1. Testing for
Testing for
Herpes Simplex
Herpes Simplex
Infections
Infections
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2. Tens of millions of people
have been diagnosed
with herpes infections
3. Genital Herpes Issues
Genital Herpes Issues
•• The Most Common Cause of Genital
The Most Common Cause of Genital
Ulceration is Herpes Simplex
Ulceration is Herpes Simplex
•• Increasing Incidence -- 30% increase
Increasing Incidence 30% increase
over the past decade
over the past decade
•• Approximately 90% of Recurrent Genital
Approximately 90% of Recurrent Genital
Herpes is Caused by
Herpes is Caused by
Herpes Simplex 2 Virus (Type 2)
Herpes Simplex 2 Virus (Type 2)
4. Why Do We Need a New
Why Do We Need a New
Diagnostic Testing Method?
Diagnostic Testing Method?
•• One in Four Adults are Infected with the
One in Four Adults are Infected with the
Herpes Virus -- 45 Million People
Herpes Virus 45 Million People
•• Only 20% of Those Individuals Have Been
Only 20% of Those Individuals Have Been
Diagnosed
Diagnosed
•• Most Cases of Genital Herpes Do NOT Present
Most Cases of Genital Herpes Do NOT Present
with the “Typical Symptoms” of External
with the “Typical Symptoms” of External
Lesions (Blisters)
Lesions (Blisters)
5. Why Do We Need a New
Why Do We Need a New
Diagnostic Testing Method?
Diagnostic Testing Method?
A major challenge posed by genital herpes is that
A major challenge posed by genital herpes is that
virtually all infected (seropositive) individuals,
virtually all infected (seropositive) individuals,
regardless of history, have periods of active viral
regardless of history, have periods of active viral
shedding. All are potentially capable of
shedding. All are potentially capable of
transmitting the infection to sexual partners; yet,
transmitting the infection to sexual partners; yet,
most take no precautions because they have not
most take no precautions because they have not
been diagnosed, counseled, or managed with anti-
been diagnosed, counseled, or managed with anti-
viral therapy.
viral therapy.
6. What is the problem?
What is the problem?
You’d think by now
that the method of diagnosing
the disease was
easy and straightforward…
…but often it is not
7. Why is this?
Why is this?
Most people already
Most people already
have type 1 HSV
have type 1 HSV
latently on the face
latently on the face
8. Blood testing
Blood testing
So, blood tests
showing a positive
test for type 1
don’t necessarily
tell you anything
about genital
infections
9. The “Gold Standard”
The “Gold Standard”
remains the
remains the
Viral Culture
Viral Culture
…unless PCR DNA testing
…unless PCR DNA testing
is available
is available
10. A positive viral culture
A positive viral culture
gives the diagnosis.
gives the diagnosis.
Remember to ask that
Remember to ask that
the virus be “typed”
the virus be “typed”
11. Incidence of Genital HSV
Incidence of Genital HSV
by Types
by Types
In America, about 75%
In America, about 75%
of new cases of genital HSV
of new cases of genital HSV
are caused by type 2,
are caused by type 2,
25% by type 1
25% by type 1
12. Incidence of Oral HSV
Incidence of Oral HSV
by Types
by Types
In America, almost all
In America, almost all
cases of new oral HSV
cases of new oral HSV
are type 1, and 80% or more
are type 1, and 80% or more
of people develop oral HSV
of people develop oral HSV
as children
as children
13. How to do
How to do
Testing
Testing
Start with a
Start with a
viral culture of the
viral culture of the
suspected herpes lesion
suspected herpes lesion
If it is positive,
If it is positive,
then the diagnosis is made
then the diagnosis is made
14. How to do
How to do
Testing
Testing
If the culture is negative,
If the culture is negative,
do “type specific serology”
do “type specific serology”
for HSV types 1 and 2.
for HSV types 1 and 2.
Alternative: POCkit test
Alternative: POCkit test
15. Test
Test
Interpretation
Interpretation
If genital lesions are
If genital lesions are
present and type 2
present and type 2
blood testing
blood testing
is positive, then
is positive, then
the problem is probably
the problem is probably
type 2 genital HSV
type 2 genital HSV
16. Test
Test
Interpretation
Interpretation
If genital lesions are
If genital lesions are
present and ONLY type 1
present and ONLY type 1
blood testing
blood testing
is positive, then
is positive, then
the problem MIGHT BE
the problem MIGHT BE
type 1 genital HSV
type 1 genital HSV
17. Test
Test
Interpretation
Interpretation
Remember, though, that
Remember, though, that
most people have positive
most people have positive
type 1 antibody anyway
type 1 antibody anyway
…so where did
…so where did
that antibody come from?
that antibody come from?
18. Test
Test
Interpretation
Interpretation
If all blood tests are
If all blood tests are
negative, repeat them
negative, repeat them
in about three months.
in about three months.
If either one turns
If either one turns
positive, then that type is
positive, then that type is
probably the cause of the
probably the cause of the
herpes outbreak.
herpes outbreak.
19. The New
The New
“POCkit Test”
“POCkit Test”
for type 2
for type 2
herpes simplex
herpes simplex
antibody
antibody
23. Testing can be
Testing can be
very confusing
very confusing
for many people
for many people
Use ONLY
Use ONLY
type specific
type specific
blood testing
blood testing
24. Negative tests
Negative tests
do NOT completely
do NOT completely
rule out the possibility of
rule out the possibility of
HSV infections,
HSV infections,
especially in the case
especially in the case
of a viral culture
of a viral culture
25. Maintaining contact
Maintaining contact
with a knowledgeable physician
with a knowledgeable physician
and utilizing Internet resources
and utilizing Internet resources
such as on-line pharmacies,
such as on-line pharmacies,
Herpes.org and Herpeshelp.com
Herpes.org and Herpeshelp.com
can really help to provide
can really help to provide
information that can help people
information that can help people
get tested appropriately and
get tested appropriately and
receive the right treatment.
receive the right treatment.
26. Please contact
the Webmaster
at webmaster@herpes.org
if you have
any questions!
