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DIAGNOSTIC TESTS FOR GENITAL AND ORAL HERPES The "gold standard" for diagnosis of herpes is the viral culture. If a viral culture taken at a clinic from an active herpes lesion is positive for herpes simplex, then this makes the diagnosis. The patient should always be sure to ask the doctor to perform complete typing of the virus so that the result will reveal if the virus in question is herpes simplex type 1 or type 2. This may be important later, especially regarding the possibility of transmission of the disease to others. Sadly, the viral culture can be falsely negative for many reasons. The virus must survive the trip to the laboratory. Anything that may affect this survival negatively could then cause a false negative result. For example, if the sample became overheated, it could kill the virus and cause a false negative result. A newer "gold standard" is even more sensitive than the viral culture. This test is called the PCR DNA test, and it can identify the DNA from viral particles to an extremely high degree of accuracy and can differentiate between the two types. This test directly reveals the presence of either type of virus from the lesion. Wald et al showed in their 1997 paper that the PCR test was almost 300% more sensitive in picking up actual viral material from vaginal specimens than was the viral culture. Sadly, the PCR DNA test is not routinely available to the clinician in the office at this time. Dr. H., Medical Director |
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