From the Guidelines
The most appropriate blood test for herpes simplex virus (HSV) detection is the type-specific glycoprotein G (gG) based IgG antibody test, which can distinguish between HSV-1 and HSV-2 infections, as recommended by the 2021 Centers for Disease Control and Prevention (CDC) guidelines 1. When it comes to diagnosing HSV infections, blood tests play a crucial role, especially in cases where lesions are not present for direct sampling. The type-specific glycoprotein G (gG) based IgG antibody test is the most commonly used blood test for HSV detection, with a sensitivity of 80-98% 1. This test detects antibodies that typically develop within 2-12 weeks after infection and remain for life. Some key points to consider when using blood tests for HSV detection include:
- The HerpeSelect ELISA and immunoblot tests are specific commercial options for type-specific glycoprotein G (gG) based IgG antibody tests, but their specificity can be limited, particularly among those with HSV-1 infection 1.
- Western blot testing is considered the gold standard for HSV serologic testing, but it is less commonly available and mainly used for confirmation 1.
- PCR blood tests that detect viral DNA are more appropriate for acute infections, offering results within 24-48 hours with high sensitivity 1.
- Blood testing is recommended for people with symptoms suggestive of herpes, those with infected partners, or as part of comprehensive STI screening, though it's essential to note that antibody tests cannot determine infection location or distinguish recent from old infections 1. It's also important to consider the limitations of serologic testing, including the potential for false-positive results, particularly among those with HSV-1 infection, and the need for confirmatory testing in some cases 1.
From the Research
Blood Tests for Herpes Simplex Virus Detection
The following blood tests can be used for herpes simplex virus (HSV) detection:
- ELISA (Enzyme-Linked Immunosorbent Assay) for detecting type-specific IgG and IgM antibodies to HSV-1 and HSV-2 2, 3
- Chemiluminescent immunoassay (CLIA) for detecting type-specific IgG antibodies to HSV-1 and HSV-2 4
- Immunoblot (IB) for detecting type-specific IgG antibodies to HSV-1 and HSV-2 4, 5
- Novagnost ELISA assays for determination of type-specific IgG antibodies against HSV-1 and HSV-2 3
- HerpeSelect-1 and HerpeSelect-2 enzyme-linked immunosorbent assay tests and the HSV-1 and HSV-2 HerpeSelect1/2 Immunoblot for detecting type-specific IgG antibodies to HSV-1 and HSV-2 5
Characteristics of Blood Tests
The characteristics of these blood tests include:
- High sensitivity and specificity for detecting type-specific IgG antibodies to HSV-1 and HSV-2 4, 3
- Ability to distinguish between HSV-1 and HSV-2 infections 4, 5
- Rapid and simple to perform 2, 3
- Can be used to confirm a genital herpes diagnosis, establish diagnosis of HSV infection in patients with atypical complaints, identify asymptomatic carriers, and identify persons at risk for acquiring HSV 5
Settings for Use
These blood tests can be used in various settings, including: