Routine serologic screening for genital herpes infection not recommended: Reaffirms USPSTF

USA: The USPSTF, in its reaffirmation recommendation statement, has recommended against serologic screening for genital HSV (herpes simplex virus) infection in asymptomatic adults and adolescents, including pregnant women. 

The final recommendation statement by the U.S. Preventive Services Task Force (USPSTF) was published in the Journal of the American Medical Association (JAMA) on February 14, 2023. 

The D-grade recommendation is consistent with USPSTF's previous guidance and calls for more studies focusing on test accuracy, predictive value, and management of asymptomatic genital HSV. 

Genital herpes is a common sexually transmitted infection (STI) that, unfortunately, has no cure and cannot be accurately detected in people who do not have signs of the condition. Current treatment for genital herpes focuses on managing symptoms. Symptoms of genital herpes can include sores, bumps, pain, tenderness, itching in the genital area, and fever. Experiencing these and other symptoms are known as having an “outbreak.”

The recommendation does not apply to people who have a  past genital herpes infection, including people who are in between outbreaks. 

The Task Force found that screening for genital herpes in people without signs and symptoms does not improve their overall health,” Task Force member James Stevermer said in a press release. “This is largely because the tests used to screen for genital herpes have limitations and a significant chance that the results will say a person has the infection when they do not. If current screening tests were used across all adolescents and adults, as many as half of the positive results could be wrong.”

Pregnant women can transmit genital herpes to their babies, most commonly during vaginal delivery, known as neonatal herpes. Although neonatal herpes is not common, when it does happen, it can have serious outcomes for the baby. The Task Force recognized pregnant women's separate and distinct preventive health needs. However, the evidence shows that the harms still outweigh the benefits of screening pregnant people without signs and symptoms.

“The Task Force encourages people who are experiencing symptoms, have a partner who has been diagnosed with herpes, or have any concerns related to their sexual health to talk to their healthcare professional about testing and treatment options,” says Task Force vice chair Michael Barry, M.D.

“It is particularly important that people who are pregnant or planning to become pregnant speak with a healthcare professional if they have questions or concerns about their sexual health.”

While screening for genital herpes among asymptomatic people is not beneficial, the Task Force recognizes the importance of sexual health.

The Task Force has positive recommendations on screening for other STIs, including gonorrhea, chlamydia, HIV, and syphilis, and behavioral counseling for STIs prevention among people who are at increased risk

Reference:

US Preventive Services Task Force. Serologic Screening for Genital Herpes Infection: US Preventive Services Task Force Reaffirmation Recommendation Statement. JAMA. 2023;329(6):502–507. doi:10.1001/jama.2023.0057