Testing With No Symptoms
Blood tests can be used when a person has no visible symptoms but has concerns about having herpes. Blood tests do not actually detect the virus instead, they look for antibodies in the blood.
IgM vs. IgG
When an individual contracts herpes, the immune system responds by developing antibodies to fight the virus: IgG and IgM. Blood tests can look for and detect these antibodiesnot the virus itself. IgG appears soon after infection and stays in the blood for life. IgM is actually the first antibody that appears after infection, but it may disappear thereafter.
IgM tests are not recommended because of three serious problems:
The accurate herpes blood tests detect IgG antibodies. Unlike IgM, IgG antibodies can be accurately broken down to either HSV-1 or HSV-2. The challenge here is that the time it takes for IgG antibodies to reach detectable levels can vary from person to person. For one person, it could take just a few weeks, while it could take a few months for another. So even with the accurate tests, a person could receive a false negative if the test is taken too soon after contracting the virus.
For the most accurate test result, it is recommended to wait 12 16 weeks from the last possible date of exposure before getting an accurate, type-specific blood test in order to allow enough time for antibodies to reach detectable levels.
Establishing Laboratory Evidence Of Immunity To Varicella
A positive IgG ELISA result indicates that a person has antibodies to VZV either from past varicella disease or vaccination. This test cannot distinguish whether the antibodies were from a past episode of varicella or vaccination. While many commercial VZV IgG ELISAs perform well enough to reliably detect seroconversion for infection by wild type virus, the performance specifications of these methods vary widely. Some commercially available VZV IgG assays are not reliable, even for the detection of people with a history of natural disease. There are currently no commercially available VZV IgG methods sensitive and specific enough to reliably detect seroconversion to vaccine.
Laboratory Criteria For Diagnosis
- Demonstration of VZV DNA by PCR tests from a clinical specimen, ideally scabs, vesicular fluid, or cells from the base of a lesion is the preferred method for varicella diagnosis. PCR is also useful for confirming breakthrough varicella. Other methods, such as DFA and culture, are available for diagnosis but are less sensitive and specific than PCR.
- Positive serologic test for varicella-zoster immunoglobulin M antibody when a varicella-like rash is present.
- Four-fold or greater rise in serum varicella immunoglobulin G antibody titer by any standard serologic assay between acute and convalescent sera.
For both unvaccinated and vaccinated people, PCR is the most reliable method for confirming infection.
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Pcr Is The Most Useful Test
Laboratory testing may be useful in cases with less typical clinical presentations, such as in people with suppressed immune systems who may have disseminated herpes zoster . Polymerase chain reaction is the most useful test for confirming cases of suspected zoster sine herpete .
PCR can be used to detect VZV DNA rapidly and sensitively, and is now widely available. The ideal samples are swabs of unroofed vesicular lesions and scabs from crusted lesions you may also detect viral DNA in saliva during acute disease, but salvia samples are less reliable for herpes zoster than they are for varicella. Biopsy samples are also useful test samples in cases of disseminated disease. It is also possible to use PCR to distinguish between wild-type and vaccine strains of VZV.
When Is It Ordered
VZV antibody tests may be ordered when a healthcare practitioner wants to check whether a person has developed immunity to VZV, especially someone who is at high risk, such as an organ transplant recipient or a pregnant woman, and/or when a healthcare practitioner wants to identify a recent infection.
VZV culture or DNA tests may be ordered when a person at risk, such as a newborn or immunocompromised person, has been exposed to VZV and is ill with atypical and/or severe symptoms to detect an active primary VZV infection in the baby or a primary or reactivated infection in the immunocompromised person.
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All of this tells us that sure, there are some currently available blood tests for herpes that can tell you your status or give you some idea of it but they’re still far from perfect. And when we’re dealing with a illness that’s highly and widely stigmatized the way herpes has become, most people are looking for airtight answers. This is precisely why so many doctors, as well as the CDC, do not recommend getting tested unless you have the common symptoms associated with herpes, such as itching, burning, or a blister.
There Are Two Common Blood Tests Used To Identify Herpes And They’re Often Misleading
“I had a patient once who underwent this test, which was positive, and was told she has herpes, which to her was devastating and life-altering,” Friedman says. “She burst into tears when I explained the significance or lack thereof with this test, which is very misleading.” There are two common blood tests used to identify herpes: IgG and IgM. The IgM test is still used by some doctors even though it has been denounced by the Centers for Disease Control and Prevention . According to the American Sexual Health Association , IgM tests can lead to deceptive results, as well as false assumptions about how and when a person acquired HSV.
