Common misperceptions about HSV in the healthcare community
can compromise the diagnosis and care of patients, their partners
and their unborn children.
As a frequent speaker on the diagnosis and treatment of HSV to
healthcare professionals, I routinely hear the same reasons why
patients are not tested for HSV infection.
- "I don’t
see those kinds of patients."
- "If they don’t have symptoms, I don’t
test for it."
- More than 1 out of every 5 adults in the US is infected
with the herpes simplex virus.
- Up to 90% of all HSV infections go undiagnosed.
- HSV infection is often asymptomatic and transmissible
without active lesions. Asymptomatic patients may unknowingly
transmit infection to their partner or to their unborn
baby.
- "Counseling patients with HSV infection requires
time and resources that I don’t have in my busy practice.
- There
are many excellent resources available to assist the healthcare
provider with answers to frequently asked questions and
counseling for patients on how to deal with the emotional issues
and life choices associated with a positive diagnosis.
HSV testing needs to become a routine part of caring for a patient’s
sexual and reproductive health.
Patients with high-risk lifestyles need to be diagnosed and made
aware of the added risk of HSV type-2 infection.
The clinical diagnosis of HSV (visual) is both insensitive and
nonspecific and often does not provide an accurate diagnosis. Culture
is the gold standard method of testing for herpes infection and
although positive culture results are generally reliable, 50% to
70% of non-positive results are falsely negative in recurrent episodes.
A Herpes infection is life long, but a positive culture is only
intermittent.
Serology (blood) tests are a must in detecting herpes infection
in patients who have no symptoms or active lesions.
You must use the right serology test to get type-specific information.
Until recently, accurate serology tests for herpes were not
available. HSV type-1 and HSV type-2 type-specific information
can aid in diagnosis, developing a treatment plan, patient and
partner counseling and evaluating prognosis for future outbreaks.
There are currently only two FDA-cleared type-specific glycoprotein-G
based serology tests on the market for HSV type-1 and HSV type-2.
The HerpeSelect test from FOCUS Diagnostics has been available
for several years. A newly released test called CAPTIA™ is
now available from Trinity Biotech. A third test, the POCKit® HSV
type-2 Rapid Test from Diagnology, not currently sold in the
US, is FDA-cleared for HSV type-2 testing only.
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