Four RCTs compared preventive medications with placebo, 2 in nonpregnant asymptomatic adults who were HSV-2 seropositive and 2 in HSV-2–serodiscordant couples. Serologic screening for genital herpes was associated with psychosocial harms, including distress and anxiety related to positive test results. Use of this test at the manufacturer’s cutpoint in a population of 100 000 with a prevalence of HSV-2 of 16% (the seroprevalence in US adults with unknown symptom status) would result in 15 840 true-positive results and 15 960 false-positive results (positive predictive value, 50%). Pooled estimates of sensitivity and specificity of the most commonly used test at the manufacturer’s cutpoint were 99% (95% CI, 97%-100%) and 81% (95% CI, 68%-90%), respectively (10 studies n = 6537). Most studies of the accuracy of screening tests were from populations with high HSV-2 prevalence (greater than 40% based on Western blot). No RCTs compared screening with no screening. Results A total of 17 studies (n = 9736 participants range, 24-3290) in 19 publications were included. Main Outcomes and Measures Accuracy of screening tests, benefits of screening, harms of screening, reduction in genital herpes outbreaks. Study Selection English-language randomized clinical trials (RCTs) comparing screening with no screening in persons without past or current symptoms of genital herpes studies evaluating accuracy and harms of serologic screening tests for HSV-2 RCTs assessing preventive interventions in asymptomatic persons seropositive for HSV-2.ĭata Extraction and Synthesis Dual review of abstracts, full-text articles, and study quality pooled sensitivities and specificities of screening tests using a hierarchical summary receiver operating characteristic curve analysis when at least 3 similar studies were available. Surveillance for new evidence in targeted publications was conducted through October 31, 2016. Objective To assess the evidence on serologic screening and preventive interventions for genital HSV infection in asymptomatic adults and adolescents to support the US Preventive Services Task Force for an updated recommendation statement.ĭata Sources MEDLINE, Cochrane Library, EMBASE, and trial registries through March 31, 2016. Vertical transmission of HSV can lead to fetal morbidity and mortality. Importance Genital herpes simplex virus (HSV) infection is a prevalent sexually transmitted infection. Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.Hierarchical Summary Receiver Operating Characteristic (HSROC) Curve Comparing Sensitivity and Specificity for the 4 Studies Reporting on the Accuracy of BiokitHSV-2 Hierarchical Summary Receiver Operating Characteristic (HSROC) Curve Comparing Sensitivity and Specificity for the 7 Studies Reporting on The Accuracy of HerpeSelect® at Cutpoints Between 2.1 and 3.5ĮFigure 3. Hierarchical Summary Receiver Operating Characteristic (HSROC) Curve Comparing Sensitivity and Specificity for the 10 Studies Reporting on the Accuracy of HerpeSelect® at the Manufacturer’s Cutpoint for a Positive Test (1.1).ĮFigure 2. Characteristics and Results of Included Studies Assessing Harms of Preventive Interventions (Key Question 6)ĮFigure 1. Characteristics and Results of Included Studies Assessing Harms of Serologic Screening for Genital Herpes (Key Question 3)ĮTable 11. Characteristics and Results of Included Studies Assessing the Accuracy of biokit Rapid HSV-2 (Key Question 2)ĮTable 10. Results of Included Studies Assessing the Accuracy of HerpeSelect for HSV-2 (Key Question 2)ĮTable 9. Quality Ratings of Studies of Assessing Harms of Preventive Interventions (Key Question 6)ĮTable 8. Quality Ratings of Studies of Antiviral Medications on HSV-2 Viral Shedding, Symptomatic Episodes and Transmission (Key Question 4 and Key Question 5)ĮTable 7. Quality Ratings of Studies Assessing the Harms of Serologic Screening for HSV-2 (Key Question 3)ĮTable 6. Quality Ratings of Studies Assessing the Accuracy of Serologic Screening Tests for HSV-2 (Key Question 2)ĮTable 5. Systematic Review Literature Search StrategiesĮTable 4.
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