Screening for Genital Herpes

U.S. Preventive Services Task Force

Release Date: March 2005

Summary of Recommendations / Supporting Documents

Summary of Recommendations

• The U.S. Preventive Services Task Force (USPSTF) recommends against routine serological screening for herpes simplex virus (HSV) in asymptomatic pregnant women at any time during pregnancy to prevent neonatal HSV infection.

  Rating: "D" recommendation.

  Rationale: The USPSTF found fair evidence that screening asymptomatic pregnant women using serological screening tests for HSV antibody does not reduce transmission of HSV to newborn infants. Women who develop primary HSV infection during pregnancy have the highest risk for transmitting HSV infection to their infants. Because these women are initially seronegative, serological screening tests for HSV (enzyme-linked immunosorbent assay [ELISA], immunoblot, and western blot assay [WBA]) do not accurately detect those at highest risk. There is no evidence that treating seronegative women decreases risk for neonatal infection. There is limited evidence that the use of antiviral therapy in women with a history of recurrent HSV, or performance of cesarean section in women with active HSV lesions at the time of delivery, decreases neonatal herpes infection. There also is limited evidence of the safety of antiviral therapy in pregnant women and neonates.

  The potential harms of screening include false-positive test results, labeling, and anxiety, as well as false negative tests and false reassurance, although these potential harms are not well studied. The USPSTF determined there are no benefits associated with screening, and therefore the potential harms outweigh the benefits.

• The USPSTF recommends against routine serological screening for HSV in asymptomatic adolescents and adults.

  Rating: "D" recommendation.

  Rationale: The USPSTF found no evidence that screening asymptomatic adolescents and adults with serological tests for HSV antibody improves health outcomes or symptoms or reduces transmission of disease. There is good evidence that serological screening tests can accurately identify those persons who have been exposed to HSV. There is good evidence that antiviral therapy improves health outcomes in symptomatic persons (e.g., those with multiple recurrences); however, there is no evidence that the use of antiviral therapy improves health outcomes in those with asymptomatic infection. The potential harms of screening include false-positive test results, labeling, and anxiety, although there is limited evidence of any potential harms of either screening or treatment. The USPSTF determined the benefits of screening are minimal, at best, and the potential harms outweigh the potential benefits.

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Supporting Documents

Screening for Genital Herpes, March 2005
Recommendation Statement (PDF File, 180 KB; PDF Help)
Brief Update (PDF File, 277 KB; PDF Help)

Current as of March 2005

Internet Citation:

Screening for Genital Herpes, Topic Page. March 2005. U.S. Preventive Services Task Force. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/clinic/uspstf/uspsherp.htm