Herpes simplex antibody testing
Herpes simplex Microchapters
Herpes simplex antibody testing On the Web
Risk calculators and risk factors for Herpes simplex antibody testing
Editor-In-Chief: C. Michael Gibson, M.S., M.D. ; Associate Editor(s)-in-Chief: Lakshmi Gopalakrishnan, M.B.B.S.
Both type-specific and nontype-specific antibodies to HSV develop during the first several weeks after infection and persist indefinitely. Accurate type-specific HSV serologic assays are based on the HSV-specific glycoprotein G2 (HSV-2) and glycoprotein G1 (HSV-1). Both laboratory-based assays and point-of-care tests that provide results for HSV-2 antibodies from capillary blood or serum during a clinic visit are available. The sensitivities of these glycoprotein G type-specific tests for the detection of HSV-2 antibody vary from 80%–98%, and false-negative results might be more frequent at early stages of infection. The specificities of these assays are greater than 96%. False-positive results can occur, especially in patients with a low likelihood of HSV infection. Repeat or confirmatory testing might be indicated in some settings, especially if recent acquisition of genital herpes is suspected. IgM testing for HSV is not useful, because the IgM tests are not type-specific and might be positive during recurrent episodes of herpes.
Nearly all HSV-2 infections are sexually acquired and the presence of type-specific HSV-2 antibody implies anogenital infection. Hence, education and counseling appropriate for persons with genital herpes should be provided. The presence of HSV-1 antibody alone is however more difficult to interpret. Most persons with HSV-1 antibody have oral HSV infection acquired during childhood, which might be asymptomatic. However, acquisition of genital HSV-1 appears to be increasing, and genital HSV-1 also can be asymptomatic. Lack of symptoms in an HSV-1 seropositive person does not distinguish anogenital from orolabial or cutaneous infection, and regardless of site of infection, these persons remain at risk for acquiring HSV-2. HSV serologic testing should be considered for persons presenting for an STD evaluation, in particular for patients with multiple sex partners, patients with HIV infection, and patients at increased risk for HIV acquisition. However, screening for HSV-1 and HSV-2 in the general population is not indicated.
Indications for Type-specific HSV Serologic Assay
- Recurrent genital symptoms or atypical symptoms with negative HSV cultures
- Clinical diagnosis of genital herpes without laboratory confirmation
- Partner with genital herpes
British Association for Sexual Health and HIV (BASHH) Recommendations
Tzanck test involving a tissue scraping of an active skin ulcer from a penile lesion, diagnosed as a case of herpes progenitalis. From Public Health Image Library (PHIL). 
BASHH guidelines mentioned in National Guideline Clearinghouse
- ↑ Ashley R, Cent A, Maggs V, Nahmias A, Corey L (1991) Inability of enzyme immunoassays to discriminate between infections with herpes simplex virus types 1 and 2. Ann Intern Med 115 (7):520-6. PMID: 1652909
- ↑ Song B, Dwyer DE, Mindel A (2004) HSV type specific serology in sexual health clinics: use, benefits, and who gets tested. Sex Transm Infect 80 (2):113-7. PMID: 15054171
- ↑ Whittington WL, Celum CL, Cent A, Ashley RL (2001) Use of a glycoprotein G-based type-specific assay to detect antibodies to herpes simplex virus type 2 among persons attending sexually transmitted disease clinics. Sex Transm Dis 28 (2):99-104. PMID: 11234793
- ↑ Zimet GD, Rosenthal SL, Fortenberry JD, Brady RC, Tu W, Wu J et al. (2004) Factors predicting the acceptance of herpes simplex virus type 2 antibody testing among adolescents and young adults. Sex Transm Dis 31 (11):665-9. PMID: 15502674
- ↑ Morrow R, Friedrich D (2006) Performance of a novel test for IgM and IgG antibodies in subjects with culture-documented genital herpes simplex virus-1 or -2 infection. Clin Microbiol Infect 12 (5):463-9. DOI:10.1111/j.1469-0691.2006.01370.x PMID: 16643524
- ↑ Xu F, Sternberg MR, Kottiri BJ, McQuillan GM, Lee FK, Nahmias AJ et al. (2006) Trends in herpes simplex virus type 1 and type 2 seroprevalence in the United States. JAMA 296 (8):964-73. DOI:10.1001/jama.296.8.964 PMID: 16926356
- ↑ Ryder N, Jin F, McNulty AM, Grulich AE, Donovan B (2009) Increasing role of herpes simplex virus type 1 in first-episode anogenital herpes in heterosexual women and younger men who have sex with men, 1992-2006. Sex Transm Infect 85 (6):416-9. DOI:10.1136/sti.2008.033902 PMID: 19273479
- ↑ Roberts CM, Pfister JR, Spear SJ (2003) Increasing proportion of herpes simplex virus type 1 as a cause of genital herpes infection in college students. Sex Transm Dis 30 (10):797-800. DOI:10.1097/01.OLQ.0000092387.58746.C7 PMID: 14520181
- ↑ http://www.bashh.org/documents/59/59.pdf
- ↑ "Public Health Image Library (PHIL)".