Herpes (HSV)

If you're struggling with troubling herpes symptoms, such as new sores on your body, herpes testing can put your mind at ease and help you find a solution.


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Herpes Simplex Virus 1 (IgG), Type-Specific Antibody (HerpeSelect®) 

Tests for HSV 1 IGG, TYPE SPECIFIC AB to diagnose HSV-1 infection when lesions are absent. A positive HSV-1 IgG antibody test indicates a previous infection.

Reference Range(s)

Index Interpretation

  • <0.90 Negative 
  • 0.90-1.09 Equivocal 
  • >1.09 Positive 

This assay utilizes recombinant type-specific antigens to differentiate HSV-1 from HSV-2 infections. A index positive result cannot distinguish between recent and past infection. If recent HSV infection is suspected but the results are negative or equivocal, the assay should be repeated in 4-6 weeks. The performance index characteristics of the assay have not been established for pediatric populations, immunocompromised patients, or neonatal screening.

Limitations

Individuals infected with HSV may not exhibit detectable IgG antibody in the early stages of infection.

Clinical Significance

Herpes Simplex Virus (HSV) is responsible for several clinically significant human viral diseases, with severity ranging from inapparent to fatal. Clinical manifestations include genital tract infections, neonatal herpes, meningoencephalitis, keratoconjunctivitis, and gingivostomatitis. There are two HSV serotypes that are closely related antigenically. HSV type 2 is more commonly associated with genital tract and neonatal infections, while HSV type 1 is more commonly associated with infections of non-genital sites. Specific typing is not usually required for diagnosis or treatment. The mean time to seroconversion using the type specific assay is 25 days. The performance of this assay has not been established for use in a pediatric population, for neonatal screening, or for testing of immunocompromised patients.


Herpes Simplex Virus 1/2 (IgG), Type-Specific Antibodies (HerpeSelect®) 

  1. HSV 1 IGG, TYPE SPECIFIC AB
  2. HSV 2 IGG, TYPE SPECIFIC AB

Diagnose HSV infection when lesions are absent; determine HSV type

Reference Range(s)

Index Interpretation

  • <0.90 Negative
  • 0.90-1.09 Equivocal
  • >1.09 Positive

This assay utilizes recombinant type-specific antigens to differentiate HSV-1 from HSV-2 infections. A index positive result cannot distinguish between recent and past infection. If recent HSV infection is suspected but the results are negative or equivocal, the assay should be repeated in 4-6 weeks. The performance index characteristics of the assay have not been established for pediatric populations, immunocompromised patients, or neonatal screening.

Limitations

Individuals infected with HSV may not exhibit detectable IgG antibody in the early stages of infection.

Clinical Significance

Herpes Simplex Virus (HSV) is responsible for several clinically significant human viral diseases, with severity ranging from inapparent to fatal. Clinical manifestations include genital tract infections, neonatal herpes, meningoencephalitis, keratoconjunctivitis, and gingivostomatitis. There are two HSV serotypes that are closely related antigenically. HSV Type 2 is more commonly associated with genital tract and neonatal infections, while HSV Type 1 is more commonly associated with infections of non-genital sites. Specific typing is not usually required for diagnosis or treatment. The mean time to seroconversion using the type specific assay is 25 days. The performance of this assay has not been established for use in a pediatric population, for neonatal screening, or for testing of immunocompromised patients.



Herpes Simplex Virus 2 (IgG), Type-Specific Antibody (HerpeSelect®) 

HSV 2 IGG, TYPE SPECIFIC AB - Diagnose HSV-2 infection when lesions are absent.

Reference Range(s)

Index Interpretation

  • <0.90 Negative
  • 0.90-1.09 Equivocal
  • >1.09 Positive

This assay utilizes recombinant type-specific antigens to differentiate HSV-1 from HSV-2 infections. A index positive result cannot distinguish between recent and past infection. If recent HSV infection is suspected but the results are negative or equivocal, the assay should be repeated in 4-6 weeks. The performance index characteristics of the assay have not been established for pediatric populations, immunocompromised patients, or neonatal screening.

