.At least 25% of couples who are clinically discordant for HSV are serologically concordant. Information about the “HSV status” of each partner helps to prevent the transmission of infection in time.

  1. For the diagnosis of genital herpes during pregnancy.

Primary HSV infection late in pregnancy is extremely unfavorable. Studies have shown that primary infection with HSV type 1 or type 2 in the third trimester of pregnancy increases the risk of developing neonatal herpes by up to 30-50%.Most of these cases are caused by the fact that a pregnant woman becomes infected and is an asymptomatic carrier of HSV, including at the time of childbirth. A test for antibodies to HSV type 2 can identify pregnant women who are at risk of primary infection with HSV. If a woman does not have a history of genital herpes, an HSV 2 antibody test should be performed. HSV infection, that is, protected sex or abstinence.If a pregnant woman has antibodies to HSV type 2 (seropositive), primary infection during pregnancy is by definition impossible, and the risk of transmitting the virus to the infant is very low (provided that active infection is excluded at the time of delivery). Testing of her sexual partner in this case is not carried out. Also, no additional measures are taken to prevent infection with HSV.

  1. For the prevention of HSV transmission in HIV-infected patients.

The isolation of HSV type 2 occurs much more actively in HIV-infected people than in immunocompetent people.Thus, HIV-infected patients pose a particular risk of transmitting HSV-2 to their sexual partners. Determination of HSV 2 antibodies and “HSV status” in these patients and recommendations for the prevention of HSV transmission can reduce the risk of transmission of the disease in this group of patients.

What is the research used for?

  • For diagnosis and prevention of transmission of HSV type 2 infection.

When is the study scheduled?

On examination:

  • All sexually active patients;
  • Sex partners of patients with genital herpes;
  • 90,031 Pregnant women.

What do the results mean?

Reference values:

The result is negative.

Positive result:

  • HSV type 2 infection.

Negative result:

  • Absence of HSV type 2.

The following points should be considered when interpreting the test result:

  1. The test does not differentiate primary infection from recurrence.Having arisen some time after the initial infection, antibodies to HSV-2 remain in the blood for an indefinitely long time. For the same reason, the analysis is not used to assess the effectiveness of treatment.
  2. Genital herpes can be caused by HSV type 1, so the absence of antibodies to HSV type 2 does not contradict the diagnosis of genital herpes.
  3. The test is not used to diagnose herpes in children under 14 years of age due to its low sensitivity and specificity in this age group.
  4. The test is not used for solving medical examination problems. In this case, HSV isolation in cell culture is used.

Since HSV type 2 infection almost always occurs sexually, when detecting antibodies to HSV 2, it is advisable to conduct additional studies for sexually transmitted infections (STIs), including syphilis and chlamydia.

What can influence the result?

  • Time elapsed since infection;
  • 90,031 years old.

Download an example of the result

Important Notes

  • The test does not differentiate primary infection from recurrence;
  • A negative test result does not completely rule out the presence of genital herpes;
  • The test is not used to diagnose herpes in children under 14 years of age.

Also recommended

[07-134] Herpes Simplex Virus 1, IgG

[09-142] Herpes Simplex Virus 1/2 with type determination, DNA [real-time PCR]

[09-013] Herpes Simplex Virus 1/2, DNA [real-time PCR]

[40-110] Intimate – 9 urine tests

[40-043] Intimate – optimal – smear analysis in men

[40-042] Intimate – optimal – smear analysis in women

Who orders the study?

Dermatovenerologist, urologist, obstetrician-gynecologist, general practitioner.

Literature

  • Wald A, Ashley-Morrow R. Serological testing for herpes simplex virus (HSV) -1 and HSV-2 infection. Clin Infect Dis. 2002 Oct 15; 35 (Suppl 2): ​​S173-82.
  • Sheary B, Dayan L. Herpes simplex virus serology in an asymptomatic patient. Aust Fam Physician. 2005 Dec; 34 (12): 1043-6.
  • Beauman JG. Genital herpes: a review. Am Fam Physician. 2005 Oct 15; 72 (8): 1527-34.
  • Sen P, Barton SE. Genital herpes and its management.BMJ. 2007 May 19; 334 (7602): 1048-52.
  • 90,041 90,000 price from 395 rubles in Moscow in the Medoc network of clinics

    Description of herpes simplex virus

    Herpes simplex virus is a virus of a specific form, which consists of 20% lipoproteins, 70% protein, 6.5% DNA, 1.6% carbohydrates. Its outer shells protect against the destructive effects of chemical and physical factors, are responsible for attachment to epithelial cells.

