How long can the herpes virus stay "undetected" in the body. When can an STD test safely rule out the absense?

by Nottingham Vet School

How long can the herpes virus stay "undetected" in the body. When can an STD test safely rule out the absense?

Herpes Simplex Virus 1: HSV-1 has a more variable presentation than HSV-2 and can be symptomatic with relatively severe symptoms. It usually presents orolabially as cold sores or fever blisters and can also appear on the nose, chin and other facial areas. A small, but increasing, proportion of these cases is primary genital herpes, associated with oral sex. Symptoms can be very minor or not apparent or, as noted above, occasionally severe. Almost 70% of adults in the US display evidence of a previous HSV-1 infection when their blood is tested for HSV-1 antibodies, usually contracted in their childhood. This number appears to be on the decline as the population becomes increasingly aware of cold sores and fever blisters as a form of transmittable herpes and alter habits that help reduce its spread. An exception is among men who have sex with men, where the epidemiology of HSV-1 appears to be increasing in first episode reports, often associated with genital episodes. Genital HSV-1 is much less frequently recurrent and each recurrence usually last only a few days. The remainder of this document will primarily discuss HSV-2; where HSV-1 is further detailed, it will be clearly identified.

Herpes Simplex Virus 2: Infections with HSV-2 are more likely to be asymptomatic, and most patients are undiagnosed – i.e., patients do not know they have HSV infection, and they shed the virus intermittently, transmitting it to others. The virus can be spread even when patients are asymptomatic and have no visible lesions. Indeed, married individuals who abstain from sexual activity during HSV outbreaks still transmit the virus to their partners at a rate of 5 to 10 percent per year. Male to female transmission is more frequent.

HSV-2 presents almost entirely genitally -- oral presentations are rare -- and accounts for 95% of recurrent genital herpes. For HSV-2, the prevalence among U.S. adults is serologically estimated via survey to be ~25% by age 30 (30% of U.S. women and 20% of U.S. men) and 4% - 18% in Western Europe. In most studies of these seropositive adults, only 10–25% (2-3% of the total population) report a history of genital lesions. Another 10% have purely asymptomatic disease, their immune systems having prevented clinical appearance. The others have unrecognized or inapparent HSV-2. Figure 1 below displays these percentages visually.Most people with herpes have no symptoms at all. So if by "undetected" you mean "symptomless" then the answer is - forever.

I've put a link to a page about herpes testing on my fave herpes website. The relevant portions is "For the most accurate test result, it is recommended to wait 12 - 16 weeks from the last possible date of exposure before getting an accurate, type-specific blood test in order to allow enough time for antibodies to reach detectable levels."

There is some important info in there. For example, request a type-specific test. Most people (50% to 80% of adults) have HSV1, so expect it to be positive for that. It's HSV2 that you are probably worried about.

The second thing to know is that you can get either virus (HSV1 or HSV2) in either place (orally or genitally). So you could easily catch HSV1 genitally, not realize it, and assume that a positive HSV1 test means ORAL herpes, and be wrong.

Finally, know that most standard STD screenings don't include herpes. You'll need to ask for it specifically.

Hope this helps.

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