Limitations

Individuals infected with HSV may not exhibit detectable IgG antibody in the early stages of infection.

Clinical Significance

Herpes Simplex Virus (HSV) is responsible for several clinically significant human viral diseases, with severity ranging from inapparent to fatal. Clinical manifestations include genital tract infections, neonatal herpes, meningoencephalitis, keratoconjunctivitis, and gingivostomatitis. There are two HSV serotypes that are closely related antigenically. HSV type 2 is more commonly associated with genital tract and neonatal infections, while HSV type 1 is more commonly associated with infections of non-genital sites. Specific typing is not usually required for diagnosis or treatment. The mean time to seroconversion using the type specific assay is 25 days. The performance of this assay has not been established for use in a pediatric population, for neonatal screening, or for testing of immunocompromised patients.


Herpes Virus 6 DNA, Qualitative, Real-Time PCR 

HERPES VIRUS 6 DNA,QL REAL TIME PCR


HHV-6 is a distinct herpes virus that typically causes a self-limiting illness in patients who are not immunocompromised. In some patients, especially if immumocompromised, HHV-6 can cause febrile convulsions in infants, encephalitis mononucleosis-like symptoms, and hepatitis.




Varicella-Zoster Virus (VZV) causes chicken pox and when reactivated, potentially decades later, causes shingles. Twenty percent of adults will develop shingles, a rash or blister of the skin that may cause severe pain. Varicella-Zoster IgG, EIA reliably measures immunity due to previous infection, but is unsuitable for detection of post-vaccination immune status.

The Varicella Zoster Virus Antibodies, IgG test is typically done to check for immunity to the virus which causes chickenpox.  Varicella Zoster Virus is a member of the Herpes Virus family.  This test measures the level of antibodies produced by the immune system in response to the virus.  Results provide a numerical value for the antibody level which can be compared to a reference interval to determine immune status.  IgG antibodies are typically detectable a few weeks after the initial infection.  In the United States, many people are vaccinated against Varicella when they are young.  In most cases those who contract the virus and recover develop a natural immunity which protects them from catching it again. 

The most common condition which results from infection with Varicella is Chickenpox.  The infection causes an outbreak of an itchy rash and the development of small fluid-filled blisters.  During the primary infection, chickenpox is highly contagious and spread through coughing, sneezing or touching fluid from the blisters.  Most people recover without treatment and the virus remains latent in their system.  There is a possibility for the virus to reactivate later in life, especially in those with weakened immune systems.  This can cause shingles, a condition characterized by a painful burning or itching sensation on one or more areas of the body.  Shingles typically clear up after a few weeks as the virus becomes latent again.

The Varicella IgG Antibody Titer is usually ordered when someone is required to show proof of immune status for work or school.  It may also be done for organ transplant patients or pregnant women.

The Varicella Titer is also available as part of our Immunity Panel which includes other common titer tests.


Varicella-Zoster Virus (VZV) causes chicken pox and when reactivated, potentially decades later, causes shingles. Twenty percent of adults will develop shingles, a rash or blister of the skin that may cause severe pain.


Did you know that the Centers for Disease Control (CDC) estimated that there were 572,000 new cases of genital herpes in the United States in a single year?

That's right. It's an incredibly common disease. But did you also know that most Americans who are infected aren't even aware of it? The CDC estimated that 87.4% of people in the 14–49 age range with the disease haven't been diagnosed!

Herpes is highly contagious and potentially dangerous, so don't stay in the dark about it. Keep reading to learn more about the symptoms of herpes and the different herpes tests that can be used to diagnose it.

About Herpes

Herpes simplex virus (HSV) produces a lifelong viral infection in humans. Both of its subtypes are highly infectious and transmissible. 

The first subtype, HSV-1, can cause infections of both the mouth and the genitalia. However, it is the primary cause of cold sores around the mouth (known in medical terminology as "herpes labialis"). These painful lesions can also affect the nasal passages and eyes.

