The Diagnosis of Genital Herpes – Beyond Culture: An Evidence‐Based Guide for the Utilization of Polymerase Chain Reaction and Herpes Simplex Virus Type‐Specific Serology

Ratnam, Sam; Severini, Alberto; Zahariadis, George; Petric, Martin; Romanowski, Barbara

doi:10.1155/2007/505364

Cited by 24 publications

(11 citation statements)

References 88 publications

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“…Additionally, AmpliVue results were in agreement with illumigene in 80% (8/ 10) of HSV-1 specimens and in 50% (1/2) of HSV-2 specimens that were initially classified as FN. These data suggest that the majority of FP results likely contained the HSV amplicon, which is consistent with the increased sensitivity of molecular assays compared to that of cell culture (22,25).…”

Section: Specimen Characteristics and Prevalencesupporting

confidence: 72%

Multicenter Evaluation of Meridian Bioscience HSV 1&2 Molecular Assay for Detection of Herpes Simplex Virus 1 and 2 from Clinical Cutaneous and Mucocutaneous Specimens

et al. 2016

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Herpes simplex virus 1 (HSV-1) and 2 (HSV-2) are doublestranded DNA viruses of the Herpesviridae family and are a common cause of cutaneous and mucocutaneous oral and genital lesions (1, 2). Historically, HSV-1 has been associated with oral lesions while HSV-2 has more often been associated with genital lesions, although recently this epidemiology has been changing. Additionally, HSV can cause invasive disease, including sepsis and fulminate encephalitis in neonates that are infected by exposure to herpetic lesions present at the time of birthing (3). Infection with HSV-1 is common, with seroprevalence reaching 50% to 70% in developed countries and Ͼ80% in developing countries (4-6). The seroprevalence of HSV-2 varies from 5% to 40% (7,8). While there is no cure for HSV infections, specific antiviral therapy exists to alleviate symptoms, shorten the duration of recurring outbreaks, and to treat life-threatening manifestations (9). Therefore, accurate laboratory diagnosis of these infections is important.The diagnosis of HSV based solely on clinical exam is difficult. Typical HSV lesions can mimic those of other sexually transmitted infectious agents (e.g., Treponema pallidum and Haemophilus ducreyi), staphylococcal folliculitis, herpes zoster, and skin abrasion due to physical injury (10). Therefore, it is essential to confirm all possible herpetic infections with laboratory diagnostics. Classically, laboratory diagnosis of superficial HSV infections relied on the collection of vesicular exudate or scrapings from a lesion and inoculation into a susceptible cell line (Hep-2, A549, etc.). Following incubation, cells are observed microscopically for viral-induced cytopathic effects (CPE) over 5 to 14 days (11). Standard cell culture was improved with the development of the enzymelinked virus-inducible system (ELVIS; Diagnostic Hybrids, Athens, OH), which increased sensitivity and reduced turnaround time (TAT) to approximately 24 h (12, 13). Overall, the sensitivity and specificity of ELVIS has been reported to range from 88% to 100% and 98% to 100%, respectively (14, 15). Importantly, the sensitivity of all culture-based diagnostics is dependent upon the presence and load of viable virus in a specimen, which is affected by the age of the lesion and specimen handling (16-18).Molecular assays include laboratory-developed and FDAcleared multiplex assays for simultaneous detection of and differ-

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Section: Specimen Characteristics and Prevalencesupporting

confidence: 72%

Multicenter Evaluation of Meridian Bioscience HSV 1&2 Molecular Assay for Detection of Herpes Simplex Virus 1 and 2 from Clinical Cutaneous and Mucocutaneous Specimens

et al. 2016

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“…Furthermore, most adolescents have no HSV1 antibodies (17), making them susceptible to a primary genital infection with this organism. Whether the susceptibility to HSV1 primary genital infection has varied over time (eg, 1998 No other published studies based on direct detection concerning the role of HSV1 in genital herpes in Canada were found, although regional differences were mentioned (18). The relative importance of HSV1 in genital herpes varies considerably in other areas of the world (Table 2).…”

Section: Discussionmentioning

confidence: 99%

Herpes Simplex Virus Type 1 is the Leading Cause of Genital Herpes in New Brunswick

