How long do herpes tests take to come back

There are different tests available for herpes. Viral culture and DNA tests can be done if you are experiencing symptoms. Blood tests are available for people who may not have had symptoms or if the signs have already healed.

Testing with symptoms

When a person has active herpes lesions (a.k.a. blisters, sores, ulcers), a swab can be taken and tests done that can detect the virus directly.

The tests used include culture and Nucleic Acid Amplification Testing (NAAT). Both culture and NAAT tests can identify the specific herpes virus type someone is infected with, but NAAT methods are more sensitive. Culture can easily miss infections and give false negative results.

Because a culture works by requiring virus that is active, if a lesion is very small, or is already beginning to heal, there may not be enough virus present for an accurate culture. Beyond 48 hours of the symptoms appearing, there is a risk of receiving a false negative test result. Viral culture is even less accurate during recurrences (positive in only about 30% of recurrent outbreaks).

NAAT methods are the preferred method, with PCR as the most-widely used NAAT method. These tests are fast, accurate, and can tell if a person has HSV-1 or HSV-2. There is also less chance of a false negative result with NAATs.

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 (the body’s immune response) 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 antibodies—not 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:

• Many assume that if a test discovers IgM, they have recently acquired herpes. However, research shows that IgM can reappear in blood tests in up to a third of people during recurrences, while it will be negative in up to half of persons who recently acquired herpes but have culture-document first episodes. Therefore, IgM tests can lead to deceptive test results, as well as false assumptions about how and when a person actually acquired HSV. For this reason, we do not recommend using blood tests as a way to determine how long a person has had herpes. Unfortunately, most people who are diagnosed will not be able to determine how long they have had the infection.
• In addition, IgM tests cannot accurately distinguish between HSV-1 and HSV-2 antibodies, and thus very easily provide a false positive result for HSV-2. This is important in that most of the adult population in the U.S. already has antibodies to HSV-1, the primary cause of oral herpes. A person who only has HSV-1 may receive a false positive for HSV-2.
• IgM tests sometimes cross-react with other viruses in the same family, such as varicella zoster virus (VZV) which causes chickenpox or cytomegalovirus (CMV) which causes mono, meaning that positive results may be misleading.

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.

There are currently several FDA-approved, gG-based blood tests that can give accurate results for herpes. Like any blood test, these tests cannot determine whether the site of infection is oral or genital. However, since most cases of genital herpes are caused by HSV-2, a positive result for type-2 antibodies most likely indicates genital herpes.

Herpes experts H. Hunter Handsfield, MD, and Kees Reitmeijer, MD, PhD, explain the types of herpes tests available, what tests are preferred for those with or without symptoms, and what test to avoid. See more of their conversation on sexualhealthTV.org. Have a question about herpes you’d like Dr. Handsfield or our other experts to answer? Visit Ask the Experts to learn how.

Herpes Test FAQ

What is the herpes test?

The herpes test measures herpes simplex types I (HSV-1) and II (HSV-2) IgG blood antibody levels.

Why is a herpes test important?

Herpes is an infection that can cause painful symptoms and can be transmitted to other people through sexual contact.

What type of specimen will I submit?

This Herpes Test is a blood test.

Do I need to fast to take this test?

Fasting is not necessary.

How long does it take to get test results?

It typically takes 4 business days or less.

Accesa Labs does not provide medical advice, diagnosis or treatment. All users should consult with a medical provider for specific health concerns.

Last updated on August 2, 2022

Herpes Blood Test - More Information

This herpes test, sometimes known as a herpes blood test panel, measures herpes virus 1 and 2 IgG antibody blood levels.

Herpes, or herpes simplex, is a disease caused by a virus known as the herpes simplex virus. Herpes is transmitted through contact with body fluids of someone with a herpes infection and, in many cases, this occurs through sexual activity.