HSV-2 is the main culprit behind genital herpes, outbreaks of which also cause blisters to erupt on or around the genitals, rectum, or mouth. During the first outbreak, which can occur from 2–12 days after exposure to the virus, these symptoms tend to be severe. The vesicles that appear break and leave behind painful ulcers that can take from two to four weeks to heal.

After this "first outbreak" episode, HSV remains in the body by invading the nerve cells, allowing it to hide from the immune system. There, it lies dormant until it reactivates, which happens sporadically. Once active, the virus uses the nerve's axon like a highway to travel to the skin, where it can begin replicating and shedding all over again.

HSV's ability to lie dormant and hidden from the immune system is one of the reasons it so often evades clinical diagnosis. Its resemblance to other skin conditions upon subsequent outbreaks, which are much milder than the initial one, are some more reasons why diagnosing genital herpes can be so difficult.

On rare occasions, both HSV subtypes can lead to aseptic meningitis.

Prevalence and Risk Factors

In the United States, the infection rate of HSV-1 is estimated at 47.8%, while that of HSV-2 is estimated at 11.9%. And although genital herpes is mainly caused by HSV-2, its infection rate is actually higher than that of HSV-2 itself. That's because HSV-1 can also cause genital herpes.

Age is not a significant risk factor. HSV can infect anyone at any age. Even a newborn can contract the disease from their infected mother during pregnancy, delivery, or the postpartum period. The primary risk factor, in any case, is coming into contact with a herpes infection.

HSV-2 was found to have been more prevalent among women (15.9%) than men (8.2%) during studies carried out from 2015–2016. This may be due to the fact that genital infections are transmitted more easily from men to women than vice versa during sexual intercourse.

Thus, an abbreviated list of risk factors for contracting genital herpes would include:

  • Having unprotected sex
  • Having multiple sexual partners
  • Having another sexually transmitted infection
  • Being female
  • Being immunocompromised at all

HSV-2 is also found more often among non-Hispanic blacks than non-Hispanic whites (34.6% versus 8.1%, respectively), and this disparity is present even among individuals with similar average numbers of sexual partners. 

Signs or Symptoms

The following are some warning signs of herpes infection.

  • Watery, blistering sores around the mouth or genitals
  • Painful urination
  • Itchy skin
  • Flu-like symptoms 
    • Headache 
    • Fever
    • Swollen lymph nodes
    • Fatigue
    • Decreased appetite
  • Herpes keratitis
    • Eye pain
    • Discharge
    • Redness
    • The feeling of a foreign substance in the eye

Bear in mind that an infected person is only more contagious when their infection is active. They can still spread the virus during periods of remission!

Laboratory Tests for Herpes

Anyone displaying the signs and symptoms outlined above (or with a sexual partner infected with HSV) should consider herpes testing so that it can be detected, officially diagnosed, and treated.

There are a variety of herpes tests available, and the best one depends on the patient's circumstances. Herpes testing does involve having blood drawn, though, so it cannot be done at home with a kit. Blood needs to be drawn by a qualified phlebotomist.

Serologic testing can be performed to identify past or recent exposure to HSV. However, it cannot tell precisely when exposure occurred, nor can it determine the infection site. The most common type of serologic test is the immunoglobulin G test, which can be targeted to either one or both subtypes.

Frequently Asked Questions

Is there a cure for herpes?

Antiviral therapy has been developed that can suppress the virus's activity, but no outright cure for either HSV-1 or HSV-2 has been found.

What kind of medication will I need to take to manage my herpes?

Antiviral drugs like acyclovir (Zovirax), famciclovir (Famvir), and valacyclovir (Valtrex) can be taken to prevent or shorten herpes outbreaks, making it less likely to infect others.

Are there only two subtypes of herpes?

No. In fact, there are six others, and they form the taxonomic family known as Herpesviridae.

Order Your Herpes Test With Ulta Lab Tests

Blood work needs to be done for herpes tests, and that can be expensive and difficult. But at Ulta Lab Tests, we've done all we can to make the process affordable and convenient.

We offer tests that are accurate and reliable, so you can make informed decisions about your health. The confidential results of your herpes simplex antibody IgM or IgG test will be with you within 24–48 hours.

