Do not use herpes simplex virus (HSV) polymerase chain reaction (PCR) testing for genital HSV infection screening in adults and adolescents. Real-time HSV PCR testing should only be used to confirm herpes diagnosis in patients with suspected herpes.
HSV shedding is intermittent. Therefore, testing swabs from asymptomatic patients is not recommended for routine diagnosis since it is unlikely to yield confirmation of carrier status. However, laboratory confirmation in all patients with suspected herpes is recommended. HSV DNA detection by real-time PCR is considered the gold standard for diagnosis. Swabs for testing are taken from the base of the lesion (vesicles should be unroofed with a needle or scalpel blade). HSV typing into HSV-1 and HSV-2 is recommended in all patients with first-episode genital herpes to guide counselling and management.
These items are provided solely for informational purposes and are not intended as a substitute for consultation with a medical professional. Patients with any specific questions about the items on this list or their individual situation should consult their physician.
George Fritsma, MS, MLS (ASCP), and the late Cindy Johns, MS, MLS (ASCP) hosted a plenary presentation “Enhancing Laboratory Communication to Reduce Extra-analytical Errors” at the ASCLS Clinical Laboratory Educators’ Conference in Boston in February 2017. Their talk referenced the ABIMF Choosing Wisely initiative. Subsequent discussions resulted in the ASCLS Board of Directors appointing a Choosing Wisely task force that evolved to a standing committee. The committee is composed of ASCLS members representing all medical laboratory science disciplines.
The committee collaborated with respective ASCLS Scientific Assemblies in developing and reviewing recommendations, which the Board of Directors reviewed and accepted for publication. The recommendations were subsequently reviewed in collaboration with the ASCP Test Utilization Steering Committee prior to submission.
American Society for Clinical Laboratory Science (ASCLS) recommendations were developed under the leadership of ASCLS’s Choosing Wisely Committee and the ASCLS president and executive vice president. The Committee examined numerous options based on evidence available through an extensive review of the literature and member proposals. Subject matter experts from the ASCLS Scientific Assemblies reviewed and recommended approval of their respective recommendations, which are subsequently approved by the ASCLS Board of Directors. The recommendations were subsequently reviewed in collaboration with the ASCP Test Utilization Steering Committee prior to submission.
Patel, R, et al. 2017 European Guidelines for the Management of Genital Herpes. Int J STD & AIDS, 2017;28:1366–79, doi:10.1177/0956462417727194.
Workowski KA, Centers for Disease Control and Prevention “Sexually Transmitted Diseases Treatment Guidelines”, Clinical Infectious Diseases. 2015, 61: S759–S62,
Ong JJ, et al. “Clinical Characteristics of Herpes Simplex Virus Urethritis Compared with Chlamydial Urethritis Among Men.” STDs 2018: 44:121–5.
Centers for Disease Control and Prevention. Genital Herpes – CDC Fact Sheet (Detailed), August 2017