Diagnosing genital herpes

When should you see a doctor?

Any genital herpes symptoms experienced should be examined, diagnosed and treated by a medical health professional (general practitioner or gynaecologist) as soon as possible.

Diagnosis and herpes tests

To make a diagnosis, your doctor will likely ask you a series of questions. These can include:

• What are your symptoms?
• When did your symptoms begin?
• Are you currently sexually active?
• Do you have a new sexual partner or multiple partners?
• Have you ever been diagnosed and treated for another sexually transmitted infection?
• Do you use condoms with your partners?
• Are you taking any medications or supplements?
• Are you experiencing any pelvic pain?
• Are you experiencing pain while urinating?
• Have you noticed any unusual discharge or sores in your genital area?

Your doctor will then conduct a physical exam and or / perform laboratory tests to make a genital herpes diagnosis. Tests he or she may perform include:

• Viral culture: A tissue sample (cells) or scraping of sores will be taken for examination under a microscope in the laboratory.
• Polymerase chain reaction (PCR) test: A sample of blood, tissue from a sore or spinal fluid will be taken. A PCR test will be used to test pieces of the virus’s DNA and establish both its presence, as well as which type of HSV it is. The PCR test is very accurate and is the most common test done to diagnose genital herpes.
• Blood test / Antibody test: A blood sample will be taken to assess the presence of HSV antibodies (detect a herpes infection). Antibodies are proteins produced by the immune system in response to an infection. A sample of cells (blood sample) will be taken for analysis under a microscope. A solution containing HSV antibodies and a fluorescent dye will be added to the sample. Antibodies will ‘stick to’ the cells if the virus is present and glow. This test will only determine if you have been exposed to or have ever had the herpes virus. ⁽⁵⁾ An antibody test can tell the difference between HSV-1 and HSV-2 types. 

A viral culture or PCR test can give a false-negative result. This generally happens if an infected person’s sores have begun the healing process or if a person has very recently become infected (before HSV antibodies are present in the blood).

A false-negative will show that you do not have genital herpes, even when in fact you might. ⁽⁶⁾ False-positive results are also possible, where a person may test positive for the virus, but the risk of getting it is low. In this case an individual may be re-tested.

A viral culture and PCR test will show that you have been exposed to the virus at some point. It will not determine when exposure may have occurred. It is possible, and your doctor may recommend testing for HSV in saliva, tears or urine. Your doctor may also order any other STD test that is appropriate at the time.

At home herpes test kit options

In the event that you would prefer to conduct a self diagnostic herpes test, you can order one online from a reliable provider. Here's everything you need to know: STD testing and at home herpest test kit options, their reliability and accuracy.

References:

^{5. SA Health - Government of South Australia. Herpes Test: https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/health+topics/health+conditions+prevention+and+treatment/medical+tests/herpes+test [Accessed 29.08.2018]}

^{6. Centers for Disease Control and Prevention. February 2017. Genital Herpes Screening FAQ: https://www.cdc.gov/std/herpes/screening.htm  [Accessed 29.08.2018]}