Herpes | Questions & Answers | 2015 STD Treatment Guidelines

Question: Is the HerpeSelect a recommended test for HSV? What alternative tests are recommended?

The HerpeSelect test is a widely available test used by multiple labs throughout the country.  It is a glycoprotein G-based type specific serologic assay. The limitations of the HerpeSelect test, i.e. false positive results with low index value reading (1.1–3.5) are discussed in the Guidelines.  While providers should be aware of these limitations and perform confirmatory testing as recommended by the Guidelines, the HerpeSelect test remains an acceptable test for HSV serologic diagnosis.  

Specific recommendations for HSV1 antibody testing (as opposed to type-specific HSV serologic assays) are not discussed in the Guidelines.   Providers may not have easy access to alternative serologic testing for HSV1 and should be aware of the limitations of the HerpeSelect HSV1 test.

The Guidelines recommend that a second serologic test be used to confirm a low positive HerpeSelect HSV2 index value.  While the Western Blot can be used, other type-specific HSV serologic assays, such as Biokit, can also be performed as confirmatory tests.  The Western Blot is only available at a single location, the University of Washington.  The HerpeSelect HSV-2 Immunoblot should NOT be used for confirmation, because it uses the same antigen as the HerpeSelect assay.