Garceau

Leblanc

Thibault

et al. 2012

Canadian Journal of Infectious Diseases and Medical Microbiolog

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INTRoDuCTIoN:Little is known about the role of herpes simplex virus (HSV) type 1 (HSV1) in the epidemiology of genital herpes in Canada. Data on herpes viral cultures for two consecutive years obtained from L'Hôpital Dr GL Dumont, which performs all the viral culture testing in New Brunswick, were reviewed. It was hypothesized that HSV1 was the main cause of genital herpes in New Brunswick. MeTHoDs: Samples of genital origin sent to the laboratory for HSV culture testing between July 2006 and June 2008 were analyzed. Samples from an unspecified or a nongenital source were excluded from analysis. Multiple positive samples collected from the same patient were pooled into a single sample. ResuLTs: HSV was isolated from 764 different patients. HSV1 was isolated in 62.6% of patients (male, 55%; female, 63.8%). HSV1 was isolated in 73.2% of patients 10 to 39 years of age and in 32% of patients ≥40 years of age. The difference in rates of HSV1 infection between the 10 to 39 years of age group and the ≥40 years of age group was statistically significant (P<0.001 [χ 2 ]). In a similar Canadian study performed in Nova Scotia, HSV1 was recovered in 53.7% of positive cultures (male, 36.7%; female, 58.1%). The rates of HSV1 infection reported by this study and the present study were significantly different (P<0.001 [χ 2 ] for male, P=0.012 for female). CoNCLusIoN: In New Brunswick, HSV1 is the dominant type of HSV isolated in samples collected from a genital site. Significant rate differences were demonstrated between the groups 10 to 39 years of age and ≥40 years of age. (1), but either HSV type 1 (HSV1) or HSV2 may be the cause (2). The relative role of HSV1 in herpes simplex genital infections varies from 3.9% to 78% (3,4). Most studies have relied on herpes simplex type-specific serology in estimating the significance of HSV2 in causing sexually transmitted infections. However, HSV1 is commonly acquired as an orolabial infection, so antibodies against it cannot be conclusively linked to genital infections. Using methods such as viral culture or molecular assays, it is possible to ascertain the role of HSV1 in causing genital ulcers. In our experience, many samples of genital origin tested in our laboratory grew HSV1. Given that our laboratory has tested all samples from New Brunswick for HSV since 2006 and given the sparsity of Canadian data, we decided to analyze two years of sample results (July 2006 to June 2008, hypothesizing that HSV1 would be the dominant type of HSV identified in those samples. MeTHoDsThere are no privately operated laboratories in New Brunswick. L'Hôpital Dr GL Dumont, located in southeast New Brunswick, is the only viral testing laboratory in the province, and has provided HSV culture services since 1992. New Brunswick laboratories ceased referring samples for HSV culture outside the province during the spring of 2006, when New Brunswick had a population of 748,000 (5). A review of the number of samples referred from other laboratories before and after the spring of 2006 confirmed that all sam...

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“…Kalon gG2 specific ELISA was found to be as sensitive as and more specific than HerpeSelect, with WB as the reference method (13). Type-specific tests are useful diagnostic tools that allow differentiation of HSV-1 and HSV-2 infections (14,15).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the HerpeSelect Express Rapid Test in the Detection of Herpes Simplex Virus Type 2 Antibodies in Patients With Genital Ulcer Disease

Al‐Shobaili

Hassanein

Mostafa

et al. 2014

Clinical Laboratory Analysis

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The Diagnosis of Genital Herpes – Beyond Culture: An Evidence‐Based Guide for the Utilization of Polymerase Chain Reaction and Herpes Simplex Virus Type‐Specific Serology

Cited by 24 publications

References 88 publications

Multicenter Evaluation of Meridian Bioscience HSV 1&2 Molecular Assay for Detection of Herpes Simplex Virus 1 and 2 from Clinical Cutaneous and Mucocutaneous Specimens

Multicenter Evaluation of Meridian Bioscience HSV 1&2 Molecular Assay for Detection of Herpes Simplex Virus 1 and 2 from Clinical Cutaneous and Mucocutaneous Specimens

Herpes Simplex Virus Type 1 is the Leading Cause of Genital Herpes in New Brunswick

Evaluation of the HerpeSelect Express Rapid Test in the Detection of Herpes Simplex Virus Type 2 Antibodies in Patients With Genital Ulcer Disease

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