Choosing Wisely:

Don’t screen for genital herpes simplex virus infection in asymptomatic adults, including pregnant women.

Rationale and Comments: Serologic testing for herpes simplex virus infection has low specificity and a high false-positive rate, and no confirmatory test is currently available. The serologic tests cannot determine site of infection. Given the prevalence of the infection in the United States, positive predictive value of the test is estimated at about 50%. A positive test can cause considerable anxiety and disruption of personal relationships.
Sponsoring Organizations:
  • American Academy of Family Physicians
  • Sources:
  • U.S. Preventive Services Task Force
  • Disciplines:
  • Infectious disease
  • Preventive Medicine
  • References: • American Academy of Family Physicians Clinical Preventive Services Recommendation: The AAFP recommends against routine serological screening for genital herpes simplex virus infection in asymptomatic adolescents and adults, including those who are pregnant. (2016) http://www.aafp.org/patient-care/clinical-recommendations/all/genital-herpes.html.
    • Feltner C, Grodensky C, Ebel C, Middleton JC, Harris RP, Ashok M, Jonas DE. Serologic Screening for Genital Herpes: An Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. 2016;316(23):2531.

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