Serological testing for herpes simplex virus (HSV) is not recommended in most cases of genital herpes due to its accuracy and clinical utility limitations. Serology detects past exposure to HSV but cannot confirm active infections or distinguish between genital and facial infections. HSV IgG antibodies may take weeks to months to develop, leading to false negatives in early infection, and even seropositive individuals may revert to seronegative status. Genital herpes screening is not recommended and is likely more harmful than helpful.
Viral swab PCR testing from active lesions is the gold standard in NZ for accurate diagnosis. The New Zealand Herpes Guidelines advise that HSV-1 and HSV-2 serology is not recommended except in rare, specific situations (e.g., an asymptomatic pregnant partner of a newly diagnosed person); discuss these with a sexual health specialist.
This Gem was checked by Dr Massimo Giola, Sexual Health Medicine Specialist.
