STD Testing

10 blood tests for herpes simplex virus REALLY ACCURATE

What Herpes test is earlier and most accurate for the recent virus infection, why negative results and outbreak, read carefully and understand herpes test results.
Herpes are group of 8 virus types, only two of them cause disease, one of them is Herpes simples virus (medical term is HHV 1,2 or HSV 1,2)
Herpes infection is one of sexually transmitted diseases which include AIDS and chlamydia for example.
Herpes simplex virus type 1 and type 2 (HSV-1 and HSV-2) are pathogenic to humans and belong to the herpesvirus family. All herpesviruses are composed of relatively large DNA genomes. Like other herpesviruses, HSV-1 and HSV-2 follow a productive lytic infection and establish a latent lifelong infection in the host. In the latent stage, the production of infectious virus particles is inhibited but periodic reactivation and successive cycles of virus replication lead to reproduction and spreading to further susceptible persons.
In general, HSV-1 infection rates are markedly higher compared to HSV-2 Both, HSV-1 and HSV-2 infect epithelial cells of the mucous membranes, HSV-1 localizes preferentially in the orofacial region (Herpes 1 called Herpes labialis) and HSV-2 in genital and anal areas (Herpes 2 called Herpes genitalis). The infection only spreads when a susceptible person comes into close contact with tissue or body fluids containing the virus.
Who is exposed to have herpes infection?
In general, primary HSV-1 infection occurs during childhood, while HSV-2 infection is usually acquired sexually in early adulthood. Perinatal infection of the newborn can lead to a severe generalized neonatal herpes infection which has the medical term Herpes neonatorum. Thus it is always recommended to determine a woman’s HSV status during pregnancy, including discrimination of HSV-1 und HSV-2, to estimate the newborn’s risk for perinatal infection.
How long does it take to get herpes test results?
Results for a rapid herpes virus culture may take 2 to 3 days, anti-herpes antibody detection test results are ready in a day. PCR test results are ready in 1 to 3 days.
Serological Herpes testing, is it reliable?
The story behind antibodies tests is that: when a virus invade the body, our immune system take the responsibility to kill and eliminate this virus from all body tissues, the first immunity weapon is IgM antibodies which take the first impressions about virus and send them to the core immune system, which in turn continue to build suitable antibodies that fit to all virus aspects, finally the immune system understand the integrity of the invading virus and send the larger IgG antibodies, so that when we see IgG positive test we know that the body has fully eliminated the virus, and IgM positive test means the beginning of immunity war against virus, of course the beginning of virus invasion could precedes the body response by 2 – 6 weeks and up to 3 months, which called the dormant period, window period, or virus outbreak, That is why can you have herpes and test negative. while this waiting period the Herpes antibodies test is not useful to detect herpes infection, instead take a PCR test from sores directly and virus culture from open blisters and fluids as CSF or urine.

HSV 1/2 test results interpretation

Positive IgG antibodies against Virus herpes 1 means the body is immune to this virus or the immunity still build up, the same for IgG antiherpes antibodies means an old infection that the body has built defense against.
Positive IgM anti-herpes antibodies Virus 1 and 2 means the body just started the immunity response against the herpes virus, while beginning of the virus infection may be occurred several weeks ago.
In the acute stage of herpes infection skin lesions with characteristic blisters (“cold sore”) occur by HSV-1 or genitalia sores which associated with STD infections. Severe manifestations, such as an HSV-associated encephalitis or herpes corneae are rare. Herpes simplex virus infects the neurons of the dorsal root ganglia, where it causes lifelong latent infection. The virus is often reactivated, leading to recurrent symptoms.
Which Ab. test can detect herpes virus earlier?
In the acute stage of infection direct detection of the virus from the vesicles content via PCR is indicated. In addition, detection of IgM antibodies against HSV is important to confirm acute primary infection. However, not all patients produce IgM antibodies in the acute phase of infection; besides, IgM antibodies may also be detectable in cases of recurrent or persistent infection.
blood tests for herpes virus
What is the most accurate specific test against herpes virus types other than PCR test?
What is against HSV-1 glycoprotein G (G1) or HSV-2 glycoprotein G (G2)?
Classic ELISA Antibody Blood Test

  • Can’t distinguish between a current infection or a recurrent herpes infection.
  • Delayed period: herpes antibodies take up to 2-12 weeks post infection to appear in the blood.
  • Positive Ab. results not specific for Herpes type 1 or 2.