    When a person becomes infected, the herpes simplex virus enters the skin and mucous membranes. As a result, special “spines” are formed – glycoproteins. Gradually, the outer viral envelope completely merges with the cell membrane, changing its structure. Having freed itself from the protective capsule, the herpes virus penetrates directly into the nucleus of the cell, after which its DNA blocks the process of the cell’s production of its own DNA (the cell begins to produce the DNA of the virus). The structure of the nucleus is destroyed.

    Approximately nine hours after the start of viral DNA synthesis, the virus moves from the nucleus to the cytoplasm of the cell.Here it acquires a new outer shell, consisting of nuclear and cell membranes – supercapsid. After a day, the herpes simplex virus leaves the cell by budding. It enters the bloodstream, is fixed on the surface of erythrocytes and, together with the blood flow, is carried throughout the body. In turn, the affected cell soon dies.

    Herpes simplex viruses 1 and 2 types

    The polymerase chain reaction (PCR) method is used to determine if a patient is infected with herpes simplex virus type 1 or type 2 (HSV 1 or 2).

    With HSV 1, tiny vesicles filled with fluid appear on the mucous membranes of the mouth and around the lips. After opening them, open foci are formed. In HSV-2, the site of the lesion is the genitals.

    According to the WHO, about 50-80% of the world’s population is infected with herpes simplex virus type 1, 20% – with type 2 virus. Since in most cases the disease is mild, 90% of those infected do not even suspect that they have an infection.

    Indications for blood donation for determination of HSV 1 and HSV 2

    Indications for blood donation for the determination of DNA of the herpes virus type 1 and 2 are:

    • pregnancy planning,
    • symptoms of placental insufficiency in pregnant women,
    • intrauterine infections,
    • HIV and other immunodeficient conditions,
    • presence of vesicular herpetiformis eruptions,
    • swelling and burning in the genital area,
    • painful urination.

    Preparing for Diagnostics

    To determine the DNA of the human herpesvirus type 1 and 2, blood is taken from a vein. The examination should be preceded by an 8-12 hour fast.

    Before visiting the medical laboratory, you can drink some still water. On the eve, you should stop eating fatty foods.

    Interpretation of analysis results

    Deciphering the results of the analysis for the determination of DNA of the HSV 1 and HSV 2 viruses in the blood should be dealt with by the specialists of the laboratory where the study was carried out.Usually, indicators are indicated on the form:

    • less than 0.9 – negative (herpes virus types 1 and 2 were not detected),
    • from 0.9 to 1.1 – doubtful (it is recommended to re-examine in 5-7 days),
    • 90,031 more than 1.1 – positive (herpes virus type 1 or 2 was detected).

    If the antibody titer is exceeded by more than 30% of the established norm, we can talk about the activation of the infection.

    When is it time to get tested for herpes?

    Herpes is a common viral infection caused by the herpes simplex virus.There are 2 main types of this virus: HSV-1 and HSV-2. During the diagnosis, several fluids can be examined: blood, saliva, cerebrospinal fluid (CSF).

    Herpes simplex virus types 1 and 2 are contagious. Periodically, it causes small blisters to form, which rupture and form open wounds. When infected with the HSV-1 virus, blisters form primarily around the mouth. When infected with the HSV-2 virus, wounds usually form near the genitals.

    Herpes simplex virus is transmitted through skin contact – when the wounds are open and heal.Sometimes you can get infected even in the absence of visible damage. The type 2 virus is often sexually transmitted, although HSV-1 can also be infected both during oral sex and during intercourse. Why is it necessary to be tested for herpes, even if a person feels healthy? According to the American Sexual Health Association, 90% of those infected may be unaware of the presence of the herpes virus due to the absence or mild manifestation of symptoms.

