Comparison of a Monoclonal Antibody-Blocking Enzyme-Linked Immunoassay and a Strip Immunoblot Assay for Identifying Type-Specific Herpes Simplex Virus Type 2 Serological Responses

Abstract

Detection of herpes simplex virus type 2 (HSV-2)-specific antibodies by a monoclonal antibody (MAb)-blocking enzyme-linked immunoassay (EIA) was compared with detection by a strip immunoblot assay (SIA) in a sexually transmitted disease (STD) clinic population. The study population consisted of 1,683 genitourinary medicine clinic attendees (582 women and 1,101 men). Sera were tested for the presence of HSV-2 antibody by use of the blocking EIA, in which binding of the MAb AP-1 to HSV-2 glycoprotein G-2 (gG-2) is blocked by HSV-2-specific antibody. The Chiron RIBA HSV-1 and -2 strip immunoassay (SIA) utilizes HSV-1-and HSV-2-specific or cross-reactive antigens immobilized on nitrocellulose strips (HSV gB-1 and HSV gG-1 peptide bands specific for HSV-1 antibody, HSV-2 gG-2 band specific for HSV-2 antibody, and HSV gD-2 band cross-reactive for HSV-1 and HSV-2 antibodies). A total of 1,612 sera were tested by MAb-blocking EIA for HSV-2 antibody and by SIA for HSV-1 and HSV-2 antibodies. By EIA, 541 (33.6%) sera were positive for HSV-2 antibody and 1,068 sera were negative for HSV-2 antibody; 3 sera gave equivocal results. HSV-2 antibody was detected in 555 (34.4%) sera by SIA; 144 (26%) of these sera possessed only HSV-2 antibody, and 411 (74%) sera contained both HSV-1 and HSV-2 antibodies. SIA detected HSV-1 antibody in 1,155 (71.6%) sera; 744 (64%) of these sera contained HSV-1 antibody alone. Sixteen sera contained antibody against HSV but could not be typed by SIA. A total of 512 sera were positive for HSV-2 antibody by both the EIA and SIA. We concluded that the blocking EIA and SIA showed a high level of agreement in detecting HSV-2 antibody in this population. In contrast to the SIA, the blocking EIA is a useful tool for large epidemiological studies, though the SIA proved to be slightly more sensitive once sera with discrepant results were further tested.The diagnosis of primary or recurrent genital herpes simplex virus (HSV) infections, which are mainly caused by HSV type 2 (HSV-2), is based on clinical symptoms, culture of clinical specimens, viral detection by nucleic acid amplification, and HSV antigen detection assays (4,30,34). HSV-1 and HSV-2 are closely related (13), and for the study of humoral responses to HSV infection, complement fixation assays, enzyme-linked immunoassays (EIA) with crude antigens, immunofluorescence assays, and neutralization assays all lack specificity due to the cross-reactivity of antibodies against HSV-1 and HSV-2 (3, 4, 5). Assays using type-specific HSV antigens which can be used to differentiate between HSV-1-or HSV-2-specific antibodies have been described (2, 7, 8, 18, 21, 24, 28; D. Alexander et al., Abstr. 96th Gen. Meet. Am. Soc. Microbiol. 1996, abstr. C-101, p. 18, 1996, with the immunoblot assay (Western blotting [WB]) considered the "gold standard" because it has been most extensively validated (1, 4). An alternative to WB which does not require affinity-purified antigen is detection of type-specific antibody by blocking monoclonal antibody (MAb) (28). Serolog...

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Herpes simplex virus type 1 in Europe: systematic review, meta-analyses and meta-regressions

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