[Question #3398] Herpes Testing Accuracy

89 months ago

Dear experts:

I am wondering about the accuracy of herpes blood tests for someone that's had riskier unprotected sex and may have had past suspicious symptoms. I realize that no AB test will be accurate if not enough time has elapsed for antibodies to build.

I'm a bit confused about the antibody tests. Do all IgG tests offered by Quest and Labcorp offer the same accuracy? I've seen Terri Warren write that the IgG hsv1 test misses 30%. That seems very high and completely unreliable.

Also, I've seen at home tests for hsv2, specifically the Everlywell HSV2 home test. What does it test for and is it accurate? Should an at home test like Everlywell be relied on for someone that may of had a sexual encounter with an hsv2 infected partner?

Thank you

Terri Warren, RN, Nurse Practitioner

89 months ago

The IgG test does indeed misses 30% of infections and 8% of HSV 2 infections - this paper was published last year in STD. It appears that the testing by LabCorp and Quest appear to both have issues but right now I am gathering more data on that question specifically
I don't know anything about the Everlywell home test - are you in the US?
The best test is the herpes western blot - it is considered the gold standard of herpes antibody testing.

Terri
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89 months ago

Hi Terri,

Thank you for taking my question.

Yes, I am in the United States. I emailed Everylywell and didn't get much in the way of good information from them.

Wow, the hsv2 igg tests miss 8% of infections? I didn't know that. It seems like a pretty large number of infections to miss. I thought the Focus igg test missed only 2-4%. Did something happen over the last few years to the test?

Is the test missing due to the virus' biology or the infected person's biology?

Terri Warren, RN, Nurse Practitioner

89 months ago

Often studies for accuracy of antibody tests are based on populations where herpes is known - positive swab test, likely. but we based our study on people who are simply SCREENING - no known infection,and it missed 8% of 2, 30% of 1, compared to the gold standard western blot. We think it is a function of the test rather than the immune system because the western blot (the best antibody test) DOES pick it up.

Terri
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89 months ago

One quick followup... Is there a commercially available test that provides more accuracy than the elisa igg hsv2 test? Or is the WB the only option?

Terri Warren, RN, Nurse Practitioner

89 months ago

western blot is the best option. Another test that may be useful if you can find it is called Biokit. It's not quite as good as the blot but better than the IgG test.

Terri
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