Glycoprotein G (gG) based herpes testing is most accurate Ab. tests:

Since HSV-1 and HSV-2 are immunologically very similar, almost all antibodies formed in an infected individual are cross-reactive. The HSV type-specific glycoprotein G is an exception, because these antigens of both viruses differ sufficiently. However, glycoprotein G almost only induces the formation of IgG antibodies. Therefore, detection of IgG antibodies against HSV-1 glycoprotein G (G1) or HSV-2 glycoprotein G (G2) allows for the differentiation of an HSV-1 infection from an infection with HSV-2.
In the early phase of primary herpes infection, the corresponding IgG antibodies are not yet produced. As a rule, IgG antibodies against HSV-1 are formed two to three months after a primary infection with the type 1 herpes simplex virus. IgG-class antibodies against glycoprotein G2 are detectable several weeks after primary infection.
The test uses HSV-1 glycoprotein G as coating antigen, and if the blood or aspirate sample contain herpes antibodies, reaction specific for each type if happen, an analyzer detect the reaction products and convert it to numbers that we can interpret.
Advanced ELISA based tests for the quantitative measurement of specific anti-herpes antibodies in human serum or plasma.

  1. Anti-HSV-1 IgG is an ELISA based test system intended for the qnt. measurement of IgG antibodies against Herpes Simplex Virus 1 glycoprotein G (gG1).
  2. Anti-HSV-1 IgM Abs. is qnt IgM antibodies measurement against Herpes Simplex Virus 1.
  3. Anti-HSV-2 IgG is qnt. IgG antibodies against Herpes Simplex Virus 2 glycoprotein G (gG2).
  4. Anti-HSV-2 IgM Abs. is for IgM class antibodies against Herpes Simplex Virus 2.
  5. Anti-HSV-1/2 IgG is for Qnt. IgG antibodies against Herpes Simplex Virus 1 and 2.
  6. Anti-HSV-1/2 IgM Abs. is for IgM antibodies against Herpes Simplex Virus 1 and 2.

Antibodies test reference range:

  • Negative herpes antibodies: less than 20 U/ml
  • Borderline: 20 – 25 U/ml
  • Positive herpes antibodies test: more than 25 U/ml

Negative antibodies test for herpes virus mean that you had never infected before, Positive antiherpes tests means you have got infection recently or the infection is old and your body did its job and killed every herpes unit with antiherpes units, however borderline herpes blood test results are neither positive nor negative but it necessitates close follow up by herpes antibody test and PCR for herpes.

Western blot (Immunoblot test) to detect the type of herpes antibodies.

Western blot herpes test, is it accurate results than Elisa?

  • The Western Blot Serology has been the gold standard for herpes specific antibody.
  • IgG/IgM (Elisa) blood test can tell if one has a current infection or antibodies from a previous infection. However, a positive IgM means that the Herpes infection is active.
  • Available over the counter test kits: The POCkit test is specific and will detect antibodies and is available through a physician.
  • Western blot results: Most HSV-2 ELISA-positive individuals tested HSV-2 Western blot-positive. Western blot positive without herpes simplex virus type 1 (HSV-1) antibody positive, and even in men without a history or clinical evidence of genital lesions, Clinicians should consider selectively using a higher index value to define Focus ELISA HSV-2 positivity based on either HSV-1 serostatus or clinical circumstances.
  • The index value defining HSV-2 positive is from >1.1 but the index >or=3.0 is more correlated with real herpes infection.
  • Drawbacks of western blot testing: detection but expensive and difficult to administer.

Does Viral Culture Test really detect herpes virus?

