Diagnostic Testing For Genital and Oral Herpes

I am continuously asked by people about testing for genital and oral herpes, as well as what the various tests mean regarding both oral and genital herpes.

Initially: The only valid blood test for the diagnosis of herpes is the IgG/IgM (Elisa) blood test. If you examine your test results you'll see the letters IgM and IgG. If the IgM is positive it means that the infection is active.

If IgM is negative and IgG is positive, it means that you have developed sufficient antibodies to put the virus into remission. i.e. The IgG/IgM test will tell you whether you have a current infection or residual antibodies from a previous infection.

Unfortunately people don't retain antibodies for life, if they did then they wouldn't have these repeated outbreaks. The cases where the virus has been destroyed in the body, the antibodies are only active for a short time and then the patient can easily be reinfected.

The length of time that antibodies remain in the blood varies greatly from one person to another. Factors to be considered are repeated exposure to the virus, stress, even unrelated diseases which can affect the body's immune system.   

With the standard IgM/IgG (Elisa) test, if the treatment was successful the result will be IgM negative IgG positive as there will still be antibodies in the blood.

Afterwards: A newer "gold standard" is even more sensitive than the standard blood test. This test is called the PCR (Polymerase Chain Reaction) DNA test, (Done from spinal fluid) and it can identify the DNA from viral particles to an extremely high degree of accuracy and can differentiate between the two types. This test directly reveals the presence or not of viral DNA of either type of virus.

The standard IgM/IgG blood test cant tell if viral DNA is present or not because herpes, cytomegalovirus and the coxsackie viruses are not present in blood in their latent stages, only a PCR DNA test can.

Let me put it to you this way: If the treatment was successful the PCR DNA test (done on spinal fluid) result will be negative indicating that no viral DNA could be detected. The PCR tracks viral DNA. The absence of viral DNA means no Virus = no Disease no Outbreaks. Cured!

You will not experience any outbreaks at all unless you are reinfected somehow. In cases where the virus has been destroyed in the body, the antibodies that protects you are only active for a short time and then the patient can easily be reinfected, not necessarily by sexual contact, but also by droplet infection (an infected person coughing or sneezing at you) infected paper money or even toilet and door handles. As +- 80% of the population is thought to be infected it is easy to see how reinfection can happen.  

To satisfy yourself that you are free from the disease you have a P.C.R. DNA test which detects viral DNA. The PCR test is almost 300% more sensitive in picking up actual viral material from spinal fluid than was the viral culture. a P.C.R DNA test is taken at any time following completion of treatment.  

The ultimate test is PCR of spinal fluid, it is the most accurate test for viruses in existence to detect viral DNA. The PCR test can be done on blood but it is uncertain, more reliable on spinal fluid where the virus hides between outbreaks. The PCR DNA test tracks viral DNA and can find herpes simplex virus even when no symptoms are present. The PCR tracks Viral DNA. Absence of DNA means no Virus.  

When PCR is negative it means that no viral DNA could be detected. i.e. No viral DNA means no virus, therefore no disease. Cured if you like. And what's more you cannot transmit a disease that no longer exists in your body.   

Sadly, in some countries the PCR DNA test is not routinely available to the clinician in the office at this time. However if your doctor has the ability to perform PCR DNA testing for herpes simplex, ask for that instead of a Standard Blood Test.