Because genital herpes is one the most common sexually transmitted diseases, early diagnosis and treatment are necessary. Unfortunately however, the variability or nonexistence of symptoms associated with it causes it to oftentimes go unrecognized and undiagnosed unless proper herpes testing is performed. It is because of its varying faces and disguise the neologism herpes incognito is born.
This STD is caused by the herpes simplex virus, of which there are two forms, type 1 and type 2. For short, the type I virus is designated as HSV-1 and the type 2 virus is designated as HSV-2. It was formerly believed in the healthcare field that HSV-1 only caused disease above the waist, primarily cold sores around the mouth and that HSV-2 was responsible for infection below the waist in the genital areas manifested by blisters. It is currently recognized in today’s age however, that either virus can cause infection in either area of the body, which must be considered when undergoing herpes testing. Most cases of genital herpes are caused by HSV-2 and most cases of cold sores, also known as herpes labialis, are caused by HSV-1 however.
During medical training back in the 1980s it was the general perception that genital herpes was easily recognized and diagnosed because infected individuals develop genital blisters which break open resulting in a raw sores that form scabs and generally heal within one to three weeks. Given this classic presentation the diagnosis can be easy confirmed by herpes testing of fluid from the blisters, but unfortunately it is now recognized that most individuals with genital herpes don’t experience the classic presentation.
Conversely, many individuals only notice skin irritation, breakage, or tearing in the genital area which is suspected to be the result of chafing by tight fitting clothes, or other factors such as wiping, laundry detergent or bath soap. Because the area heals within seven to ten days of applying a believed home remedy, the infected person concludes that mechanical irritation was the cause of the symptoms, when in fact, the experience was the natural course of a mild herpetic outbreak which might have been initial or recurrent.
Herpes testing of a specimen obtained by swabbing the area of an atypical outbreak will sometimes provide a diagnosis but more times than not, herpes blood testing is required to unmask genital herpes incognito and establish the diagnosis when the disease presents in such a disguised manner, because testing of swabbed specimens frequently results in false negative test results.
As common as the disguised presentation of genital herpes is, it is more commonly invisible inasmuch as most individuals affected with the HSV does not have any symptoms at all. Many of these individuals will have their initial outbreak months to years after initial infection and sometimes will never manifest symptoms. This fact explains why 80 percent to 90 percent of individuals who have the disease are not aware of having it despite shedding of the virus which is transmissible during sexual intercourse. Since one in five adults and teenagers has genital herpes and most are not aware of it because of the absence of symptoms, it is easy to understand why HSV infection is epidemic at this time.
In the absence of classic symptoms, the only reliable way of diagnosing genital disease is through serologic herpes testing of blood. These serologic tests measure antibodies produced by the immune system of the infected individual in its unsuccessful attempt to rid the body of the infection. These tests can distinguish between HSV-1 and HSV-2, thus providing partial but not absolute distinction between herpes labialis (cold sores) or genital herpes.
In order to avoid negative test results when undergoing serologic herpes testing of blood it is important to make sure that the testing is not performed during the window period, which is the time frame between the initial infection and the body’s development of antibodies against it. The window period is generally four to six weeks for the herpes test which detects acute infection and can be up to three to six months for the test which detects chronic or latent infection.
Because today’s FDA approved blood tests which detect antibodies to HSV-1 and HSV-2 are very accurate and because most infected individuals don’t have classic symptoms, herpes testing of blood is the most common and reliable means of identifying the disease.
This article is for informational purposes only and is not intended to be legal advice or a substitute for medical consultation with a qualified professional. If you are seeking legal advice or are unsure about your medical condition you should consult an attorney and/or physician.