Screening for Asymptomatic Genital Herpes

Is Serologic Testing Worth It?

Leia Raphaelidis, FNP


Journal for Nurse Practitioners. 2014;10(3):194-199. 

In This Article

Herpes and Its Risks: Can Screening Make a Difference?

From a physiologic standpoint, asymptomatic herpes is largely harmless to immunocompetent individuals. Although HSV can carry rare but serious complications such as ocular herpes, herpes encephalitis, and neonatal herpes, most individuals infected with the virus will suffer no adverse physical sequelae. Furthermore, there is no evidence that screening reduces the risk of such complications. The American College of Obstetricians and Gynecologists recommends against routine serologic screening of pregnant women because of a lack of evidence for a cost-effective strategy that prevents neonatal herpes.[15]

However, genital herpes can increase the risk of human immunodeficiency virus (HIV) acquisition by 3-fold because the inflammation associated with HSV activation facilitates HIV entry into the body.[16] Nevertheless, there is no evidence at this time that this risk can be decreased by treating the HSV infection with antivirals.[17] In 1 double-blind, randomized, placebo-controlled study, suppressive therapy with the antiviral acyclovir taken daily had no effect on the risk of HIV acquisition despite significantly reducing the number of herpes outbreaks.[18]