December 13, 2012
Identifying Genital Herpes and Herpes Testing
By: Victor. Battles,
Because genital herpes is one the most
common sexually transmitted diseases, early diagnosis and treatment are necessary. Unfortunately however, the
variability or nonexistence of symptoms associated with it causes it to oftentimes go unrecognized and undiagnosed
unless proper herpes testing is performed. It is because of its varying faces and disguise the neologism herpes
incognito is born.
This STD is caused by herpes simplex virus, of which there are two forms, type 2 and type 2. For short the type I
virus is designated as HSV-1 and the type 2 virus is designated as HSV-2. It was formerly believed in the
healthcare field that HSV-1 only caused disease above the waist, primarily cold sores around the mouth and that
HSV-2 was responsible for infection below the waist in the genital areas manifested by blisters. It is currently
recognized in today’s age however, that either virus can cause infection in either area of the body, which must be
considered when undergoing herpes testing. Most cases of genital herpes are caused by HSV-2 and most cases of cold
sores, also known as herpes labialis, are caused by HSV 1 however.
medical training back in the 80s it was the general perception that genital herpes was easily recognized and
diagnosed because infected individuals develop genital blisters which break open resulting in a raw sores that
form scabs and generally heal within 1-3 weeks. Given this classic presentation the diagnosis can be easy
confirmed by herpes testing of fluid from the blisters, but unfortunately it is now recognized that most
individuals with genital herpes don’t experience the classic presentation.
Conversely, many individuals only notice skin
irritation, breakage, or tearing in the genital area which is suspected to be the result of chafing by tight
fitting clothes, or other factors such as wiping, laundry detergent or bath soap. Because the area heals with 7
-10 days of applying a believed home remedy, the infected person concludes that mechanical irritation was the
cause of the symptoms, when in fact, the experience was the natural course of a mild herpetic outbreak which
might have been initial or recurrent.
testing of a specimen obtained by swabbing the area of an atypical outbreak will sometimes provide a diagnosis
but more times than not, herpes blood testing is required to unmask genital herpes incognito and establish the
diagnosis when the disease presents in such a disguised manner, because testing of swabbed specimens frequently
results in false negative test results.
As common as the disguised presentation of genital herpes is, it is more commonly invisible inasmuch as most
individuals affected with the HSV does not have any symptoms at all. Many of these individuals will have their
initial outbreak months to years after initial infection and sometimes will never manifest symptoms. This fact
explains why 80% to 90% of individuals who have the disease are not aware of having it despite shedding of the
virus and transmissibility during sexual intercourse. Since one in five adults and teenagers has genital herpes and
most are not aware of it because of the absence of symptoms, it is easy to understand why HSV infection is epidemic
at this time.
absence of classic symptoms, the only reliable way of diagnosing genital disease is through serologic herpes
testing of blood. These serologic tests measure antibodies produced by the immune system of the infected
individual in its unsuccessful attempt to rid the body of the infection. These tests can distinguish between HSV
1 and HSV-2, thus providing partial but not absolute distinction between herpes labialis (cold sores) or genital
to avoid negative test results when undergoing serologic herpes testing of blood it is important to make sure
that the testing is not performed during the window period, which is the timeframe between the initial infection
and the body’s development of antibodies against it. The window period is generally 4 to 6 weeks for the herpes
test which detects acute infection and can be up to 3 to 6 months for the test which detects chronic or latent
today’s FDA approved blood tests which detect antibodies to HSV-1 and HSV-2 are very accurate and because most
infected individuals don’t have classic symptoms herpes testing of blood is the most common and reliable
means of identifying the disease.
This article is for informational purposes 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.
The author is a board certifed internist with 20 + years of experience.
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