• Also Known As:
  • Herpes Serology
  • HSV Blood Test
  • Herpes Simplex Virus Culture
  • HSV Tissue Culture
  • Tzanck Smear
  • HSV NAAT Testing
  • HSV PCR Test
  • Direct Fluorescent Antibody Test
  • DFA Test
  • Rapid Herpes Simplex Test
  • Formal Name:
  • Herpes Simplex Virus 1 and 2
  • Qualitative PCR
  • Herpes Simplex Virus (HSV) Culture
  • Herpes Simplex Virus (HSV) Type 1- and Type 2-Specific Antibodies
  • IgG
  • Serum
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Test Quick Guide

Genital and oral herpes are infections caused by the herpes simplex virus (HSV). HSV is spread through close contact with a person who is actively shedding the virus, usually through skin to skin or sexual contact. Patients without symptoms of HSV can still actively shed the virus and infect others.

Lab tests are used to diagnose HSV and confirm the type of virus causing an infection. Diagnostic tests may require a blood sample or a sample of fluid taken from a sore. Less commonly, a lumbar puncture may be used to diagnose an infection in the brain or spinal cord.

About the Test

Purpose of the test

The purpose of testing for genital and oral herpes is to identify evidence of an HSV infection. Testing for genital and oral herpes may be ordered for several reasons, including:

  • Confirming a diagnosis of HSV infection in symptomatic patients
  • Diagnosing patients with a history of genital sores who don’t have symptoms
  • Identifying a potential HSV infection in pregnant women without symptoms
  • Understanding if a sexual partner of a person with HSV is susceptible to infection
  • Estimating the frequency of future symptom outbreaks

Testing can also determine the type of HSV causing an infection. There are two main types of HSV:

  • Herpes simplex virus type 1 (HSV-1): HSV-1 is the cause of most cases of oral herpes and is often contracted during childhood. HSV-1 can also be spread to the genitals during oral sex.
  • Herpes simplex virus type 2 (HSV-2): HSV-2 is the most common cause of genital herpes. HSV-2 can also be spread to the mouth during oral sex, causing infections of the mouth or lips. HSV-2 is typically spread through sexual contact, including vaginal, oral, or anal sex.

What does the test measure?

Testing for genital and oral herpes detects evidence of an HSV infection. There are four types of tests that confirm the presence of an HSV-1 or HSV-2 infection:

  • Viral culture: A herpes viral culture is used to determine if a skin sore is infected with HSV-1 or HSV-2 by collecting a sample from a skin sore, placing it in a special laboratory environment, and watching to see if the virus or virus-related substances grow. A viral culture is most useful early in an outbreak, when a sore is open.
  • Polymerase chain reaction (PCR) testing: PCR testing, also called a viral DNA test, uses a sample taken from a patient’s sore to look for the DNA of HSV-1 and HSV-2. PCR testing can distinguish between HSV-1 and HSV-2 infections, making this test useful in determining which virus is causing a person’s infection. PCR testing is the primary method of testing samples of cerebrospinal fluid.
  • Tzanck smear: The Tzanck smear uses a sample of cells scraped from a patient’s sore to look for cells that are characteristic of a herpes infection. During a Tzanck smear, cells can be examined under a microscope in a clinic or doctor’s office without needing to send the sample to a laboratory.
  • Antibody tests: Antibodies are produced by the immune system in response to potentially harmful substances called antigens. Because every type of antibody is unique to a specific antigen, herpes simplex antibody testing can determine if a patient is infected with HSV-1 or HSV-2. HSV antibodies can be detected in a blood sample or a sample taken from a patient’s sore. It takes time for the body to develop antibodies, so a positive result may not occur for up to three months after the initial infection.

When should I get a genital or oral herpes test?

Testing for the viruses that cause genital and oral herpes may be ordered when a patient develops signs and symptoms of a herpes infection. Although many people who contract HSV never notice symptoms, signs of an initial infection appear 2 to 20 days after infection and depend on the type of HSV causing the infection.

When signs and symptoms of an initial infection occur, they may include:

  • Small sores on the skin
  • Blisters on the lips, penis, vagina, buttocks, anus, or around the mouth.
  • Tingling, itching, or burning on the skin
  • Fever, headache, or body aches
  • Swollen lymph nodes

After the initial infection, HSV remains dormant inside of the body. HSV can reactivate throughout a patient’s life, causing symptoms of genital or oral herpes to reappear. While the trigger for an HSV outbreak is often unknown, potential triggers include a fever, stress, physical trauma, and a suppressed immune system.

