Routine Herpes Screening Not Recommended in Asymptomatic Patients

Cautious retail clinicians may consider routinely testing all patients for genital herpes, but they might want to hold off on screening those who don’t exhibit symptoms.

The US Preventive Services Task Force (USPSTF) recently released a public draft of its forthcoming guidelines on serologic screening for genital herpes infection. After analyzing data on 18 previous studies of serologic herpes tests, it observed that herpes blood tests had a relatively high rate of false-positive results and were associated with potential psychosocial harms, such as distress and anxiety.

The USPSTF added that routine screening appeared to offer almost no benefit to patients, as the early detection and treatment of genital herpes made little difference in outcomes. There’s currently no cure for genital herpes, so treatment focuses on alleviating its symptoms, which can include bleeding between periods, blisters, discharge, and burning.

“Because there’s no cure, there isn’t much doctors and nurses can do for people who don’t have symptoms,” said USPSTF member Maureen Phipps, MD, in a press release.

Based on its findings, the task force ultimately recommended against routine serological screening for herpes in asymptomatic adolescents and adults, giving the use of the test in this population the lowest grade of “D.” However, it nevertheless advised clinicians and other health care providers to screen patients for other sexually transmitted infections (STIs) like chlamydia, gonorrhea, syphilis and HIV, as well as to counsel patients at high risk for developing these diseases. It also encouraged patients to consult their providers immediately if they experience any signs of herpes or another STI.

“People should be aware of the signs and symptoms of genital herpes and should talk to their doctor or nurse if they are concerned,” stated task force member Ann Kurth, PhD. “This is especially true for women who are pregnant because there are things clinicians can do to help women who have genital herpes protect their babies during delivery.”

The USPSTF acknowledged several limitations to its research, noting that most of the studies it evaluated were conducted in African countries, where the rate of herpes is higher than that of the United States. It also explained that the benefits of behavioral counseling interventions or preventive antiviral medication in asymptomatic patients has yet to be established.

Approximately 1 in 6 individuals 14 to 49 years in the United States has contracted genital herpes, according to the CDC.