Herpes is more common than many people think. The lack of knowledge and absence of routine testing by doctors makes HSV easy to spread. So how do you know if you have herpes? The best way is through a reliable antibody test. Read on for details about how oral and genital herpes is diagnosed. You’ll find out what could clue you in that it’s time to get tested. You’ll also learn what kinds of tests are most reliable.
How Do You Know if You Have Herpes?
Routine STD Tests Can Miss Herpes
Have you ever had a routine STD test? Double-check it. Standard STD panels don’t usually include a herpes test by default, and you may have to specially request it. Tell your doctor or lab clinician if you are concerned you have ever been exposed to HSV.
Sometimes There Are No Symptoms
Some people who contract herpes can go for years before having their first outbreak. It’s even possible to have no symptoms at all but still pass on the virus. For some reason, male carriers of herpes seem to have no symptoms but still be infectious more often than females.
But why? Everyone’s body and immune systems is different. Plus, some strains of the virus are less aggressive than others. Studies also suggest that people who already have HSV-1 (which causes cold sores) are less likely to show symptoms of genital HSV-2 as quickly as those who don’t.
Interestingly, the CDC doesn’t recommend herpes testing without the presence of symptoms. One reason is that a potential false positive result would have undue psychological costs for the patient. They also don’t believe routine tests would have a large enough impact to curb the spread of the infection.
Without symptoms, how do you know if you have herpes that’s dormant? Talk to your physician and decide if your symptoms or history warrant a check-up. If you know that you have been exposed to the virus by sexual or other physical contact, you may decide you have a valid reason to be concerned. Remember that herpes can spread even while using a condom. What’s more, oral herpes can be spread to the genitals from oral sex.
Typical Herpes Symptoms
What about people who do get symptoms?
- A newly infected person will typically have their first outbreak two weeks after contact. However, it can begin within hours of contact or even take years to ever happen.
- A first herpes outbreak is considered to be the most severe.
- It can be accompanied by fever, swollen lymph nodes, fatigue, and a tingling sensation or pain in the affected area.
- Herpes blisters look like clusters of blisters that dry up and scab off.
- Some people don’t get the blisters, or the blisters are internal, such as around the cervix.
Sometimes the blisters associated with other conditions can be mistaken for herpes:
- Syphilis chancres or blisters;
- the bacterial disease impetigo; or
- genital warts associated with HPV.
These should be ruled out by a professional when you get tested. Never attempt to diagnose yourself. Experts agree that a physical exam alone is not enough. These days, professionals emphasize the importance of confirming everything with lab tests, and for good reason. It’s important that if you get tested, you do it using the most accurate possible methods.
Getting Tested for Herpes
Luckily, getting tested is easy and you can even order private tests online to have done in your area the same day. Read on to learn the different tests you can have done.
Herpes Swab Tests
If you are quick enough, your doctor can take a viral culture. That means they will take a swab of a fresh sore. To be accurate, the swab must be taken within a day or two of the sore appearing. Otherwise, it may turn back a false negative. Some swab tests are able to tell you which herpes simplex type is causing the sore (wherever it is located): HSV-1 or HSV-2.
Herpes Blood Tests
Blood tests are able to determine whether you have the antibodies to HSV. The most reliable blood tests are the IgG and Western Blot. However, the Western Blot is not widely available. A test called ELISA (or the igM), is good, but it can return false positives. It is common, though. If you get a positive result back from the ELISA / igM, ask your doctor to follow up with an igG to confirm it and rule out a false positive.
Blood tests can report whether the antibodies are for HSV-1 or HSV-2. The HSV-1 is usually associated with cold sores, but it can also be transmitted to genitals, causing genital herpes of the HSV-1 type. HSV-2 is the strain more associated with genital herpes. To know which one you have, you only need a blood test, but you may also like a culture taken of a certain problem area.
If you go this route, ask your doctor for a “type-specific” blood test. Be sure to request your actual antibody levels, too. That information may come in handy:
How Long Should You Wait To Test?
The amount of time between contact with herpes and getting tested can affect your results. The accuracy of the test depends on the amount of antibodies you’ve built up, which takes time. The antibodies present in your blood will need to be above a certain level to be definitive.
When is a herpes test most accurate? A herpes test is most reliable three months after infection.
See the article: When Should I Get Tested for STDs for details.
Early on after being infected, you have a low number of antibodies. This is measured as a “volume index.” Generally, 1.1 is the lowest number for a passable diagnosis, but it not high enough to be firmly convinced. It might be wrong, or require further testing in the future. Anything above 3.5 is considered a highly reliable positive result.
With that in mind, it’s probably best to wait three months after being exposed to get a blood test. However, you can start testing as soon as 4-6 weeks after exposure.
What If You Have an Outbreak?
The exception is if you have an actual outbreak or sore. A swab test of a lesion can be done as soon as one appears. Be quick though, as such swab tests are reliable on sores up to two days old.
If you do have an active herpes outbreak, your doctor can prescribe you a medication like Valtrex.
You Can Get Tested for Herpes Today
Never attempt to diagnose yourself. Experts agree that a physical exam alone is not enough. These days, professionals prefer to confirm everything with lab tests.
How do you know if you have herpes? This site’s affiliate, STDcheck, lets you order a confidential STD test online for same day testing in your area at any of their 4,500+ lab locations.