Generally, expert organizations do not recommend herpes testing for patients without symptoms. An exception may be made for certain patients, including:

  • Patients who have a partner with genital herpes
  • Patients seeking a more complete STD test panel, including people with multiple sexual partners
  • Babies born to a mother who has HSV

Finding a Genital or Oral Herpes Test

How to get tested

Tests for genital and oral herpes are available at doctor’s offices, medical clinics, and community-based organizations that offer STD testing. Testing is often ordered by a doctor, but may be available over-the-counter and at community-based organizations without a physician’s orders.

Can I take the test at home?

At-home tests are available to test for evidence of an HSV infection. At-home herpes testing typically detects HSV antibodies in a self-collected sample of blood and may require additional follow-up if preliminary results are positive. At-home herpes tests can be obtained online or at a local pharmacy.

How much does the test cost?

The cost of testing for genital and oral herpes depends on the type of test that is performed, where the test is conducted, and whether the patient has medical insurance. Testing is often covered by insurance when ordered by a doctor, although patients may still be responsible for costs such as copays and deductibles.

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Taking a Genital or Oral Herpes Test

Testing for genital and oral herpes may be performed with a blood sample or a sample of fluid swabbed or scraped from a sore. Both types of samples are collected by a health professional when conducted at a doctor’s offices, clinic, or community organization.

If a patient is experiencing an outbreak, a doctor can collect a sample for testing by swabbing or scraping a sore. Material from the sore can be used for a herpes viral culture, PCR testing,

A Tzanck smear or an antibody test.

If a patient is not currently experiencing an outbreak, a blood test may be used to identify HSV antibodies. If a doctor suspects a brain infection with HSV, a lumbar puncture may be performed to obtain a sample of cerebrospinal fluid for analysis.

Before the test

Before taking a test for genital and oral herpes, patients should talk to their doctor about any medications or supplements being taken. For tests that require a sample taken from a sore, the sample must be collected when lesions are open, before they begin to form a scab. For a blood test, no special preparation is required.

During the test

Collecting material from a sore may involve rubbing a sterile swab against the skin lesion or scraping the base of the lesion or ulcer with the blade of a scalpel. During collection, patients may experience discomfort.

A blood sample for antibody testing is collected from a vein in a patient’s arm or from pricking a finger with a small needle. If using a vein, a needle is used to draw blood. Blood is usually drawn from inside of the elbow or back of the hand.

During a blood draw, the site is first cleaned with an antiseptic and an elastic band is tied around the upper arm. The needle is then inserted and blood is drawn into a tube or vial. Some people feel minor pain or a stinging sensation when the needle is inserted. Blood draws are usually completed in under three minutes

After the test

After material is collected from a skin lesion, there are no special post-test restrictions. Patients may have some slight bleeding or temporary discomfort where the skin was swabbed or scraped.

After a patient’s blood is drawn, a piece of gauze or bandage is placed over the puncture site along with some gentle pressure. Slight soreness or bruising can occur but normally isn’t long-lasting. Patients can return to normal activities after a blood draw.

Genital and Oral Herpes Test Results

Receiving test results

Results from genital and oral herpes testing are usually available within a few business days, depending on the type of test performed. Viral culture testing may take several additional days, while rapid blood tests may be completed in as little as 15 minutes. The health care team that conducted the test typically contacts the patient to provide results. Test reports may also be sent electronically or by mail.

Interpreting test results

The results of genital and oral herpes testing are often given as negative/normal or positive/abnormal. The interpretation of these results depends on the type of test conducted.

Viral culture and PCR test results indicate whether the sample used for the test contained HSV. A positive result means that the patient has an HSV infection. The patient may be experiencing an initial outbreak or a recurrent outbreak from a past infection. Test results may also include the type of HSV identified in the sample.

A negative result on a viral culture or PCR test indicates that the test sample did not contain HSV. It’s important to keep in mind that a negative viral culture or PCR test does not always mean that a patient doesn’t have a current or past HSV infection.

The results of an antibody test report whether antibodies produced in response to an HSV infection were detected in the sample used for testing. A positive result indicates that HSV antibodies were detected and the patient has an active outbreak or past infection.