You won't need insurance or a referral, and the doctor's order will be included in the price. And your satisfaction is 100% guaranteed!

Take control of your health with Ulta Lab Tests today!

Genital herpes is a common sexually transmitted disease (STD). A majority of people who have this virus do not have any symptoms. However, even when there are no signs of this disease, herpes may still be spread to the sex partners of the infected person.

What is genital herpes?

It is a type of sexually transmitted disease caused by two kinds of viruses. These viruses are HSV-1 (herpes simplex virus type 1) and HSV-2 (herpes simplex virus type 2).

What is oral herpes?

Usually, oral herpes is caused by HSV-1. It may result in fever blisters or cold sores around or on the mouth. However, a majority of individuals don’t have symptoms. Most individuals who have oral herpes became infected as children or young adults from non-sexual forms of contact with saliva.

Are there any links between oral herpes and genital herpes?

Oral herpes, which is caused by HSV-1, may be spread to the genitals from the mouth via oral sex. That is why HSV-1 causes some genital herpes cases.

Is genital herpes common?

In the US, genital herpes is fairly common – over one out of each six 14-49-year-old individuals has genital herpes.

How is genital herpes spread?

A person gets genital herpes from having oral, anal, or vaginal sex with an individual who has this disease. You can get infected with herpes, if you don’t have it already, by coming into contact with this virus in:

  • A herpes sore
  • Genital secretions (if a partner is infected with genital herpes) or saliva (if a partner is infected with oral herpes)
  • The skin within the oral area if a partner is infected with oral herpes, or skin within the genital area if a partner is infected with genital herpes

Herpes can be contracted from a sex partner who doesn’t have any visible sores or who isn’t aware that she or he is infected. Genital herpes can also be contracted if a sex partner with oral herpes gives you oral sex.

You won’t get herpes from swimming pools, bedding, toilet seats, or from touching objects like towels, soap, or silverware. If you have any more questions about the ways that herpes is spread, you should talk to a healthcare provider about your concerns.

What can I do to lower the chances of getting genital herpes?

The only thing you can do to avoid getting STDs is not having oral, anal, or vaginal sex. If you are a sexually active person, the following things can be done to reduce the risk of you getting genital herpes:

  • Use latex condoms properly each time that you have sex
  • Have a mutually monogamous long-term relationship with a partner not infected with an STD (a partner who was tested for STDs and showed negative test results)

Be aware that herpes sores do not always occur in areas covered by a latex condom, and the herpes virus may also be shed (released) from parts of the skin without any visible herpes sores. That is why condoms do not fully protect you from getting herpes.

If your partner has genital herpes, you can reduce your risk of obtaining genital herpes when:

  • Anti-herpes medication is taken daily by your partner. This is something that should be discussed by your partner and his or her physician
  • Avoid having oral, anal, or vaginal sex whenever your partner has any herpes symptoms (i.e., when your partner has an outbreak).

I am pregnant. How can my baby be affected by genital herpes?

If you have genital herpes and are pregnant, it is critical that you have prenatal care visits. Inform your physician if you have been diagnosed in the past with genital herpes or had any symptoms. You should also let your doctor know if you have been exposed at any time to genital herpes. Some research suggests that a genital herpes infection might lead to a miscarriage, or it could increase the chances of our baby being delivered too early.

Although it is possible to pass a herpes infection to your unborn baby,  it is more common to pass it to your baby during delivery. Either way, your baby can get a potentially fatal infection (neonatal herpes). During pregnancy, it is critical to avoid getting herpes. If you have genital herpes and are pregnant, towards the ending of your pregnancy, you may be offered anti-herpes medicine. The medicine may reduce your risk of having symptoms or signs of genital herpes when you are delivering our baby. At the delivery time, your doctor should examine you carefully for herpes sores. Usually, a C-section will be performed if you have herpes symptoms at the time of your delivery.

How can I tell if I have genital herpes?

A majority of individuals with genital herpes have only very mild symptoms or no symptoms at all. You might notice having mild symptoms, or you might mistake them for a different skin condition like ingrown hair or a pimple. This is why the majority of individuals with the virus are not aware that they have herpes.