    When a person first becomes infected, noticeable and painful blisters may form at the site of infection.These blisters usually appear within 2 weeks after infection and heal within two to four weeks. Blisters can appear in the vagina in women or in the penis in men. They also appear in the anus, on the buttocks and thighs.

    At the first infection with herpes simplex virus types 1 and 2, the bubbles may reappear. Also, the patient may be disturbed by flu symptoms – high fever and swelling of the glands in the neck. It is worth noting that not everyone forms blisters, and some are so small that they are mistakenly confused with an insect bite or rash.As soon as the initial infection subsides, it will remain in the human body in a latent form. During times of stress or illness, the herpes virus can remind of itself again.

    A special group includes persons with weakened immunity. For example, people with HIV or people who have undergone organ transplant surgery. These patients may experience more frequent and severe outbreaks of herpes. Although the virus cannot be completely cured, antiviral medications can help contain outbreaks and shorten the duration of symptoms.

    Occasionally, the virus is transmitted from mother to child during natural childbirth. In this case, this infection is called neonatal herpes. Symptoms appear within the first month after the baby is born. If left untreated, the disease can cause long-term damage to a child’s health.

    A pregnant woman with diagnosed herpes should be regularly examined and examined in the period before childbirth. If an outbreak of virus activity is detected during follow-up, a caesarean section will be required during labor.This will help protect your baby from infection.

    Herpes simplex virus types 1 and 2 can enter the brain and cause encephalitis. This disease can be fatal or cause serious, long-term neurological damage.

    How is the herpes virus test performed?

    If blisters or sores have formed in the genital area, a swab is taken from the patient. If meningitis or encephalitis is suspected, a sample of cerebrospinal fluid may be taken.If wounds have formed in the mouth, a saliva sample is taken from the patient. Herpes antibody test requires a venous blood sample. No special preparation for the diagnosis is required.

    Inoculation of HSV-1 and HSV-2 cells

    In this case, a sample of fluid is collected from an open wound using a cotton swab. This liquid is then “seeded” into cells that allow the virus to grow. Once a virus is found, it can be identified as HSV-1 or HSV-2.Such a differential analysis for the herpes virus helps to predict the course of the disease. This is a specific and sensitive test, and it takes 2 or more days to get the result. A false negative result is obtained if there is not enough active virus in the sample. This happens when the crop is inoculated more than 48 hours after the bubbles appear.

    Herpes Virus Test DNA Testing (PCR)

    This method detects the genetic material of the virus in a sample taken from a vesicle, blood or cerebrospinal fluid. The PCR technique not only detects the virus itself, but also allows you to identify its type. This herpes virus test is more sensitive than cell culture. It is performed in 2 cases:

    1. When the virus is present in small quantities (this happens with viral encephalitis),
    2. If several days have passed after the formation of bubbles.

    For people with pronounced wounds in the genital area, viral DNA testing (PCR) is usually done.PCR is also preferred when neonatal virus or encephalitis is suspected.

    Herpes Antibody Test

    HSV Antibody Testing detects immune proteins that the body produces in response to virus penetration. Our body produces 2 classes of antibodies: IgM and IgG. A few days after the initial infection with the herpes virus, IgM antibodies are produced. These substances can be found in the blood for several weeks.Then the body begins to produce antibodies of the IgG class. Their level rises over several weeks, and then slowly decreases and stabilizes. An infected person will continue to produce small amounts of IgG antibodies.

    Herpes antibody test detects both types of virus: HSV-1 and HSV-2. It shows both an early burst of IgM antibodies and the presence of IgG antibodies, which can constantly remain in the patient’s blood. This herpes blood test is not as sensitive as a PCR test or cell culture.But it has its advantages. An antibody test is used to check if blood samples were collected several weeks apart. This indicator is monitored by the amount of IgG antibodies.

    Also, an analysis for antibodies to herpes is prescribed for the examination of certain groups of the population. These include:

    • Sexually active people, 90,032
    • Patients awaiting organ transplant surgery, 90,032
    • HIV-positive.

