Current Thinking on Genital Herpes

Annika M. Hofstetter; Susan L. Rosenthal; Lawrence R. Stanberry


Curr Opin Infect Dis. 2014;27(1):75-83. 

In This Article

Herpes Simplex Virus Screening

Universal or widespread HSV screening has been recently debated.[34,108] Proponents argue that HSV screening may be a valuable strategy for increasing awareness of infection, particularly among the many asymptomatic individuals who are unaware of their risk for shedding virus, which in turn may reduce HSV transmission and burden of disease.[34] Accurate, type-specific HSV serological assays have been available since 1999,[109] making routine screening of the general population possible. Moreover, effective management options are available for newly identified HSV-infected individuals. Nonetheless, routine HSV screening is not currently recommended by the U.S. Preventive Services Task Force for a variety of reasons.[110] First, predictive values of currently available HSV serological assays may be inadequate, especially for low positive samples, in some populations (i.e. those with low disease prevalence).[108] It may also be difficult to interpret HSV-1 results given the rising proportion of genital herpes infections caused by HSV-1.[34] Moreover, some worry that screening could lead to detrimental psychological outcomes;[110] however, there is no evidence to date that this is true, particularly among asymptomatic patients. Certainly, concerns about psychological sequelae should not deter providers from screening when appropriate.[111] Lastly, there are few, if any, studies that have examined whether knowledge of HSV infection, especially among asymptomatic individuals, actually changes behaviours (e.g. initiation of antiviral therapy, condom use, partner disclosure) or lowers transmission rates.[108]