Negative results from antibody testing indicate that HSV antibodies weren’t detected in the sample. This result could occur because the patient doesn’t have an active outbreak or past infection. A negative result can also occur because the test sample didn’t have enough of the virus to be found during testing due to a very recent infection. It can take up to three months after an infection to test positive for HSV antibodies.

For patients that have a Tzanck smear, results indicate whether or not certain cells, called multinucleate giant cells, were detected under a microscope. These cells are characteristic of a herpes infection, so positive test results suggest that a patient has an infection. A Tzanck smear cannot distinguish between types of herpes infections, so a patient may have HSV-1, HSV-2 or another type of herpesvirus.

Negative results from a Tzanck smear indicate that multinucleate giant cells were not found in the test sample. A negative result often isn’t helpful, as a Tzanck smear typically isn’t able to accurately identify patients who don’t have HSV or distinguish between types of herpesviruses.

Are test results accurate?

Tests that identify evidence of HSV infections are routine and commonly used medical tests. The ability of a test to accurately diagnose or rule out HSV infection depends on the test used for analysis and the stage of a patient’s infection.

The Tzanck smear and viral culture are less able to accurately identify patients who have an HSV infection than other tests. PCR testing and antibody testing are more sensitive, which means that they miss fewer cases of infection.

Blood tests that detect antibodies to HSV can distinguish between HSV-1 and HSV-2 but not the site of infection. This means that blood tests cannot tell whether a patient has a genital or oral herpes infection.

Although these tests are valuable for identifying HSV infection, no test is perfect. When learning of test results, patients should talk to their doctor about the type of test conducted, the reliability of test results, and if additional tests are necessary to confirm or rule out a diagnosis.

Do I need follow-up tests?

Although one test may be sufficient to confirm an HSV infection, there are circumstances in which follow-up tests may be prescribed after you have completed a genital and oral herpes test.

If an initial test is not specific to herpes simplex, such as a Tzanck smear, additional testing may be needed to confirm or rule out an HSV infection. Confirmation testing may also be recommended after some types of blood tests.

Additionally, if doctors suspect that a herpes infection has reached a patient’s brain, additional testing may be necessary to diagnose an HSV infection in this part of the body.

If a patient is diagnosed with genital or oral herpes, a doctor may discuss treatment options. Although there is no cure for HSV, treatment for this infection can shorten the duration of symptoms and outbreaks.

Questions for your doctor about test results

The following questions may be useful as patients review genital and oral herpes test results with their doctor:

  • What type of test was conducted?
  • What is my test result?
  • What is the most likely explanation for my test result?
  • Are there any follow-up tests that you recommend?
  • How should I discuss my test result with sexual partners?

View Sources

Sources

A.D.A.M. Medical Encyclopedia. Venipuncture. Updated April 26, 2019. Accessed August 17, 2021. https://medlineplus.gov/ency/article/003423.htm

A.D.A.M. Medical Encyclopedia. Herpes viral culture of lesion. Updated June 30, 2019. Accessed August 17, 2021. https://medlineplus.gov/ency/article/003739.htm

A.D.A.M. Medical Encyclopedia. Serum herpes simplex antibodies. Updated June 30, 2019. Accessed August 17, 2021. https://medlineplus.gov/ency/article/003352.htm

A.D.A.M. Medical Encyclopedia. Herpes – oral. Updated July 11, 2019. Accessed August 17, 2021. https://medlineplus.gov/ency/article/000606.htm

A.D.A.M. Medical Encyclopedia. Antibody. Updated August 13, 2020. Accessed August 17, 2021. https://medlineplus.gov/ency/article/002223.htm

Albrecht MA. Epidemiology, clinical manifestations, and diagnosis of genital herpes simplex virus infection. In: Hirsch MS, ed. UpToDate. Updated December 22, 2020. Accessed August 17, 2021. https://www.uptodate.com/contents/epidemiology-clinical-manifestations-and-diagnosis-of-genital-herpes-simplex-virus-infection

Albrecht MA. Treatment of genital herpes simplex virus infection. In: Hirsch MS, ed. UpToDate. Updated June 28, 2021. Accessed August 17, 2021. https://www.uptodate.com/contents/treatment-of-genital-herpes-simplex-virus-infection

American Academy of Dermatology. Herpes simplex: Who gets and causes. Date unknown. Accessed August 17, 2021. https://www.aad.org/public/diseases/a-z/herpes-simplex-causes