Herpes virus culture is the most specific test for herpes and can tell the type of herpes 1 or 2, samples cultivated are from fluids of active lesions only to avoid false negative culture.
Polymerase Chain Reaction or PCR Test for Herpex Simplex Virus 1,2
PCR test for herpes virus is the most accurate and reliable way to diagnose herpes, based on amplifying the virus DNA/RNA to detect tiny amounts, require active viral shedding, samples for PCR taken from blood, cells or fluids from sores.
Drawbacks of PCR test for herpes: a false positive for HSV2 for persons with an oral HSV1 infection, thick cells-rich fluids can make PCR false positives, PCR tests are limited and more expensive than culture.
Herpes Antigen Test
Looks for the virus itself, based on detecting specific proteins on the virus body, done be taking a swab from the lesions onto a microscopic slide and sent to the reference laboratories, drawbacks: Ag herpes test are very limited, expensive, not specific for herpes type, less sensitive than herpes culture.
Other STD tests for herpes:
TzanckTest or Chickenpox skin test
Not a specific test for herpes and not clinically recommended. Based on using a scraping to look for Tzanck cells.
Do Pap Smear or silver pap test for Herpes detection?
Only accurate for active herpes sores, otherwise false negative and erroneous results would be given, do pap smears test for herpes and other STIs, so that PAP test is not specific for herpes virus alone unless combined with PCR test,

Herpes test for men including PCR from the lesions/open sores on mouth, lips, or penile or around genitalia, virus culture from pimples leaks, and anti-herpes antibodies test.
Herpes test for women include PCR for herpes simplex virus 1/2, culture of herpes virus taken from the open blister or puss swab or aspiration by a needle, serological test and viral culture from vaginal cervical discharges swab.
Test for oral herpes simples 1 include specific PCR test but not usually ordered, Anti-HSV-1 IgG, and Anti-HSV-1 IgM.
Test for genital herpes simples 2 include HSV-2 PCR test, serum Anti-HSV-2 IgG, serum Anti-HSV-1 IgM, viral culture from the herpes sores wherever their site.

What does Aids HIV test results means if positive, normal, borderline or non-reactive?

People nowadays are terrified that become infected with the disease called AIDS
If you had unprotected sex with a girl/man and suspected that You/He or she was a carrier… anyways, your test results came in as HIV- with a value, scaring of results?
If you are afraid of AIDS, and you have drawn a blood sample to test for HIV infection,
Then; I invite you to read this thread to recognize the results of AIDS test results.
What is HIV?
What is HIV different from AIDS?
What viruses cause AIDS disease?
Human Immunodeficiency Virus (HIV) testing, well the HIV is the virus cause AIDS disease
HIV 1&2 is the measurable levels of antibodies in the blood.
It is used to diagnose HIV infection, in addition to Viral load tests (PCR) are used to inform treatment strategies and monitor disease progression.
List of expected results of HIV testing results using different analysis techniques against normal value:
HIV Antibody rapid test and using EIA/ELISA: negative
HIV Western Blot: negative (to confirm results with a more specific test)
HIV Antigen (P-24 Antigen): negative
HIV Viral load: _50 copies/mL (PCR ‘Polymerase Chain Reaction’ test, also known as a “viral load,” is used to measure the amount of HIV in an HIV-positive person’s blood.)
Normal HIV 1&2 test results
Normally most laboratories express the HIV test results with “Cut off = 1.0”
Some Labs write results as:
<1.0 = negative…
>1.0 = positive…
So that all test results values under “1.0” interpreted as “0”.
For example: when you receive HIV test results like this “HIV 1&2 Ab test result = 0.2”
It is simply means you are not infected with HIV virus, and the HIV test is negative however it can take 3 to 6 weeks, and sometimes up to 3 months (and in few cases up to 6 months) before HIV antibodies show up on a standard test, so that you have freedom to accept this result or that re-analysis after another 3 months
Abnormal HIV test results
1- Positive HIV results:
HIV 1&2 Ab test result: 1.2, where cut off level is 1.0
Means you are infected, and should be confirmed with more sensitive test.
2- Borderline HIV values:
HIV 1&2 Ab test result: 1.0, where cut off level is 1.0
It means No Infection detected” but Also It means equivocal test result, should be retested to be reassured whether your result is positive or negative
3- False positive HIV result:
Occur when sample contaminated, it is must to repeat sample testing.
4-False Negative HIV result:
If you very suspected that you may be infected with HIV virus and lab test results show negative result, then it is may be false negative results and should be repeated with different blood sample and different and more sensitive lab techniques, Rapid, EIA/ELISA, or PCR.
Also False results/indeterminate/inconclusive result means that the antibody test was neither positive nor negative due to:

  1. Recent HIV infection,
  2. Prior blood transfusions, even with non-HIV infected blood,
  3. Prior or current infection with syphilis, malaria, or other viruses,
  4. An autoimmune disease such as lupus or diabetes,
  5. Being a recipient of an experimental HIV vaccine,
  6. Or problems with the test procedure itself, such as contamination of the blood sample.

