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Testing for
   Testing for
Herpes Simplex
Herpes Simplex
    Infections
     Infections
                    E!
           ...
Tens of millions of people
  have been diagnosed
  with herpes infections
Genital Herpes Issues
   Genital Herpes Issues
•• The Most Common Cause of Genital
    The Most Common Cause of Genital
  ...
Why Do We Need a New
    Why Do We Need a New
   Diagnostic Testing Method?
   Diagnostic Testing Method?
•• One in Four A...
Why Do We Need a New
    Why Do We Need a New
   Diagnostic Testing Method?
   Diagnostic Testing Method?
A major challeng...
What is the problem?
What is the problem?

      You’d think by now
that the method of diagnosing
        the disease was
...
Why is this?
Why is this?
Most people already
Most people already
  have type 1 HSV
  have type 1 HSV
latently on the face...
Blood testing
Blood testing
  So, blood tests
showing a positive
   test for type 1
 don’t necessarily
 tell you anything
...
The “Gold Standard”
The “Gold Standard”
    remains the
     remains the
   Viral Culture
    Viral Culture



…unless PCR...
A positive viral culture
A positive viral culture
 gives the diagnosis.
  gives the diagnosis.



Remember to ask that
Rem...
Incidence of Genital HSV
Incidence of Genital HSV
        by Types
        by Types
   In America, about 75%
   In America...
Incidence of Oral HSV
Incidence of Oral HSV
      by Types
       by Types
    In America, almost all
    In America, almo...
How to do
      How to do
       Testing
       Testing
       Start with a
       Start with a
   viral culture of the
  ...
How to do
       How to do
        Testing
        Testing
If the culture is negative,
 If the culture is negative,
do “ty...
Test
      Test
 Interpretation
 Interpretation
  If genital lesions are
   If genital lesions are
    present and type 2
...
Test
        Test
   Interpretation
   Interpretation
    If genital lesions are
     If genital lesions are
present and O...
Test
       Test
  Interpretation
  Interpretation
Remember, though, that
 Remember, though, that
most people have positiv...
Test
       Test
  Interpretation
  Interpretation
   If all blood tests are
   If all blood tests are
  negative, repeat ...
The New
      The New
“POCkit Test”
 “POCkit Test”
     for type 2
     for type 2
herpes simplex
herpes simplex
      ant...
Collect sample
Collect sample
of blood into
of blood into
capillary tube
capillary tube
Positive   Negative
 Result     Result
Summary Thoughts
Summary Thoughts
Testing can be
Testing can be
very confusing
very confusing
for many people
for many people

Use ONLY
Use ONLY
type specif...
Negative tests
       Negative tests
   do NOT completely
   do NOT completely
rule out the possibility of
rule out the po...
Maintaining contact
       Maintaining contact
 with a knowledgeable physician
 with a knowledgeable physician
 and utiliz...
Please contact
     the Webmaster
at webmaster@herpes.org
      if you have
     any questions!
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Testing%20for%20 Herpes%20 Simplex%20%20%20%20 Getting%20it%20 Done

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Transcript of "Testing%20for%20 Herpes%20 Simplex%20%20%20%20 Getting%20it%20 Done"

