December 14, 2012
A Genital Herpes Conundrum Begets a Herpes Testing Verdict
"Knowledge is precious, especially when tempered by prudence."
By: Victor Battles
Because of improvements in methodology in recent years herpes blood tests for diagnosing genital herpes have
made herpes testing more accurate and reliable. Currently available FDA approved tests are highly sensitive
and specific, which means they result in few false positive and few false negative herpes test results. Given
the reliability of these tests, when ordered appropriately, they can provide answers to some of the puzzling
questions and concerns that arise following an apparent new onset of signs and symptoms of
For the purpose of this discussion and to
illustrate the central point, consider a scenario in which two individuals (partner at A and partner B)
have been involved in an intimate relationship for approximately one year. Partner B has been monogamous
throughout the relationship and has never been diagnosed with genital herpes, but on day notices the acute onset of
signs and symptoms of the disease including blisters in the genital area. After seeing a physician and being
diagnosed with genital herpes via testing of fluid from the blisters partner B is rather distraught, angry,
disappointed and confused.
Because partner B has never had any
prior signs or symptoms of genital herpes he or she assumes that the std was contracted from partner A
and wonders if partner A is aware of having it but concealed it or is unaware. Before any form of guilt is
attributed to partner A however, partner B needs to be absolutely certain that the newly experienced
signs and symptoms is in fact an initial outbreak and if so the std was contracted from
partner A. Judicious herpes testing can provide answers.
Today's commercially available herpes blood
tests diagnose genital herpes by detecting antibodies produced by the body which are directed against the
herpes simplex virus which causes the disease. Antibodies are small molecular particles generated by one's immune
system (defense mechanism) in an attempt to fight off and rid the body of foreign particles including those
that cause infection. Antibodies that are produced early on, generally within days to a few weeks following
infection, are called IgM antibodies. Those that are produced much later, sometimes up to 6 months after
infection, are called IgG antibodies.
Because the std may not cause the
body to produce IgG antibodies for weeks to months following infection its purpose is primarily for establishing a
diagnosis chronic disease well after the initial infection. The herpes blood test which measures IgM
antibodies, on the other hand, is for diagnosing acute disease unless a diagnosis has been made via testing of
fluid from the area of an outbreak as was the case in scenario presented.
IgM antibodies usually recede or vanish after
the initial acute infection but IgG antibodies usually remain detectable as long as infection is present,
whether it is active or latent. Since there is not any known means of eliminating the virus from the body once
infection is established, IgG antibodies are presumed to remain detectable throughout the life of an
individual who has been infected.
In the scenario presented partner B could
prove with reasonable certainty that the disease was contracted from partner A if partner A
undergoes herpes blood testing and has elevated IgG antibodies, partner B undergoes herpes blood testing and
has elevated IgM antibodies within 4-6 weeks of the outbreak, and partner B's IgM antibodies begin to decline
4-6 weeks after the genital outbreak. One caveat to relying on IgM antibodies alone to diagnose acute genital
herpes and an initial outbreak however, is the discovery through recent research that in some
individuals IgM antibodies rise again during recurrent genital outbreaks, in which case herpes testing of
partner B with measurement of IgG antibodies at least 6 week intervals and as far out as 6 months from the
initial genital herpes outbreak if necessary could confirm that partner B contracted genital herpes from
partner A if the IgG antibodies were initially not elevated but rise during the period of time just
The scenario discussed in this article is but
one example of how herpes blood tests can elucidate some of the questions and circumstances surrounding newly
discovered disease. Appropriate herpes testing can also be helpful in other scenarios depending on the
circumstances if the herpes testing is done thoughtfully and methodically.
This article is for informational purpose only and is not intended to be legal advice or a substitute for medical
consultation with a qualified professional. If you are seeking legal advice or are unsure about your medical
condition you should consult an attorney and/or physician.
For more information about herpes testing and for sources of STD testing in
general click here.
The author is a board certified internist who began solo practice in 1983. In addition to direct patient care he
has been involved in clinical research. He is currently a disability consultant and owner of Proactive Health