HIV test results interpretation:
The screen test has a cut-off level of 1 unit.
Below this the test is reported as negative. Above 1 unit, the serum is referred for the more specific Western Blot test. Results in the 1-1.5 unit range can be false positive screen results due to cross-reactivity with other viral antigens and the level may fall below 1, i.e. become negative, on subsequent testing. Patients with established HIV infection typically have results in the 5-20 range.
A screen result of 1-2 with negative Western Blot should be repeated in a month.
A negative antibody test does not exclude HIV infection during the first few months after transmission of the virus but for practical purposes, all those infected will test HIV positive within 6 months.
The median time from infection to the development of AIDS is about 10 years.
Prevalence of HIV in New Zealand By mid 1999, 1,355 patients had been reported with HIV infection since the beginning of the epidemic and 678 with AIDS. Currently there are about 700 HIV infected people living in New Zealand of whom 107 have AIDS. Homosexual males remain the biggest identifiable risk group (63% now) but in the last 18 months infected heterosexual immigrants, particularly from Africa, are the most rapidly increasing group. After falling for several years, the number of newly reported HIV infected people rose in 1998, significantly contributed to by this immigrant group.
GPs are the group who most frequently test for and diagnose HIV infection in New Zealand, far more than hospital, sexual health clinics or special clinics combined. Sometimes an HIV screen is requested “as an outside possibility”, without mentioning the test to the patient. The current advice and recommendation is that an HIV test should always be discussed prior to testing with pretest counselling as seems appropriate.
Early symptoms of HIV include exacerbation of previous skin disease, e.g. eczema, somewhat recalcitrant tinea, surprising shingles, oral candidiasis, recalcitrant vaginal candidiasis : in other words, common or ordinary events occurring oddly or excessively.
Lymphoma predisposes to HIV infection and HIV is an uncommon cause of acute immune thrombocytopenia. Pneumocystis carinii pneumonia (found only when patients have CD4 counts <200/cmm and essentially preventable) is most often a creeping, slow illness with dry cough, fever and shortness of breath which may not be easy to diagnose or confirm.
HIV testing in helping monitor the HIV virus progression Viral load The concentration of virus in the plasma can now be measured. As a generalisation the higher the concentration (max. 1,000,000 or 106 copies/ml) the more rapid will be progression in time to clinical illness and AIDS. The lower the concentration (at present the lowest level of detection is 500 or 10 27 copies/ml), the slower the disease progression.
The aims of treatment are to suppress this level as low as possible.
CD4 counts The concentration of this lymphocyte subset correlates with the stage the patient’s immune system has reached in its battle with HIV. The lower it is (normal >500 cells/cumm) the more likely will that individual have illness, with the risk rising progressively as it falls below 200 and then below 100 cells/cumm.

Most used Treatment for AIDS disease
Treatment requires use of at least two agents and most commonly three, to slow virus replication, minimize development of resistance, preserve and augment immune function and thus minimize clinical illness and prolong life. The moment to begin treatment is ill defined: with CD4 counts <350 cells/cmm and a high viral load, few would not wish to treat or be treated. At higher CD4 counts and lower viral loads, everyone has a different opinion and individual patient views are often the ultimate determinant for the decision.
My recommendations:
for those infected or under hope not to be infected with HIV virus by simple procedures and how to do steps prior to discovering positive HIV test results.
HIV 1, 2 Ab test is an initial screen test with >99% sensitivity followed by a Confirmatory test is available and must for those who screen positive.
The screen test detects both HIV-1 (the commonest) and HIV-2.
A DNA-based test is available for babies born to seropositive mothers.
If anonymity is required, the patient is identified by a code using the first 2 letters of
the patient’s surname, first initial, sex and date of birth, e.g. John Harris, male, d.o.b. 18/9/47, becomes HAJM180947. If you are unsure about the need for anonymity or forget to ask, assuming it is required is a good philosophy.
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