TYPES OF HERPES TESTS

Tzanck Prep Test

The Tzanck prep test is not performed today as often as it was in the past, and it is less sensitive than culture in the diagnosis of herpes. This test is performed by scraping a lesion, putting the sample on a slide, staining it, and looking under the microscope for characteristic cell changes. It cannot distinguish between herpes type 1 and herpes type 2.

Antigen Detection

Antigen detection is performed from a lesion and can usually provide results more quickly than culture because nothing needs to “grow.” The test is designed to detect the antigens or proteins that are on the surface of the virus. Even in the scab stage, a lesion may have antigen present, so this test may be more sensitive than a culture in testing an older lesion. It cannot distinguish between the types of herpes, however, and a negative test does not rule out herpes.

Polymerase Chain Reaction Test

The polymerase chain reaction (PCR) test is newer. It is intended to detect the genetic material of the herpes virus and is much more sensitive than culture tests. It is also much more expensive than culture tests and is not offered in all areas of the country. It can be used to test a lesion or spinal fluid to evaluate for herpes.

Pap Smear

Sometimes a Pap smear shows changes consistent with herpes if there is an outbreak on the cervix at the time the smear is performed, but the test is not a reliable screen for herpes. (See the section on genital warts for more information on the Pap smear.) In one study, in which women had active cervical inflammation from herpes that was confirmed by culture, the Pap smear detected the herpes virus only about 60 percent of the time.

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