  1. 1. Testing for Testing for Herpes Simplex Herpes Simplex Infections Infections E! N E! DO N ttiing tt ng iitt DO Ge Ge
  2. 2. Tens of millions of people have been diagnosed with herpes infections
  3. 3. Genital Herpes Issues Genital Herpes Issues •• The Most Common Cause of Genital The Most Common Cause of Genital Ulceration is Herpes Simplex Ulceration is Herpes Simplex •• Increasing Incidence -- 30% increase Increasing Incidence 30% increase over the past decade over the past decade •• Approximately 90% of Recurrent Genital Approximately 90% of Recurrent Genital Herpes is Caused by Herpes is Caused by Herpes Simplex 2 Virus (Type 2) Herpes Simplex 2 Virus (Type 2)
  4. 4. Why Do We Need a New Why Do We Need a New Diagnostic Testing Method? Diagnostic Testing Method? •• One in Four Adults are Infected with the One in Four Adults are Infected with the Herpes Virus -- 45 Million People Herpes Virus 45 Million People •• Only 20% of Those Individuals Have Been Only 20% of Those Individuals Have Been Diagnosed Diagnosed •• Most Cases of Genital Herpes Do NOT Present Most Cases of Genital Herpes Do NOT Present with the “Typical Symptoms” of External with the “Typical Symptoms” of External Lesions (Blisters) Lesions (Blisters)
  5. 5. Why Do We Need a New Why Do We Need a New Diagnostic Testing Method? Diagnostic Testing Method? A major challenge posed by genital herpes is that A major challenge posed by genital herpes is that virtually all infected (seropositive) individuals, virtually all infected (seropositive) individuals, regardless of history, have periods of active viral regardless of history, have periods of active viral shedding. All are potentially capable of shedding. All are potentially capable of transmitting the infection to sexual partners; yet, transmitting the infection to sexual partners; yet, most take no precautions because they have not most take no precautions because they have not been diagnosed, counseled, or managed with anti- been diagnosed, counseled, or managed with anti- viral therapy. viral therapy.
  6. 6. What is the problem? What is the problem? You’d think by now that the method of diagnosing the disease was easy and straightforward… …but often it is not
  7. 7. Why is this? Why is this? Most people already Most people already have type 1 HSV have type 1 HSV latently on the face latently on the face
  8. 8. Blood testing Blood testing So, blood tests showing a positive test for type 1 don’t necessarily tell you anything about genital infections
  9. 9. The “Gold Standard” The “Gold Standard” remains the remains the Viral Culture Viral Culture …unless PCR DNA testing …unless PCR DNA testing is available is available
  10. 10. A positive viral culture A positive viral culture gives the diagnosis. gives the diagnosis. Remember to ask that Remember to ask that the virus be “typed” the virus be “typed”
  11. 11. Incidence of Genital HSV Incidence of Genital HSV by Types by Types In America, about 75% In America, about 75% of new cases of genital HSV of new cases of genital HSV are caused by type 2, are caused by type 2, 25% by type 1 25% by type 1
  12. 12. Incidence of Oral HSV Incidence of Oral HSV by Types by Types In America, almost all In America, almost all cases of new oral HSV cases of new oral HSV are type 1, and 80% or more are type 1, and 80% or more of people develop oral HSV of people develop oral HSV as children as children
  13. 13. How to do How to do Testing Testing Start with a Start with a viral culture of the viral culture of the suspected herpes lesion suspected herpes lesion If it is positive, If it is positive, then the diagnosis is made then the diagnosis is made
  14. 14. How to do How to do Testing Testing If the culture is negative, If the culture is negative, do “type specific serology” do “type specific serology” for HSV types 1 and 2. for HSV types 1 and 2. Alternative: POCkit test Alternative: POCkit test
  15. 15. Test Test Interpretation Interpretation If genital lesions are If genital lesions are present and type 2 present and type 2 blood testing blood testing is positive, then is positive, then the problem is probably the problem is probably type 2 genital HSV type 2 genital HSV
  16. 16. Test Test Interpretation Interpretation If genital lesions are If genital lesions are present and ONLY type 1 present and ONLY type 1 blood testing blood testing is positive, then is positive, then the problem MIGHT BE the problem MIGHT BE type 1 genital HSV type 1 genital HSV
  17. 17. Test Test Interpretation Interpretation Remember, though, that Remember, though, that most people have positive most people have positive type 1 antibody anyway type 1 antibody anyway …so where did …so where did that antibody come from? that antibody come from?
  18. 18. Test Test Interpretation Interpretation If all blood tests are If all blood tests are negative, repeat them negative, repeat them in about three months. in about three months. If either one turns If either one turns positive, then that type is positive, then that type is probably the cause of the probably the cause of the herpes outbreak. herpes outbreak.
  19. 19. The New The New “POCkit Test” “POCkit Test” for type 2 for type 2 herpes simplex herpes simplex antibody antibody
  20. 20. Collect sample Collect sample of blood into of blood into capillary tube capillary tube
  21. 21. Positive Negative Result Result
  22. 22. Summary Thoughts Summary Thoughts
  23. 23. Testing can be Testing can be very confusing very confusing for many people for many people Use ONLY Use ONLY type specific type specific blood testing blood testing
  24. 24. Negative tests Negative tests do NOT completely do NOT completely rule out the possibility of rule out the possibility of HSV infections, HSV infections, especially in the case especially in the case of a viral culture of a viral culture
  25. 25. Maintaining contact Maintaining contact with a knowledgeable physician with a knowledgeable physician and utilizing Internet resources and utilizing Internet resources such as on-line pharmacies, such as on-line pharmacies, Herpes.org and Herpeshelp.com Herpes.org and Herpeshelp.com can really help to provide can really help to provide information that can help people information that can help people get tested appropriately and get tested appropriately and receive the right treatment. receive the right treatment.
  26. 26. Please contact the Webmaster at webmaster@herpes.org if you have any questions!
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