How Accurate Are Herpes Blood Tests?

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Wondering if you have herpes can be stressful. If you think you have herpes because you have symptoms or suspect that you may have been exposed to the virus sexually, your healthcare provider may give you a blood test to confirm. Find out if you have the herpes simplex virus (HSV).

Herpes blood test is a two-step process in which an initial positive result is followed by a second confirmatory test. A positive result from both tests can be considered a definitive diagnosis of herpes.

Although herpes blood tests provide high accuracy, they are infallible. Furthermore, if you do have symptoms, they may not be as helpful or informative as an HSV culture test or a PCR test (both of which can detect HSV in a swab of fluid from a wound). Herpes).

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This article explores the accuracy of the herpes blood test and outlines current recommendations for herpes testing in the United States.

How to measure the accuracy of the test

The accuracy of all medical tests, including herpes tests, is measured against two values: sensitivity and specificity.

Sensitive is how often the test correctly identifies a person with the disease. A test with 90% sensitivity will correctly identify 90 out of 100 people with the disease. Ten people will get a false negative.

On the other hand, specificity refers to the ability of the test to accurately identify people who do not have the disease. If a test is 90% specific, that means 90 people out of 100 will be correctly diagnosed as Not infected, and those 10 will have a false-positive result.

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The higher the sensitivity and specificity, the lower the chance of false (inaccurate) results.

Accuracy by test type

Two blood tests are used to screen for herpes. To ensure that the initial positive result is correct, a second test using a different detection method is used to confirm the result.

The first test is an enzyme-linked immunosorbent assay (ELISA). ELISA looks for immune proteins, called antibodies, that are produced by the immune system in response to HSV. HSV antibodies are present even in the absence of symptoms.

If the ELISA result is positive, your healthcare provider may perform a Western blot test. This second test looks for proteins on the surface of the virus, called antigen, which acts as the “ID tag” of the virus. HSV antibodies produced in response to these antigens help the immune system target its attack.

According to the US Preventive Services Task Force, the accuracy of the two blood types used to diagnose herpes is as follows:

Test Sensitive Specificity
HerpeSelect . ELISA Toolkit 96% to 100% 87% to 100%
Herpes Western Blot Test Over 99% Over 99%

Due to its high sensitivity and specificity, Western blot is considered the gold standard of herpes blood testing.

With that said, the accuracy of the tests can be affected by the timing of the tests. For an ELISA to return accurate results, the immune system needs to produce enough antibodies to reach detectable levels.

Testing too early during the so-called window period can lead to a false-negative result (where the test says you don’t have HSV even if you do).

Window period for genital herpes

The window period for genital herpes can be from three to 12 weeks. While most cases can be detected by the third week, some people may take longer to produce detectable antibodies.

Other test options

When ELISA is confirmed by Western blot, the diagnosis of herpes is unlikely to be false. However, other tests may be more useful and/or more reliable in certain situations. Both tests rely on direct detection of HSV using fluid obtained from a herpes swab.

Polymerase chain reaction (PCR)

One polymerase chain reaction (PCR) test can detect HSV by making copies of the virus’ genetic material in a process known as nucleic amplification. Even if only a small amount of virus is present, the genetic material can be amplified enough to return an accurate positive diagnosis.

PCR is considered the gold standard of testing for herpes that has invaded the brain or spinal cord (typically in people with advanced HIV infection).

Viral culture

HSV virus culture is a process in which the virus is “grown” in a laboratory using a swab with fluid. Compared with all other HSV detection methods, viral culture is considered the gold standard of testing.

Even so, HSV virus cultures are more time-consuming, taking three to eight days to return results. Furthermore, user error can affect the results. For example, the test may be less accurate if the health care provider takes a scab, not an ulcer. Delays in transportation or improper cooling can also impair the accuracy of the test.

Limitations of testing

Exactly like herpes tests, they are not used for routine screening. This is because, in the absence of symptoms, a positive result does not mean you will have symptoms or need treatment.. On the other hand, knowing your HSV status can reinforce safer sex practices if you’re in a relationship.

Herpes Screening Recommendations

Currently, the US Preventive Services Task Force advises against screening for herpes in people without herpes symptoms, including those who are pregnant.

This doesn’t mean you shouldn’t get tested under certain circumstances. According to the Centers for Disease Control and Prevention, HSV testing can be used in asymptomatic (asymptomatic) people:

  • Having sex with someone who has genital herpes
  • Being tested for other sexually transmitted infections
  • Have HIV and a history of genital herpes symptoms
  • Have a higher risk of infection for any reason (including having multiple sex partners)


Herpes can be diagnosed with a blood test. This includes an ELISA test that detects herpes antibodies and a Western blot test used to confirm the results. Herpes testing is usually only recommended for people with herpes symptoms.

Although the ELISA test and the Western blot test are highly accurate when used together, other direct testing methods may be used, especially if you have symptoms. This includes a PCR test that can detect the genetic material of the virus and a culture of the virus that can “grow” the virus in the lab. Both rely on a swab filled with fluid from the herpes sore.

A very good word

While routine herpes screening is not recommended for the general public, it still has its place even if you have no symptoms. If you suspect you may have herpes for any reason, talk to your healthcare provider to assess your risk and determine if herpes testing is appropriate based on: your risk and circumstances.

frequently asked Questions

  • What tests are used to diagnose herpes simplex?

    There are two blood tests used to diagnose a herpes infection:

    • ELISA testused for initial testing, detecting antibodies specific to herpes.
    • Western styleUsed to confirm the diagnosis, detect herpes antigens.

  • How accurate are the herpes blood tests?

    The accuracy of the new generation herpes blood tests is particularly high. Sensitivity and specificity vary according to the type of test used:

    • ELISA: Sensitivity from 96% to 100% and specificity from 97% to 100%
    • Western style: Sensitivity and specificity above 99%

  • Can a herpes test return a false positive or a false negative?

    The chance of false positive results is low but can occur due to user error or improper storage or handling. Conversely, a false-negative result can occur if your body does not produce enough antibodies to reach detectable levels. For this reason, everyone should wait at least three weeks from the time of suspected exposure prior to testing. This waiting period is often referred to as the “window period”.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts in our articles. Read our editorial process to learn more about how we verify authenticity and keep our content accurate, trustworthy and trustworthy.

  1. Maxim LD, Niebo R, Utell MJ. Screening test: review with examples. Inhal Toxicol. 2014; 26 (13): 811–28. doi: 10.3109 / 08958378.2014.955932

  2. Arshad Z, Alturkistani A, Brindley D, Lam C, Foley K, Meinert E. Herpes simplex virus diagnostic tools 1/2: a systematic review of studies published between 2012 and 2018. JMIR . public health survey. 2019; 5 (2): e14216 length: 10.2196 / 14216

  3. United States Preventive Services Task Force. Serological screening for genital herpes infection: US Preventive Services Task Force recommendation statement. JAMA. 2016; 316 (23): 2525-2530. doi: 10.1001 / jama.2016.167776

  4. University of California, San Francisco. Serum herpes simplex antibodies.

  5. Centers for Disease Control and Prevention. Genital Herpes – CDC fact sheet (details).

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