American Academy of Dermatology. Herpes simplex: Diagnosis and treatment. Date unknown. Accessed August 17, 2021. https://www.aad.org/public/diseases/a-z/herpes-simplex-treatment

American College of Obstetricians and Gynecologists. Genital herpes. Published April 2019. Accessed August 17, 2021. https://www.acog.org/womens-health/faqs/genital-herpes

Ayoade FO. How is Tzanck preparation performed for the diagnosis of herpes simplex virus (HSV) infection? Bronze MS, ed. Medscape. Updated May 24, 2021. Accessed  August 17, 2021. https://www.medscape.com/answers/218580-11394/how-is-tzanck-preparation-performed-for-the-diagnosis-of-herpes-simplex-virus-hsv-infection

Caliendo AM. PCR testing for the diagnosis of herpes simplex virus in patients with encephalitis or meningitis. In: Hirsch MS, ed. UpToDate. Updated May 26, 2021. Accessed August 17, 2021. https://www.uptodate.com/contents/pcr-testing-for-the-diagnosis-of-herpes-simplex-virus-in-patients-with-encephalitis-or-meningitis

Centers for Disease Control and Prevention. Genital herpes screening FAQ. Updated February 9, 2017. Accessed August 17, 2021. https://www.cdc.gov/std/herpes/screening.htm

Centers for Disease Control and Prevention. Genital herpes – CDC fact sheet. Updated August 28, 2017. Accessed August 17, 2021. https://www.cdc.gov/std/herpes/stdfact-herpes.htm

Centers for Disease Control and Prevention. Genital herpes – CDC fact sheet (detailed). Updated July 22, 2021. Accessed August 17, 2021. https://www.cdc.gov/std/herpes/stdfact-herpes-detailed.htm

Goldstein BG, Goldstein AO. Office-based dermatologic diagnostic procedures. In: Dellavalle RP, ed. UpToDate. Updated April 14, 2021. Accessed August 17, 2021. https://www.uptodate.com/contents/office-based-dermatologic-diagnostic-procedures

Janniger CK. What is the role of Tzanck smear in the workup of herpes zoster (shingles)? Elston DM, ed. Medscape. Updated July 22, 2021. Accessed  August 17, 2021. https://www.medscape.com/answers/1132465-41020/what-is-the-role-of-tzanck-smear-in-the-workup-of-herpes-zoster-shingles

Kaye KM. Herpes simplex virus (HSV) infections. Merck Manuals Professional Edition. Updated October 2019. Accessed August 17, 2021. https://www.merckmanuals.com/professional/infectious-diseases/herpesviruses/herpes-simplex-virus-hsv-infections

Kaye KM. Herpes simplex virus (HSV) infections. Merck Manual Consumer Edition. Updated April 2020. Accessed August 17, 2021.

https://www.merckmanuals.com/home/infections/herpesvirus-infections/herpes-simplex-virus-hsv-infections

MedlinePlus: National Library of Medicine. Herpes (HSV) test. Updated December 3, 2020. Accessed August 17, 2021. https://medlineplus.gov/lab-tests/herpes-hsv-test/

National Heart, Lung, and Blood Institute. Blood tests. Date unknown. Accessed August 17, 2021. https://www.nhlbi.nih.gov/health-topics/blood-tests

National Institutes of Health. Herpes can happen to anyone: Share facts, not fears. Published June 2018. Accessed August 17, 2021. https://newsinhealth.nih.gov/2018/06/herpes-can-happen-anyone

Riley LE, Wald A. Genital herpes simplex virus infection and pregnancy. In: Hirsch MS, Lockwood CJ, eds. UpToDate. Updated June 10, 2020. Accessed August 17, 2021. https://www.uptodate.com/contents/genital-herpes-simplex-virus-infection-and-pregnancy

Tuddenham S, Ghanem KG. Approach to the patient with genital ulcers. In: Marrazzo J, ed. UpToDate. Updated December 7, 2020. Accessed August 17, 2021. https://www.uptodate.com/contents/approach-to-the-patient-with-genital-ulcers

Wald A. Prevention of genital herpes virus infections. In: Hirsch MS, ed. UpToDate. Updated November 12, 2020. Accessed August 17, 2021. https://www.uptodate.com/contents/prevention-of-genital-herpes-virus-infections

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