Usually, herpes sores appear as one or several blisters around or on the mouth, rectum, or genitals. These blisters break and can leave sores that are painful and can take a week or longer to heal. Sometimes the symptoms are referred to as “having an outbreak.” The very first time that a person has an outbreak, the individual might have flu-like symptoms as well, like swollen glands, body aches, or fever.

People experiencing an initial herpes outbreak may have repeated outbreaks, particularly if they have been infected with HSV-2. Repeated outbreaks are normally less severe and shorter compared to the initial outbreak. Although this infection remains in the person’s body for the rest of their life, over time, the number of outbreaks might decrease.

You should have your doctor examine you if you notice any symptoms or if your partner has STD symptoms or an STD. STD symptoms may include burning when urinating, an unusual sore, smelly genital discharge, or bleeding between periods (for women).

How can my doctor tell if I have herpes?

Your healthcare practitioner might diagnose genital herpes by just looking at your symptoms. A sample can be taken from the sore(s also and tested. Also, a blood test might be used in certain situations to search for herpes antibodies. Talk to your healthcare practitioner and ask them whether you should be tested for STDs such as herpes.

Note: Although a herpes blood test may help to determine whether or not you have a herpes infection, it will be unable to tell how long you have been infected or who gave you your infection.

Is there a cure for herpes?

Herpes has no cures. However, medicines are available that can help to shorten or prevent outbreaks. There is an anti-herpes medication that is  taken on a daily basis, which makes it less likely that an infection will be passed to a sex partner.

What will happen if I am not treated?

Genital herpes may cause painful genital sores, and for individuals with suppressed immune systems, it can be severe.

If you touch fluids from your sores or the sores themselves, you could transfer herpes to a different part of your body, like your eyes. You should not touch the fluids or sores to avoid spreading herpes to a different part of your body. But if you do happen to touch the fluids or sores, thoroughly wash your hands immediately to avoid spreading the infection.

For a pregnant woman, there may be problems for the mother and her newborn baby or developing fetus. See the section above for more information.

If I have herpes, can I still have sex?

If you have herpes, it is important to discuss it with your sex partner(s) and tell them that you have the virus and the risks that are involved. You can help to lower the risk by using condoms, but it won’t completely eliminate the risk. Having sores or other herpes symptoms can help to increase the risk of you spreading the disease. You can still end up infecting your sex partners even if you don’t have symptoms.

You might have concerns about the ways that genital herpes can impact your relationships, sex life, and overall health. The best thing to do is to talk with your healthcare practitioner about any concerns you have, but also it is very important for you to recognize that although there is no cure for herpes, you can manage it by taking medication. Using antiviral medicines daily (or daily suppressive therapy) can reduce the risk of you spreading genital herpes to sexual partners. Treatment options should be discussed with your healthcare practitioner. A genital herpes diagnosis might affect the way you feel about a future or current relationship, so understanding how to discuss STDs with sexual partners is very important. 

Is there a link between genital herpes and HIV?

Breaks or sores in the skin or the lining of the rectum, vagina, or mouth can be caused by herpes infection. That can provide HIV with a way of entering the body. Even without any visible sores, when you have genital herpes, it increases how many CD4 cells you have (cells targeted by HIV for entering the body) in the lining of your genitals. When an individual has both genital herpes and HIV, there is a higher chance that HIV will spread to the sex partner who is not infected with HIV during sexual contact with a partner’s rectum, vagina, or mouth.

Where can I get additional information on genital herpes?

Centers for Disease Control and Prevention

Division of STD Prevention (DSTDP)

www.cdc.gov/std

CDC-INFO Contact Center

1-800-232-4636 (1-800-CDC-INFO

wwwn.cdc.gov/dcs/ContactUs/Form

American Sexual Health Association (ASHA)

www.ashasexualhealth.org

919-361-8488

P. O. Box 13827

Research Triangle Park, NC 27709-3827

CDC National Prevention Information Network

https://npin.cdc.gov/disease/stds

P.O. Box 6003

Rockville, Maryland 20849-6003

Content source: Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention