Can you only test positive for herpes during an outbreak

Does this test have other names?

HSV-1 antibodies, HSV-2 antibodies

What is this test?

The herpes simplex virus antibodies test is a blood test that screens for the herpes simplex virus (HSV). Culturing a sample from an active outbreak of HSV is the best method to diagnose a current infection. But the herpes simplex virus antibodies test can help identify the recurrence of a previous infection.

Why do I need this test?

You may need this test if you believe you may have herpes, but you don't have an active infection. For instance, if you have had sex with a partner who has herpes infection.

You may also have this test if you have HIV. Or are pregnant or hope to become pregnant. The herpes simplex virus antibodies test screens for current or previous HSV infections.

In some cases, the HSV antibodies test can be used to diagnose an active HSV infection. But more often, a herpes culture is used.

The antibodies test is valuable because many early herpes infections show no symptoms. If symptoms do happen, they can include soreness, as well as pain or burning at the site of the infection. This often happens before the outbreak of sores. You may also have headache, fever, body aches, or pain.

What other tests might I have along with this test?

If you have an active herpes infection, you may also need a physical exam so your healthcare provider can visually inspect the sores. Your provider may collect a sample from the sores to culture in a lab.

What do my test results mean?

Test results may vary depending on your age, gender, health history, and other things. Your test results may be different depending on the lab used. They may not mean you have a problem. Ask your healthcare provider what your test results mean for you.

If your test result is positive, it can mean that you have an active herpes infection without symptoms. It can also mean that you had an HSV infection in the past. The antibody blood test is not as reliable as culturing a sample from a herpes sore. But in a herpes infection without symptoms, it can be a useful method for finding out if you have an infection.

How is this test done?

The test is done with a blood sample. A needle is used to draw blood from a vein in your arm or hand. 

Does this test pose any risks?

Having a blood test with a needle carries some risks. These include bleeding, infection, bruising, and feeling lightheaded. When the needle pricks your arm or hand, you may feel a slight sting or pain. Afterward, the site may be sore. 

What might affect my test results?

An antibody test for HSV is not as reliable as culturing a sample from an active herpes outbreak because the results are not always easy to interpret. A positive test result can mean you have an active infection, or simply that you were exposed to the virus at some point in the past.

How do I get ready for this test?

You don't need to get ready for this test. Be sure your healthcare provider knows about all medicines, herbs, vitamins, and supplements you are taking. This includes medicines that don't need a prescription and any illegal drugs you may use.

What is a herpes (HSV) test?

Herpes is a skin infection caused by the herpes simplex virus, known as HSV. HSV causes painful blisters or sores in different parts of the body. There are two main types of HSV:

  • HSV-1, which usually causes blisters or cold sores around the mouth (oral herpes)
  • HSV-2, which usually causes blisters or sores in the genital area (genital herpes)

Herpes is spread through direct contact with sores. HSV-2 is usually spread through vaginal, oral, or anal sex. Sometimes herpes can be spread even if there are no visible sores.

Both HSV-1 and HSV-2 are recurring infections. That means after your first outbreak of sores clears up, you may get another outbreak in the future. But the severity and number of outbreaks tend to lessen over time. Although oral and genital herpes can be uncomfortable, the viruses usually don't cause any major health problems.

In rare cases, HSV can infect other parts of the body, including the brain and spinal cord. These infections can be very serious. Herpes can also be dangerous to a newborn baby. A mother with herpes can pass the infection to her baby during delivery. A herpes infection can be life threatening to a baby.

An HSV test looks for the presence of the virus in your body. While there is no cure for herpes, there are medicines that can help manage the condition.

Other names: herpes culture, herpes simplex viral culture, HSV-1 antibodies, HSV-2 antibodies, HSV DNA

What is it used for?

An HSV test may be used to:

  • Find out whether sores on the mouth or genitals are caused by HSV
  • Diagnose an HSV infection in a pregnant woman
  • Find out if a newborn is infected with HSV

Why do I need an HSV test?

The Centers for Disease Control and Prevention (CDC) does not recommend HSV testing for people without symptoms of HSV. But you may need an HSV test if:

  • You have symptoms of herpes, such as blisters or sores on the genitals or other part of the body
  • Your sex partner has herpes
  • You are pregnant and you or your partner has had a previous herpes infection or symptoms of genital herpes. If you test positive for HSV, your baby may need testing as well.

HSV-2 may increase your risk of HIV and other sexually transmitted diseases (STDs). You may need a test if you have certain risk factors for STDs. You may be at higher risk if you:

  • Have multiple sex partners
  • Are a man who has sex with men
  • Have a partner with HIV and/or another STD

In rare cases, HSV can cause encephalitis or meningitis, life-threatening infections of the brain and spinal cord. You may need an HSV test if you have symptoms of a brain or spinal cord disorder. These include:

  • Fever
  • Stiff neck
  • Confusion
  • Severe headache
  • Sensitivity to light

What happens during an HSV test?

HSV testing is usually done as a swab test, blood test, or lumbar puncture. The type of test you get will depend on your symptoms and health history.

  • For a swab test, a health care provider will use a swab to collect fluid and cells from a herpes sore.
  • For a blood test, a health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
  • A lumbar puncture, also called a spinal tap, is only done if your provider thinks you may have an infection of the brain or spinal cord. During a spinal tap:
    • You will lie on your side or sit on an exam table.
    • A health care provider will clean your back and inject an anesthetic into your skin, so you won't feel pain during the procedure. Your provider may put a numbing cream on your back before this injection.
    • Once the area on your back is completely numb, your provider will insert a thin, hollow needle between two vertebrae in your lower spine. Vertebrae are the small backbones that make up your spine.
    • Your provider will withdraw a small amount of cerebrospinal fluid for testing. This will take about five minutes.
    • Your provider may ask you to lie on your back for an hour or two after the procedure. This may prevent you from getting a headache afterward.

Will I need to do anything to prepare for the test?

You don't need any special preparations for a swab test or a blood test. For a lumbar puncture, you may be asked to empty your bladder and bowels before the test.

Are there any risks to the test?

There is no known risk to having a swab test.

There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

If you had a lumbar puncture, you may have pain or tenderness in your back where the needle was inserted. You may also get a headache after the procedure.

What do the results mean?

Your HSV test results will be given as negative, also called normal, or positive, also called abnormal.

Negative/Normal. The herpes virus was not found. You may still have an HSV infection if your results were normal. It may mean the sample didn't have enough of the virus to be detected. If you still have symptoms of herpes, you may need to get tested again.

Positive/Abnormal. HSV was found in your sample. It may mean you have an active infection (you currently have sores), or were infected in the past (you have no sores).

If you tested positive for HSV, talk to your health care provider. While there is no cure for herpes, it hardly ever causes serious health problems. Some people may only have one outbreak of sores their whole lives, while others break out more often. If you want to reduce the severity and number of your outbreaks, your provider may prescribe a medicine that can help.

Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I need to know about an HSV test?

The best way to prevent genital herpes or another STD is to not have sex. If you are sexually active, you can reduce your risk of infection by

  • Being in a long-term relationship with one partner who has tested negative for STDs
  • Using condoms correctly every time you have sex

If you've been diagnosed with genital herpes, condom use can reduce your risk of spreading the infection to others.

References

  1. Allina Health [Internet]. Minneapolis: Allina Health; Herpes viral culture of lesion; [cited 2018 Jun 13]; [about 3 screens]. Available from: https://wellness.allinahealth.org/library/content/1/3739
  2. American Pregnancy Association [Internet]. Irving (TX): American Pregnancy Association; c2018. Sexually Transmitted Diseases (STDs) and Pregnancy; [cited 2018 Jun 13]; [about 3 screens]. Available from: http://americanpregnancy.org/pregnancy-complications/stds-and-pregnancy
  3. American Sexual Health Association [Internet]. Triangle Park (NC): American Sexual Health Association; c2018. Herpes Fast Facts; [cited 2018 Jun 13]; [about 2 screens]. Available from: http://www.ashasexualhealth.org/stdsstis/herpes/fast-facts-and-faqs
  4. Centers for Disease Control and Prevention [Internet]. Atlanta: U.S. Department of Health and Human Services; Genital Herpes-CDC Fact Sheet; [updated 2017 Sep 1; cited 2018 Jun 13]; [about 3 screens]. Available from: https://www.cdc.gov/std/herpes/stdfact-herpes.htm
  5. Centers for Disease Control and Prevention [Internet]. Atlanta: U.S. Department of Health and Human Services; Genital Herpes Screening FAQ; [updated 2017 Feb 9; cited 2018 Jun 13]; [about 5 screens]. Available from: https://www.cdc.gov/std/herpes/screening.htm
  6. Lab Tests Online [Internet]. Washington D.C: American Association for Clinical Chemistry; c2001–2018. Herpes Testing; [updated 2018 Jun 13; cited 2018 Jun 13]; [about 2 screens]. Available from: https://labtestsonline.org/tests/herpes-testing
  7. Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; c1998–2018. Genital Herpes: Diagnosis and Treatment; 2017 Oct 3 [cited 2018 Jun 13]; [about 4 screens]. Available from: https://www.mayoclinic.org/diseases-conditions/genital-herpes/diagnosis-treatment/drc-20356167
  8. Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; c1998–2018. Genital Herpes: Symptoms and Causes; 2017 Oct 3 [cited 2018 Jun 13]; [about 3 screens]. Available from: https://www.mayoclinic.org/diseases-conditions/genital-herpes/symptoms-causes/syc-20356161
  9. Merck Manual Consumer Version [Internet]. Kenilworth (NJ): Merck & Co. Inc.; c2018. Herpes Simplex Virus Infections; [cited 2018 Jun 13]; [about 2 screens]. Available from: https://www.merckmanuals.com/home/infections/viral-infections/herpes-simplex-virus-infections
  10. Merck Manual Consumer Version [Internet]. Kenilworth (NJ): Merck & Co. Inc.; c2018. Tests for Brain, Spinal Cord, and Nerve Disorders; [cited 2018 Jun 13]; [about 2 screens]. Available from: http://www.merckmanuals.com/home/brain,-spinal-cord,-and-nerve-disorders/diagnosis-of-brain,-spinal-cord,-and-nerve-disorders/tests-for-brain,-spinal-cord,-and-nerve-disorders
  11. National Heart, Lung, and Blood Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Blood Tests; [cited 2018 Jun 13]; [about 3 screens]. Available from: https://www.nhlbi.nih.gov/health-topics/blood-tests
  12. UF Health: University of Florida Health [Internet]. University of Florida; c2018. Genital herpes: Overview; [updated 2018 Jun 13; cited 2018 Jun 13]; [about 2 screens]. Available from: https://ufhealth.org/genital-herpes
  13. UF Health: University of Florida Health [Internet]. University of Florida; c2018. Herpes: oral: Overview; [updated 2018 Jun 13; cited 2018 Jun 13]; [about 2 screens]. Available from: https://ufhealth.org/herpes-oral
  14. University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; c2018. Health Encyclopedia: Herpes Simplex Virus Antibody; [cited 2018 Jun 13]; [about 2 screens]. Available from: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=herpes_simplex_antibody
  15. University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; c2018. Health Encyclopedia: HSV DNA (CSF); [cited 2018 Jun 13]; [about 2 screens]. Available from: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=hsv_dna_csf
  16. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2018. Health Information: Genital Herpes: Topic Overview; [updated 2017 Mar 20; cited 2018 Jun 13]; [about 2 screens]. Available from: https://www.uwhealth.org/health/topic/major/genital-herpes/hw270613.html
  17. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2018. Health Information: Herpes Tests: How It Is Done; [updated 2017 Mar 20; cited 2018 Jun 13]; [about 5 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/herpes-tests/hw264763.html#hw264785
  18. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2018. Health Information: Herpes Tests: Results; [updated 2017 Mar 20; cited 2018 Jun 13]; [about 8 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/herpes-tests/hw264763.html#hw264791
  19. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2018. Health Information: Herpes Tests: Test Overview; [updated 2017 Mar 20; cited 2018 Jun 13]; [about 2 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/herpes-tests/hw264763.html
  20. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2018. Health Information: Herpes Tests: Why It Is Done; [updated 2017 Mar 20; cited 2018 Jun 13]; [about 3 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/herpes-tests/hw264763.html#hw264780

Can you test negative for herpes during an outbreak?

If the infection occurred very recently (within a few weeks to 3 months), the test may be negative, but you may still be infected. This is called a false negative. It can take up to 3 months after a possible herpes exposure for this test to be positive.

Can you test positive for herpes and then negative?

This is most common in the first few weeks after infection, before the body has produced antibodies to the virus – the blood test is looking for these antibodies, so the blood test can be negative during the first few weeks after someone has been infected with herpes.

How long can you have herpes before you test positive?

Your doctor will likely suggest waiting until at least 12 days after exposure before testing. If you get tested for herpes too soon after exposure, you may get a false negative result. It takes time for the body to produce antibodies in response to a viral infection.