The most common types of herpes viruses are herpes virus type 1 (HSV-1) and herpes virus type 2 (HSV-2). While the viruses can be tested independently through the HSV-1 test and the HSV-2 test, they are frequently tested together for broader coverage. Generally speaking, HSV-1 causes oral herpes infections while HSV-2 causes genital herpes infections. However, ordering both herpes tests at the same time is also beneficial as HSV-2 can cause oral herpes and vice versa. People who want to test for herpes and other common sexually transmitted infections should consider the STD test panel.

Most healthy people will not have any major complications for a herpes simplex virus infection. After the symptoms are present for a period of time, they often go away spontaneously. Populations at risk for complications from a herpes infection include very young children, the elderly, and people with compromised immune systems. Complications from a herpes infection include infections affecting the eyes, nervous system, and genital tracts.

Oral herpes infections are characterized by cold sores around the mouth or lips which look like clusters of blisters. Occasionally, no blisters will be present but some throat pain might be present. Genital herpes also manifests as blisters around the genital areas which occasionally form ulcers that can be painful. Historically, it was thought that someone was considered capable of infecting others only when they had blisters but now it is believed that someone can transmit the infection even without active symptoms (asymptomatic shedding). When symptoms are present, they typically start four days after an exposure and can last for several weeks. HSV-1 may also be involved in causing a condition called Bell's palsy but there is no clear, strong evidence in that regard.

Herpes Test - Results Process

Getting a herpes test near you is usually a relatively straightforward task if you have a lab in your area. Most lab locations carry the necessary equipment to perform the herpes virus blood test. Once you get your blood drawn, lab results come back relatively quickly (typically four business days but sometimes much sooner, depending on the lab location). Herpes IgG blood testing is thought to be 98% specific at identifying and discriminating HSV-1 and HSV-2. In the setting of a herpes virus infection, this herpes test is typically positive approximately 25 days after the exposure. A herpes test can be positive and identify an infection even in the absence of symptoms.

Interpreting a herpes blood test lab result is not an overly complex process. In the herpes sample lab report we have provided in the link above, the IgG Type Specific Ab levels are <0.90 for both HSV 1 and HSV 2. Per the reference range provided by the laboratory, a result <0.90 indicates a negative test result. As noted by the other reference ranges, >1.10 is considered a positive herpes result while 0.90-1.10 is considered equivocal. Unfortunately, equivocal results are indeterminate and repeat herpes testing is usually warranted.

While herpes blood testing is accurate, the lab results can be negative even when a herpes infection is present (i.e. false negative lab result). There are several reasons why this may happen. In most cases, the reason that a herpes lab result came back as a false negative is because the testing was performed too early after the herpes exposure. In these cases, it is not so much that the herpes test was wrong but rather the test was not sensitive enough to detect herpes in the blood at this early of a stage. Other reasons why a herpes lab result might come back as a false negative is if one's immune system is so compromised that an adequate herpes IgG antibody response cannot be generated (rare).

Herpes Home Test vs. Herpes Lab Testing

While our herpes test requires a visit to a lab, our testing process is private and no information is shared with your health insurance company or your personal doctor without your consent. That being said, some people would prefer to get a home herpes test (i.e. mail order). While there are some herpes test kits available on the market, current data suggests that they may not be as accurate as the FDA-approved herpes blood testing labs that we use and are trusted by doctors and medical providers across the country.

In order to prevent exposure to herpes, one must avoid any oral or sexual contact with an infected person. While condoms might help during sexual activity, they are by no means foolproof in preventing transmission of the herpes virus. Once infected, there is no cure for herpes. During periods of active symptoms like blisters, specific antiviral medications can sometimes reduce the duration of the symptoms and intensity of any associated pain.

The CDC estimates that 776,000 people get new herpes infections each year and that 15.7% of people between the ages of 14 and 49 have an HSV-2 infection. For anyone concerned about a herpes exposure or for people in a new relationship, herpes lab testing is a helpful way to determine your status with simple, affordable blood testing.