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Serologic Screening for Genital Herpes Infection: US Preventive Services Task Force Reaffirmation Recommendation
, Carol M Mangione1, Michael J Barry2
1University of California, Los Angeles.
JAMA
|February 14, 2023
Summary
Routine screening for genital herpes simplex virus type 2 (HSV-2) in asymptomatic individuals is not recommended. The US Preventive Services Task Force found that the harms of screening outweigh potential benefits for adolescents and adults.
Area of Science:
- Public Health
- Infectious Diseases
- Preventive Medicine
Background:
- Genital herpes, caused by herpes simplex virus types 1 and 2 (HSV-1, HSV-2), is a common, lifelong sexually transmitted infection with no cure.
- While antiviral medications can manage symptoms, transmission to infants during pregnancy or delivery can lead to severe neonatal herpes.
- The US Preventive Services Task Force (USPSTF) previously recommended against HSV screening in 2016.
Purpose of the Study:
- To systematically evaluate the evidence on the accuracy, benefits, and harms of routine serologic screening for HSV-2 infection.
- To reaffirm or update the 2016 USPSTF recommendation regarding HSV-2 screening in asymptomatic populations.
- To assess screening for asymptomatic adolescents, adults, and pregnant individuals.
Main Methods:
- Commissioned a reaffirmation evidence update focusing on key questions related to HSV-2 screening.
- Systematically evaluated evidence concerning the accuracy, benefits, and harms of serologic screening for HSV-2.
- Focused on asymptomatic adolescents, adults, and pregnant persons without a known history of genital HSV infection.
Main Results:
- The USPSTF concluded with moderate certainty that the harms of population-based screening for genital HSV infection outweigh the benefits.
- Evidence regarding the accuracy and clinical utility of screening asymptomatic individuals was reviewed.
- Potential harms associated with screening, such as psychological distress and partner notification issues, were considered.
Conclusions:
- The USPSTF recommends against routine serologic screening for genital HSV infection in asymptomatic adolescents and adults, including pregnant persons.
- This constitutes a 'D' recommendation, indicating that the USPSTF recommends against the service.
- The decision is based on a careful balance of the evidence on benefits versus harms in the target population.
