How accurate are the herpes tests

It can be incredibly stressful to wonder if you have herpes. That's true whether you're concerned because of symptoms because you know you've just been exposed, or for any other reasons. One way to determine whether or not you have genital herpes or oral herpes infection is to get a herpes test.

Many people have questions about how accurate herpes tests are. The truth is that herpes blood tests work reasonably well, but no test is perfect.

As with all herpes viruses, once an individual is infected with the herpes simplex virus, or HSV, he or she is infected for life. The presence of antibodies against herpes simplex means an individual is currently infected with the virus.

The accuracy of a herpes blood test depends on two things: how many people in the tested population have herpes and which specific test was used.

Get tested within the window period

All the herpes tests are time sensitive. So they accuracy depends on when the tests are done.

A swab test is best done on fresh sores within 48hours or them appearing. If they aren’t fresh the swab can give a false negative.

Serologic, or blood, testing allows us to screen individuals for infection with herpes simplex. The new tests for herpes, called type-specific serologic tests, distinguish between HSV-2 and HSV-1, the other type of herpes simplex virus.

These newer tests detect IgG antibodies directed against the cell wall protein specific for HSV-1 or HSV-2. Older serologic tests did not reliably distinguish between HSV-1 and HSV-2 and, as a result, were not a reliable way to make a diagnosis of genital herpes.

The IgG test looks for antibodies towards the virus but it takes our body 4-6 months (for some even longer) to produce those antibodies for them to be detectable on that test. It takes about three to six weeks for individuals to develop detectable antibodies for herpes simplex. Virtually everyone will have detectable antibodies by 16 weeks. So testing too soon can give false negatives.

IgM Test

An IgM is the most unreliable test it detects a recent infection within a 7-10 day timeframe. But it can also be positive for reoccurring outbreaks not just “the first” and it can be positive for other herpes viruses like chickenpox, shingles and mono.

It all sounds a bit too complicated — but it’s not, really. The world is not perfect, and like all things, tests require some degree of interpretation too. That's one reason doctors may be reluctant to test for herpes. They worry about balancing the patient's desire to know with the potential emotional damage caused by a positive herpes blood test result.

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