And that’s not all: IgM tests fail to accurately distinguish between HSV-1 and HSV-2 antibodies, leading them to provide false-positive results for HSV-2. In other words, if you’ve been exposed to oral herpes , results of the IgM test could lead you to believe you’re positive for genital herpes, when in fact you simply have antibodies against HSV-1.
IgG tests, on the other hand, are more accurate, but aren’t without their own issues. For instance, ASHA says that while an IgG test can distinguish between HSV-1 and HSV-2, the problem is that the time it takes for IgG antibodies to reach a detectable level varies from person to person. This means that even with accurate results, someone could get a false-negative if they have the test administered too soon after contracting the virus .
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Varicella Zoster Virus Antibodies Blood Test Igg
The VZV Antibodies Blood Test, IgG is used to detect antibodies in the blood to determine an immunity and to evaluate the potential of reactivating a VZV infection.
Also Known As: Chicken Pox Titer Herpes Zoster Antibodies VZV IgG Chickenpox Titer Shingles
Methodology:
2-3 days. May take longer based on weather, holiday or lab delays.
Also Known As: Chicken Pox Titer Herpes Zoster Antibodies VZV IgG Chickenpox Titer Shingles
Methodology:
2-3 days. May take longer based on weather, holiday or lab delays.
What Does The Test Result Mean
Care must be taken when interpreting the results of VZV testing. The healthcare practitioner evaluates the results in conjunction with clinical findings. It can sometimes be difficult to distinguish between a latent and active VZV infection. This is possible for several reasons, including:
- A healthy person who has been infected with VZV will continue to harbor the virus after the symptoms disappear. The VZV can reactivate intermittently, shedding small amounts of virus into body fluids but not causing symptoms.
- An infant or immunocompromised person may not have a strong antibody response to the VZV infection their IgM and IgG levels may be lower than expected even though the person has an active case of VZV.
- The virus may not be present in sufficient number in the particular fluid or tissue tested to be detected.
Antibody detectionIf both VZV IgG and IgM are present in a symptomatic person, then it is likely that the person has either recently been exposed to VZV for the first time and has chickenpox or that the previous VZV infection has been reactivated and the person has shingles.
Viral detectionIf someone is symptomatic and the culture is positive for varicella zoster virus, then the person likely has an active VZV infection. If the culture is negative, then the person’s symptoms may be due to another cause or the VZV virus is not detectable in the sample tested.
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Laboratory Confirmation Of Suspected Varicella
The most sensitive method for confirming a diagnosis of varicella is the use of polymerase chain reaction to detect VZV in skin lesions . Vesicular lesions or scabs, if present, are the best for sampling. Adequate collection of specimens from maculopapular lesions in vaccinated people can be challenging. However, one study comparing a variety of specimens from the same patients vaccinated with one dose suggests that maculopapular lesions collected with proper technique can be highly reliable specimen types for detecting VZV. Other sources such as nasopharyngeal secretions, saliva, urine, bronchial washings, and cerebrospinal fluid are less likely to provide an adequate sample and can often lead to false negative results.
Other viral isolation techniques for confirming varicella are direct fluorescent antibody assay and viral culture. However, these techniques are generally not recommended because they are less sensitive than PCR and, in the case of viral culture, will take longer to generate results.
IgM serologic testing is considerably less sensitive than PCR testing of skin lesions. IgM serology can provide evidence for a recent active VZV infection, but cannot discriminate between a primary infection and reinfection or reactivation from latency since specific IgM antibodies are transiently produced on each exposure to VZV. IgM tests are also inherently prone to poor specificity.
How Is The Sample Collected For Testing
The sample required depends on whether testing is being done to determine the presence of antibodies or to detect the virus itself and on the health status of the person. Antibody testing requires a blood sample drawn from a vein in the arm. Viral detection may be done on a variety of samples, including a sample of vesicle fluid, blood, cerebrospinal fluid, other body fluid, or tissue.
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The Bottom Line: Tests For Herpes Are More Worry Than They’re Worth
If you do have symptoms, don’t fret: If you know your status, you’re at an advantage in that you can talk with your doctor and find an antiviral drug that works for you. Medication can curtail the severity of your symptoms, as well as the number of outbreaks you get. Additionally, taking an antiviral daily will greatly reduce your chances of transmitting the virus to someone else. In case you missed it, there’s also a very promising new drug for herpes on the horizon, which researchers say could be the most effective one yet.
