Polymerase chain reaction for diagnosis of genital herpes: a missed opportunity?

Abstract

This study audited the utilization of herpes simplex virus polymerase chain reaction (HSV PCR) in the investigation of recurrent anogenital ulceration at the Mortimer Market Centre. Clinic guidelines for use of HSV PCR were modified in April 2003 to expand PCR use. Ninety-six case-notes belonging to patients presenting with recurrent anogenital ulceration between 1 April and 16 October 2003 were reviewed and 59 were suitable for inclusion. Details of the investigations carried out at each visit were recorded. HSV PCR was used according to guidelines in eight of the 59 cases studied. This audit showed under-utilization of HSV PCR testing with poor adherence to clinic guidelines when cases of suspected recurrent genital herpes were investigated. This led to under-diagnosis and delay in diagnosis. This audit stresses the importance of informing all clinical staff of the improved sensitivity and relative affordability of HSV PCR compared with HSV tissue culture.

The management of first episode genital herpes in genitourinary medicine clinics: a national audit in 2006

“…7 Our audit shows that more clinics are using PCR with 71% virus culture and 28% PCR. Our audit supports previous findings in the literature: PCR is better at detection (Po0.0001) than virus culture 5,6,8,9 The stage of the lesion determines the success of virus detection (Po0.0001) 3 Women present with shorter duration of symptoms (P ¼ 0.001) 10 HSV-1 causes almost half of GH first episodes (46%). [11][12][13] Results achieved for some clinical standards were disappointing; for example, for 243 (15%), there was no evidence of discussion or information about the diagnosis and risks of transmission and 40% received no written information.…”