    In general, experts from the Centers for Disease Control and Prevention (CDC) recommend regular screening for individuals at risk:

    1. People who have recurrent genital sores,
    2. If genital herpes has been diagnosed clinically but laboratory tests have not confirmed the presence of infection,
    3. Persons who have had a sexual partner with genital herpes,
    4. People who are tested for other sexually transmitted infections, especially if they have multiple partners,
    5. HIV-infected, and persons who are at risk of HIV infection.

    How to decipher the test results for herpes?

    On direct diagnosis (culture or DNA determination):

    • A positive wound smear result indicates an active HSV-1 or HSV-2 infection.
    • A negative result indicates that no herpes simplex virus has been detected. However, this does not exclude the presence of infection by 100%. The sample may contain too low a concentration of virus, or it may not be active.If the doctor nevertheless suspects the presence of a virus, in this case, a second diagnosis will be required.

    Herpes Antibody Test:

    • A positive HSV-1 or HSV-2 IgM antibody test indicates active infection or recent infection.
    • A positive test for antibodies of the IgG class to HSV-1 or HSV-2 viruses indicates that a person has been infected for some time, perhaps for a long time.
    • A significant increase in IgG antibodies compared to the previous test indicates active infection or recent infection.
    • A negative herpes antibody test indicates that the person has either not been exposed to the virus or has not yet begun to produce antibodies.

    If you would like to undergo a herpes diagnosis, come to the Persomed Medical Center. Our specialists perform several types of analyzes. In order to determine which one is right for you, call the phones at the top of the site.

    Source : Herpes Testing, American Association for Clinical Chemistry.

    Herpesvirus type 6 (DNA qualitative determination)

    Herpes virus type 6 , also called HHV-6, is an infection that is no less widespread in the world than herpes viruses of types 1 and 2. The virus has 2 subtypes – A and B, subtype B is the main cause of sudden exanthema (baby roseola), one of the childhood infections that occurs with a high fever and rash.

    Herpes simplex virus type 6 is characterized by the same features as for other types of herpesvirus: lifelong and often asymptomatic carriage. A distinctive feature of this virus is its pronounced manifestation in children. Today, scientists believe that most often this virus is transmitted through saliva, and therefore young children become infected with this virus almost from the first days of contact with the mother or other people who are carriers of the virus.

    However, in the first few months of life, infection of a child with the herpes simplex virus type 6 does not lead to any consequences: the innate immunity transmitted from the mother confidently suppresses viral particles.Only if the mother does not have this virus, and the child becomes infected from another person, the typical symptoms of herpes type 6 can occur in an infant from the first months of life. Usually, children get sick with herpes at the age of 4 to 13 months. If the herpes virus type 6 enters the adult body for the first time, it causes about the same symptoms as in children: fever and skin rashes.

    The main route of transmission of the herpes simplex virus type 6 is contact. Transmission of the virus from mother to child directly during childbirth is rarely recorded.As a result of the studies, it turned out that in 2% of women in labor, the herpes virus is present in the vaginal secretion, and in another 1% – in the blood in the umbilical cord. It is not surprising that during childbirth, herpes can easily enter the child’s body through microtrauma and scratches.

    The main symptom of the disease caused by the herpes simplex virus type 6 is a large, small rash on the skin of a child, which is often referred to as baby roseola. Small rashes spread throughout the child’s body are slightly raised above the skin and usually do not cause itching.

    Always a few days before the appearance of the rash, the child has a fever characteristic of a fever. However, even at this body temperature, the child remains active. The high temperature lasts for 4-5 days, after which it drops sharply and sprinkles the child.

    It happens that the disease proceeds without rashes

    If a child has a rash, then they do not stay on the skin for long: in some cases they disappear after a few hours, sometimes they can persist for several days. In parallel with them, the child loses appetite, he becomes inactive and irritable, sometimes he has an increase in lymph nodes.

