Recommendations

Australasian Chapter of Sexual Health Medicine

The Australasian Chapter of Sexual Health Medicine (AChSHM) is a Chapter of the Royal Australasian College of Physicians (RACP) Adult Internal Medicine Division. It connects & represents Sexual Health Medicine Fellows & trainees.

1.
Do not order herpes serology tests unless there is a clear clinical indication.

Herpes serology is not an appropriate screening test in asymptomatic patients and does not accurately confirm whether the person is infected or is a transmission risk to others from asymptomatic shedding. Clinicians also need to consider whether test results will influence treatment or outcomes because, if they do not, then testing is a waste of finite health resources and is not indicated. Herpes serology tests only have good sensitivity and specificity in high prevalence populations. However, selective use of herpes serological tests may be justified for particular groups, such as those at high risk for STIs and human immunodeficiency virus (HIV) infection who are motivated to reduce their sexual risk behaviour; HIV-infected patients; patients with sexual partners with genital herpes; and in cases where a woman appears to have a first episode of herpes simplex virus (HSV) during pregnancy.

This recommendation is endorsed by The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG).

Supporting evidence
  • Guerry SL, Bauer HM, Klausner JD, Branagan B, Kerndt, PR. Recommendations for the selective use of herpes simplex virus type 2 serological tests. Clinical Infectious Diseases 2005; 40(1): 38-45.
  • New Zealand Herpes Foundation. Guidelines for the Management of Genital Herpes in New Zealand. 10th Ed, 2013.
  • Scoular A. Using the evidence base on genital herpes: optimising the use of diagnostic tests and information provision. Sexually Transmitted Infections 2002; 78(3): 160–165.
  • Strick L, Wald A. Type specific testing for herpes simplex virus. Expert Review of Molecular Diagnostics 2004; 4: 443-53.