[Question #2565] Herpes 2 Blood Test

44 months ago

A woman I am dating is asking me to get a Herpes 2 blood test.  Doctors I have spoken to recommend against taking the test.  I have had a full panel of recommended STD blood tests and all were negative.

I have had no outbreak or symptoms of herpes ever.  8 years ago I was in a 9-month monogamous relationship with a woman who had Herpes, but who was on suppression therapy. She had no outbreaks during that time. We always used condoms.

Since then I have been in other monogamous relationships.  One of the women I dated was for 3 years, she was on the pill, so we didn’t use condoms.  Neither she nor I have ever any symptoms of Herpes since.

During my own research, I came across this article that also recommends against taking the test as the test I would take has up to a 50% false positive rate. The letter grade from the US preventive task force for Serologic Screening of Herpes is a D.

http://jamanetwork.com/journals/jama/fullarticle/2593571

Do you believe I should go against the recommendation and have a Herpes 2 blood test?  Also, according to the article, the Focus HerpesSelect test has up to 50% false positive.  If you do believe the test is of value, then could you explain why you think it is valuable?  My fear is that I get a false positive, and all that that entails based on a coin flip.

The only other potentially pertinent information is that I have never had chicken pox, despite being exposed as a child.  Either I had a subclinical case, or I may have an immunity.


Terri Warren, RN, Nurse Practitioner
Terri Warren, RN, Nurse Practitioner
44 months ago
There is some misinformation here.  IF you achieve an index value of 1.1 to 3.5, there is a 50-50 chance that this is a false positive.  In that case, the CDC recommends that a second test, preferably the western blot, be done to sort out the true from false positives.  This two tier approach is one we used in our clinic for the past 25 year and which Dr. Ned Hook discusses in a response to the USPTF article.  The CDC recommends also against routine screening of the population for herpes but it also says herpes testing "should be considered" when a person presents for an STD screen.  I think this is essentially the positionh that you are in - your partner accepts the rest of your STD screen but wishes you to include herpes as well. 

I personally included herpes testing in every STD screen we did at our clinic unless a patient refused.  If they tested between 1.1 and 3.5, a western blot was done to get a clearer answer.  It was simply routine to do that two tiered approach.  We kept records for 7 years, and during that time, the rate of people who tested between 1.1 and 3.5 ranged from 5.1 to 5.8% of the people we tested - the rest were negative or above 3.5.  I absolutely do not agree that a person with an index value of >5 has a 50-50 chance of being a false positive.  That is just not so.  The work by Dr. Rhoda Ashley Morrow very clearly shows that people who test above 3.5 have a 90% of higher rate of being confirmed by western blot.  Or you could skip the IgG test and just jump right into the western blot if you are worried about the possibility of a false positive.  It is done only at the UW but they can send you a kit for the blood draw and shipment to them and the process of usually pretty quick once you get going. 

Clearly this is important to her for some reason and I personally think you can test and come up with an answer that you can be certain about, one way or another. 

Terri
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