Screening for Genital Herpes
Screening for Genital Herpes
There are 2 types of test for Herpes:
Blood test – for people without symptoms
Swab test – for people with skin symptoms like rash, ulcer, blisters etc
If you wish to have a test for Herpes, please visit any one of our clinics. We use gold-standard testing methods and provide a discrete, comfortable and 100% confidential setting for our patients.
Genital Herpes is very common and is incurable. Herpes infection of the genitals can be caused by either Herpes Simplex Type 1 (HSV 1) or Herpes Simplex Type 2 (HSV 2).
Previously, Herpes was mostly diagnosed via physical examination of typical symptoms and confirmed by testing swab samples taken from the blisters. However, since up to 80% of people with Herpes do not show any symptoms, this method misses out the vast majority of people who carry the Herpes virus.
Previously, blood tests for Herpes were extremely inaccurate and almost impossible to interpret. Now however, newer blood tests have greatly increased in accuracy thus giving us the option to screen for asymptomatic Herpes infections.
However, before you run to your doctor’s and request for a blood test for Herpes, there are certain things you should know about.
How accurate are Herpes blood tests?’
About 96% sensitive and 97% specific. In other words, if the test says you do not have Herpes, it is wrong 4% of the time and if it says that you do, it is wrong 3% of the time. This is when the Index Value comes into play. If the Index Value is more than 3.5, it is extremely likely that it is a true positive.
Of course, the gold standard for Herpes antibody identification is the Western Blot but that is not available in Singapore. Even then, the accuracy only reaches 99%.
Please remember that all the above only applies to people with no symptoms. If you do get symptoms, you should see a doctor for a swab test.
What are the symptoms of Genital Herpes?
Classic textbook symptoms are a cluster of painful blisters appearing in crops of 3 to 5 that break and form ulcers. Several crops would appear over a few days. Initial attacks can last up to 3 weeks. The blisters are always surrounded by red skin earning them the rather romantic name of ‘dewdrops on a rose petal’.
However, symptoms are not always classical. Herpes symptoms have been misdiagnosed as yeast infections, urinary tract infections, razor burn, insect bites, friction rubs, allergic reactions etc
When should I test for Herpes?
Antibodies to Herpes can usually be detected in 2 to 3 weeks from the time of infection. However, detectable antibodies can take up to 16 weeks to appear.
Can I swab normal looking skin to look for Herpes?
Yes you can. In fact, there was a study that used this method to determine the frequency of asymptomatic viral shedding of Herpes. But since it is estimated that the virus only sheds 20% to 25% of the time, you will need many swabs in order to get an accurate answer. This can be very costly.
How effective are condoms against Herpes?
Apparently not very useful at all. There was one study that said consistent and correct used of condoms provided 30% protection against Herpes.
How effective is suppressive treatment in preventing Herpes transmissions?
We do not really know. Studies have quoted anything from 48% to 71% reduction in risk of transmission. So we know that it does reduce the risk of transmission. And since these medicines have very few side effects if at all, and are rather low cost, doctors are advised to at least speak to their patients about the option.
So should I test for Herpes if I have no symptoms?
This is the golden question. Everyone can deal with a clear result. So if you test and the test shows you have no Herpes infection, all is well and good.
The question to ask yourself is can you deal with a positive result? Getting a positive Herpes test can be emotionally overwhelming. So you need to ask yourself what will you do if you are tested positive. If you are doing the test for a specific reason like you intend to take suppressive treatment to protect your spouse if you are positive etc then I think that is a very good reason to test. In other words, the test results will make a difference in clinical decision making. If you are testing because you just want to know, then please be emotionally and psychologically prepared to deal with a positive result.
Also, you have to bear in mind that the blood test can only tell you if you are infected with Herpes or not. It does not tell you where the infection is. If you test positive for HSV 2, then most likely you have genital herpes. This is because HSV 2 mostly infects the ano-genital region. However, HSV 2 has been found in the head and neck area too. HSV 1 is much more complicated as it can infect both areas just as frequently. If there are no symptoms, it will be impossible to determine where the Herpes infection is.
Follow this link for more information on Herpes.
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About Dr. Tan
Dr. Tan graduated from the National University of Singapore in 2001. His residency was in the two largest public hospitals in Singapore; Tan Tock Seng Hospital and Singapore General Hospital.