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Our Herpes Tests are blood tests andcan test individually for
Herpes type 1 or
Herpes type 2
or both. CDC recommends to test for both since 30% of Genital
Herpes is known to be caused by Herpes type 1. Herpes Blood Tests
are presented according to the serological methodology used.
The selection
of tests offered
is not only "type" but also "time and money specific ". STDWeB.com
has an extensive experience not only with the dynamics of Herpes
serology but also with the most common and real concerns that people
have with Herpes infections.
There are settings in which Herpes IgM's testing may have a positive, though
limited, value.
Herpes IgM serology
may be useful in newborns of culture positive mothers; to
individuals, and their partners, presenting with a first
episode of genital herpes, particularly those who are
anxious to know more about the possible source of the
infection; and to individuals concerned about viral shedding
and reoccurrences.
As shown in a recent
study "…people who present with a first clinical episode
of genital herpes may be classified into three categories on
the basis of history, clinical features, viral isolation,
and serology." Categories: 1) True Primary Infection (IgM positive
and/or viral culture positive and IgG negative at the time
of symptoms presentation) 2) Non-primary first
episode (IgG positive for one of the two viruses
with IgM antibody to the other)
3) Previous Infection (both HSV-l and HSV-2
IgG positive and IgMs negative)
This classification is
useful in defining the natural history of first episode
genital herpes and in providing patients and their partners
with helpful information about the source of the infection.
Many individuals acquire genital herpes in the context of
monogamous relationships and knowing whether the infection
is new or pre-existing may be very reassuring or at least
help to unravel what is sometimes seen as an illogical
situation. Ongoing counseling and support for patients and
partners will also be essential." J Pge, J Taylor, R L
Tideman, C Seifert, C Marks, A Cunningham, and A Mindel -
Sex. Transm. Inf., Aug 2003; 79: 276 - 279
IgM antibodies appear within a few days to a week from
exposure, reach a peak level within 2-4 weeks and slowly
become undetectable within 2-4 months from the date of
exposure. A reappearance of elevated IgM antibodies
blood levels may occur every time the virus is reactivated
form its latent state (flare ups) even when symptoms
are not present.
The IgM
Antibodies Screen is a non-type specific Herpes test and therefore does not distinguish between the two Herpes types
and may show cross-reactivity with other types of
Herpes viruses like Mono and CMV, two common Herpes viruses.
The turnaround time for this test is typically 4-6 business
days.
Herpes Type 1 testing is
performed by using the FDA approvedHerpeSelect®
HSV 1 IgG ELISA test. This test is a type
specific herpes test that can detect HSV 1 by using the Glycoprotein
G-based technology. Some people may be detectable for a past
exposure to herpes as soon as 4 weeks from a suspected contact
although most of the population would be detectable with this test
after 12 weeks. The turnaround time for this test is typically 2-3
business days. The sensitivity and specificity values ranging from
91-100%.
This test is also an ELISA Antibodies test and is
generally performed to detect a remote exposure to both the
Herpes-1 and
Herpes- 2 viruses.
IgG antibodies may
appear within 3-4 weeks and are definitely present four months after
exposure. They remain present indefinitely as memory of the past infection.
This test also is a type
specific herpes test and does distinguish between Herpes type 1
and 2 using FDA approved
HerpeSelect® of Focus Technologies HSV 1 & 2.
The turnaround time for this
test is typically 2-3 business days.
This test is also an ELISA Antibodies test and is generally performed to
detect either a Recent or a Remote exposure to the
Herpes-1 and/or
Herpes-2 viruses. IgM antibodies appear within a few days to a week
from exposure, reach a peak level within 2-5 weeks and slowly disappear
within four months from the date of suspected contact. IgG antibodies
may appear within 3-4 weeks and are definitely present four months
after exposure. They remain present indefinitely as memory of the past
infection. Therefore the exposure date is the starting point.
80% of people who tested
positive to either Herpes 1 or 2 antibodies were unaware of the infection. If
the exposure date is not known a screening test for both the IgM and IgG
antibodies is appropriate. The testing time can
than be used as a starting point in the Herpes testing.
This new test detect antibodies
to a protein that differs between Herpes-1 and Herpes-2. This protein is
called glycoprotein G (or "gG") and the test is sometimes referred to as the
glycoprotein G specific or "gG-based" tests.
The Herpes-2 IgG type Specific
test is also an ELISA antibodies test and is performed using a special
diagnostic kit produced by
Focus Technologies and called HerpeSelect®
. Although several kits for type specificity are available in the USA
our Lab has chosen to use the HerpeSelect® which is the number one seller of
this type of test around the world and has been approved by the FDA
for diagnosing HSV infection not only in adults but also in pregnant
women.
The turn around time for this
test ranges from 2-4-business days and is mainly due the transit time of the
specimen in reaching the testing laboratory since it is performed in only a
couple of location in the United States. The Herpes-2 assay is 96-97%
sensitive and 98% specific.
To further improve both
sensitivity and specificity Focus Technology has recently made available
a new diagnostic Herpes testing kit which use a technology called
Immunoblot. This is also a FDA approved type specific test for both
Herpes-1 and Herpes-2 test and contains the same recombinant glycoproteins gG-1 and gG-2
that are used in the HerpeSelect ELISA and is slightly more accurate since
it detects antibodies to both HSV-1 and HSV-2 on a paper strip and slightly
more expensive than the ELISAs.
The turnaround time for this test may vary depending upon
which day
your specimen is collected. On average, this test takes approximately 3-5
business days. This test is performed in the lab on Wednesdays only. Please
consult with one of our trained representatives to approximate your
turnaround time. The sensitivity and specificity values range from
95-98%.
In the domain of Serology, the
Western Blot technology is the Gold Standard for detection of antibodies
to viruses. It is what is used as a final test for HIV infections and is
the gold standard also for Herpes infections. Whereas ELISA testing
measures antibody to whole virus and gives a "positive," "negative" or
indeterminate test result, Western Blotting is a more specific test. It
allows one to visualize antibodies directed against each viral protein.
For this reason, it is used as a confirmatory test for a positive HIV or
Herpes ELISA. In Western blotting, proteins are faced with the passage
of electrical current (electrophoresed) into a gel. As the proteins migrate through the gel they
are separated based upon size and charge. Characteristically, smaller
proteins migrate through the gel faster than larger proteins The separated
proteins are then transferred to a solid membrane for Western Blot analysis.
In the USA this test is available only through the University of
Washington's Serology Laboratory and, while it is very accurate (with a
sensitivity and specificity approaching 100%), it takes longer to perform.
It is used as a reference test and it may of value as a last resort when the
ELISA tests or the HerpeSelect are indeterminate (not definitively positive
or negative) or very low positive. The turn around time for the Western Blot
is usually between 5-14 business days.
