U.S. Preventive Services Task Force

Serologic Screening for Genital Herpes Infection: Recommendation Statement

 

Am Fam Physician. 2017 Jun 15;95(12):online.

As published by the U.S. Preventive Services Task Force.

Related Putting Prevention into Practice: Serologic Screening for Genital Herpes Infection.

Summary of Recommendation and Evidence

The USPSTF recommends against routine serologic screening for genital herpes simplex virus (HSV) infection in asymptomatic adolescents and adults, including those who are pregnant (Table 1). D recommendation.

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Table 1.

Serologic Screening for Genital Herpes Infection: Clinical Summary of the USPSTF Recommendation

Population

Asymptomatic adolescents and adults, including those who are pregnant

Recommendation

Do not routinely screen for genital HSV infection.

Grade: D

Screening tests

The most widely used, currently available serologic screening test for HSV-2 is not suitable for population-based screening, based on its low specificity, the lack of widely available confirmatory testing, and its high false-positive rate. While serologic screening tests can detect HSV-1 infection, the tests cannot determine if the site of infection is oral or genital.

Treatment and interventions

There is no cure for genital HSV infection. Antiviral medications are used for the management of symptomatic outbreaks and for prevention in patients with a history of frequent symptomatic outbreaks.

Balance of benefits and harms

The USPSTF concludes with moderate certainty that the harms outweigh the benefits for population-based screening for genital HSV infection in asymptomatic adolescents and adults, including those who are pregnant.

Other relevant USPSTF recommendations

The USPSTF recommends intensive behavioral counseling interventions to reduce the likelihood of acquiring a sexually transmitted infection for all sexually active adolescents and for adults at increased risk.

The USPSTF has also issued recommendations on screening for other sexually transmitted infections, including chlamydia and gonorrhea, hepatitis B virus, human immunodeficiency virus, and syphilis. These recommendations are available on the USPSTF website (https://www.uspreventiveservicestaskforce.org).


note: For a summary of the evidence systematically reviewed in making this recommendation, the full recommendation statement, and supporting documents, go to http://www.uspreventiveservicestaskforce.org/.

HSV = herpes simplex virus; USPSTF = U.S. Preventive Services Task Force.

Table 1.

Serologic Screening for Genital Herpes Infection: Clinical Summary of the USPSTF Recommendation

Population

Asymptomatic adolescents and adults, including those who are pregnant

Recommendation

Do not routinely screen for genital HSV infection.

Grade: D

Screening tests

The most widely used, currently available serologic screening test for HSV-2 is not suitable for population-based screening, based on its low specificity, the lack of widely available confirmatory testing, and its high false-positive rate. While serologic screening tests can detect HSV-1 infection, the tests cannot determine if the site of infection is oral or genital.

Treatment and interventions

There is no cure for genital HSV infection. Antiviral medications are used for the management of symptomatic outbreaks and for prevention in patients with a history of frequent symptomatic outbreaks.

Balance of benefits and harms

The USPSTF concludes with moderate certainty that the harms outweigh the benefits for population-based screening for genital HSV infection in asymptomatic adolescents and adults, including those who are pregnant.

Other relevant USPSTF recommendations

The USPSTF recommends intensive behavioral counseling interventions to reduce the likelihood of acquiring a sexually tr


This recommendation statement was first published in JAMA. 2016;316(23):2525–2530.

The “Other Considerations,” “Discussion,” “Update of Previous USPSTF Recommendation,” and “Recommendations of Others” sections of this recommendation statement are available at https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/genital-herpes-screening1.

The USPSTF recommendations are independent of the U.S. government. They do not represent the views of the Agency for Healthcare Research and Quality, the U.S. Department of Health and Human Services, or the U.S. Public Health Service.

REFERENCES

show all references

1. Centers for Disease Control and Prevention. Genital herpes: CDC fact sheet. http://www.cdc.gov/std/herpes/stdfact-herpes.htm. 2016. Accessed October 5, 2016....

2. Centers for Disease Control and Prevention. Genital HSV infections. http://www.cdc.gov/std/tg2015/herpes.htm. 2015. Accessed October 5, 2016.

3. US Preventive Services Task Force. Behavioral counseling interventions to prevent sexually transmitted infections: US Preventive Services Task Force recommendation statement. Ann Intern Med. 2014;161(12):894–901.

4. US Preventive Services Task Force. Screening for chlamydia and gonorrhea: US Preventive Services Task Force recommendation statement. Ann Intern Med. 2014;161(12):902–910.

5. US Preventive Services Task Force. Screening for hepatitis B virus infection in nonpregnant adolescents and adults: US Preventive Services Task Force recommendation statement. Ann Intern Med. 2014;161(1):58–66.

6. US Preventive Services Task Force. Screening for HIV: US Preventive Services Task Force recommendation statement. Ann Intern Med. 2013;159(1):51–60.

7. US Preventive Services Task Force. Screening for syphilis infection in nonpregnant adults and adolescents: US Preventive Services Task Force recommendation statement. JAMA. 2016;315(21):2321–2327.

This summary is one in a series excerpted from the Recommendation Statements released by the USPSTF. These statements address preventive health services for use in primary care clinical settings, including screening tests, counseling, and preventive medications.

The complete version of this statement, including supporting scientific evidence, evidence tables, grading system, members of the USPSTF at the time this recommendation was finalized, and references, is available on the USPSTF website at http://www.uspreventiveservicestaskforce.org/.

This series is coordinated by Sumi Sexton, MD, Associate Deputy Editor.

A collection of USPSTF recommendation statements published in AFP is available at http://www.aafp.org/afp/uspstf.

 

 

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