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What’s The Treatment If I’m Not Immune
Treatment can reduce the risk of rare complications that chickenpox can cause during pregnancy.
Antiviral medicine will not necessarily stop chickenpox from developing but will make it milder and not last as long.
The medicine is started 7 days after the first contact with someone with chickenpox, and is taken for 7 days. This may be extended if you get chickenpox.
I Tested Positive For Herpes What Should I Do Now
For most people, having herpes does not affect their health or quality of life. To prevent passing on cold sores and genital herpes to others, a person can:
- avoid kissing others when the virus is active
- use condoms when having sex
- avoid skin-to-skin contact during an active outbreak
- avoid sharing towels, toothbrushes, and lipstick when they have sores around the mouth
- wash their hands well after touching a sore
Having multiple sexual partners can increase the risk of
transmitting STIs such as herpes. People can decrease this risk by openly discussing STI status and prevention with any partners and practicing safe sex.
It is
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What Happens During A Herpes Antibody Test
There are different tests for HSV. Doctors will choose a test based on a persons health history and symptoms. Options include the following:
- Swab test: A healthcare professional uses a swab to take a sample of fluid and cells from a herpes sore. They then order a PCR test or viral culture to determine whether HSV is present. This is the most reliable way to test for HSV. Doctors normally do this as standard procedure before ordering any other sort of test.
- Blood test: A healthcare professional uses a needle to take a small amount of blood from a vein in a persons arm.
- Lumbar puncture: Doctors may use this method if they suspect a person has an infection in the brain or spinal cord. It involves numbing the skin of the lower spine and inserting a thin, hollow needle between two vertebrae to collect cerebrospinal fluid.
A doctor will send samples to a laboratory for testing and a person should get their results within a few days.
Other Names: Herpes Zoster Varicella Zoster Virus Varicella Zoster Virus By Pcr Varicella Zoster Virus Culture Igc And Igm Varicella Zostervirus Antibodies Varicella Zoster Virus By Dfa
The chicken pox and shingles test is used to diagnose patients with illnesses in the event that they display atypical symptoms and the doctor cannotdiagnose them by physical examination alone. Chicken pox and shingles are caused by the varicella zoster virus the virus is very common and can bepassed from person to person very quickly.
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Submission And Collection Notes
VZV IgG testing will be performed on all requests for VZV serology
VZV IgG and IgM testing will only be performed when the following clinical information is provided on the General Test Requisition Form indicating acute/recent infection, relevant signs, symptoms, and/or clinical history, and onset date.
Chickenpox And Shingles Tests
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- Varicella Zoster Virus by Culture
- VZV Antibodies IgG and IgM
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Useful Methods Include Testing An Actual Lesion
Keep in mind that there’s no such thing as “safe” sex, only safer sex, which means using protection and being open and honest with your partner. “It can definitely happen,” Friedman says of the chances of transmitting the virus to a partner without a visible outbreak. “Its called asymptotic shedding there are studies showing that the rates of transmission of HSV-2 are the same for symptomatic and asymptomatic.” He adds that this is why using protection during sexual contact is so important, regardless of what blood tests say. Unfortunately, you can never ensure your risk of transmission will be zero, whether or not you know you have herpes, but using a condom or dental dam will get you closer to it.
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ANSWER: I wouldnt test a person in your situation for antibody levels. Whether or not you had been exposed to chickenpox, I still would recommend a shingles vaccine, which is what the current guidelines recommend.
However, now that you have the result, it isnt clear from the CDC guidelines what you should do. My recommendation is that you still get the vaccine. The reason is that antibody levels are representative of the part of the immune system called humoral. This part of the immune system is critical for bacterial infections, and it is led by the antibody-producing B cells. For viral infections like varicella zoster, its the cellular immune system that is critical. This is led by T cells. A high antibody titer, a measure of concentration, like yours may not predict a strong cellular immunity. Furthermore, the downside of getting a shingles vaccine is small: It is not very expensive, and the risk of serious side effects is very small. I dont think that the high antibody level you have will make it more likely that you will have a side effect.
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Dr. Roach
628 Virginia Dr.
Orlando, FL 32803
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