    More serious manifestations of primary infection with herpes type 6 are:

    • meningoencephalitis
    • myocarditis
    • fulminant hepatitis
    • thrombocytopenic purpupa
    • mononucleosis-like syndrome
    • various pneumonia.

    It is very important to remember that herpes itself often manifests itself as a companion of other diseases.

    Diagnosis of an infection caused by the herpes virus type 6 is based on the determination of the DNA of the virus and the determination of class G antibodies. In the adult population, IgG antibodies to this virus are detected in 70 – 90% of people. IgG antibodies appear on the 7th day of fever, reaching a maximum after 2 to 3 weeks, then their concentration decreases, but they are determined throughout life.At birth, maternal IgG antibodies can be detected in the blood of children, the titer of which decreases by 5 months.

    After suffering a childhood illness caused by the herpes simplex virus type 6, the body develops lifelong immunity, and in adults, HHV-6 does not manifest itself in any way. Despite the fact that he often relapses when a blood test can determine its presence in the body, in people with normal immunity, such relapses occur asymptomatically.

    Revealing DNA detection using real-time PCR is possible from the very first days of the disease. Examine the scraping of epithelial cells from the back of the pharynx or blood. When the infection is reactivated, the detection of DNA will happen with a diagnostic confirmatory marker.

    Indication for examination:

    • Differential diagnosis of childhood infections accompanied by fever and maculopapular rash
    • Swollen lymph nodes with fever
    • Frequently ill children (more than 3 times a year)
    • Decreased immunity
    • Examination before and after tissue and organ transplantation

    Diagnostics of herpes in Zaporozhye in “SHEKI” MC quickly and efficiently!

    Herpes is one of the most common viral infections. She, according to statistics, infected up to 90% of the population. The disease is caused by the herpes simplex virus and is often asymptomatic. Only about 5% of carriers of the virus experience symptoms of the disease, and everyone else may not even know that they are infected. A huge role in the treatment of the disease is its early diagnosis. In the “SHEKI” medical center, the diagnosis of this disease is carried out through PCR studies, as well as by the enzyme immunoassay method based on the detection of antibodies to the virus.What tests need to be passed and, according to what methodology, the doctor recommends to the patient. Different techniques are used at different stages of the disease. For the accuracy of the diagnosis, it is important to properly prepare for the delivery of the analysis!

    Symptoms of herpes infection

    A person infected with herpes may for many years not even realize that he is its carrier. It can affect the skin, eyes, mucous membranes of the face, genitals and the nervous system. Its complications can be very life-threatening diseases – meningitis and encephalitis.Infection from an infected person occurs through the skin with a relapse of the disease or sexual contact. Herpes simplex virus manifests itself as rashes on the mucous membranes of the genitals, on the skin of the face in the form of small bubbles with liquid, a slight rise in temperature and weakness. There are several types of the disease:

    • Primary. In this form, the symptoms are more pronounced, there are still no antibodies to the virus in the body.
    • Not primary.This type of infection is not strongly expressed in symptoms, while the person already has antibodies to one of the types of viral infection.
    • Recurrent. A variant of an infection that has recurred, while the body already has antibodies to it and symptoms of genital herpes infection appear. The period of healing of wounds after rashes is four to five days.

    Herpes and pregnancy

    Herpes during pregnancy can lead to the most serious complications of pregnancy, up to the loss of a child and inflammation of the uterus. A virus that has been dormant for many years and has not manifested itself in any way, during pregnancy, when a woman’s immune system is stressed and weakens somewhat, it activates and can cause problems during pregnancy. To protect themselves from possible complications, all women planning a pregnancy are advised to do a test for herpes , and, if necessary, carry out antiviral therapy.

    What can trigger a relapse?

    The latent course of the disease can sharply worsen for a number of reasons:

    • with exacerbation of another infectious disease
    • with weakened immunity
    • with fever
    • during pregnancy 90,032

    • after surgery
    • after undergoing cosmetic procedures that violate the integrity of the skin, for example, tattoo
    • with exacerbation of mental state

    Resting in a sauna, sunbathing on the beach, hypothermia when swimming in cold water, or simple freezing at a stop can affect the appearance of herpes sores.