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New Herpes Virus Screening Guidelines Call for Less Routine Testing

DEC 22, 2016 | CONTAGION EDITORIAL STAFF
Genital herpes is among the most-prevalent sexually transmitted infections and according to the Centers for Disease Control and Prevention (CDC), 1 in 6 individuals aged 14 to 49 years are infected in the United States. Despite these statistics, routine test to screen for the infection is no longer recommended by the US Preventive Services Task Force (USPSTF).
 
Genital herpes is caused by one of two herpes viruses: herpes simplex type 1 (HSV-1) and herpes simplex type 2 (HSV-2). Although most people associate a herpes infection with visible rash-like sores, it is important to know that most individuals who are infected with the virus do not show any symptoms. Perhaps more importantly, the virus can still be transmitted—through oral, vaginal, or anal sex—even if a person is not showing any outward signs of infection.
 
The updated USPSTF guidelines, however, “recommend against routine serologic screening for genital HSV infection in asymptomatic adolescents and adults, including those who are pregnant.” The task force came to this decision after evidentiary review and “concluded that the potential harms of screening outweigh the benefits” according to a press release about the updated recommendations. Because “blood test screening for genital herpes is highly inaccurate and there is no cure, so screening, early identification and treatment are unlikely to affect the course of the disease.” Likewise, because of the high incidence of false-positives, the experts stated that the test causes unnecessary anxiety in those who are tested and negatively impacts relationships with their romantic partners.
 
Although the task force is recommending against routine screening for genital herpes, they still encourage those who think they may be infected to seek out their healthcare provider, particularly if they are pregnant or trying to become pregnant as a herpes infection can be transmitted to the newborn in utero, or lead to a miscarriage. Maureen Phipps, MD, chairwoman of the department of obstetrics and gynecology and an assistant dean at Brown University's Medical School in Providence, Rhode Island stated in the press release, "People who are concerned about their personal risk or are experiencing signs and symptoms of genital herpes should talk to their primary care clinician. This is especially true for women who are pregnant because clinicians can help women who have genital herpes minimize the chance of passing this on to their babies."
 
The full updated recommendation statement was published in the Journal of the American Medical Association.
 
Earlier this fall, the results of a recent study showing the effectiveness of a genital herpes vaccine were presented at ID Week 2016. Upon completion of a Phase 2a trial of the genital herpes immunotherapy GEN-003, Lisa K. McNeil, PhD, from Genocea Biosciences in Cambridge, Massachusetts, and her colleagues found that viral shedding was reduced by 66%, and genital lesion rate was reduced by 65%. And 30% of the participants remained lesion-free for 12 months after receiving the experimental vaccine.
 
The researchers recently enrolled participants in a follow-up study to examine the long-term efficacy and immunogenicity of the experimental vaccine in those who have a genital HSV-2 infection.
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