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.
BACKGROUND
Most genital herpes simplex virus type 2 (HSV-2) infections are unrecognized, thus, strategies to reduce the sexual transmission of HSV-2 are partly dependent on serologic screening.


OBJECTIVE
To define performance characteristics of the Gull/ Meridian glycoprotein G-based HSV-2 enzyme-linked immunosorbent assay among sexually transmitted disease clinic attendees and correlates of test acceptance.


METHODS
The cross-sectional study was conducted during two periods. Serologic testing was offered at a US $15 charge during the first period and at no charge during the second period. Sera were tested by a type-specific glycoprotein G enzyme-linked immunosorbent assay and Western blot analysis, with the latter test used as the reference standard.


RESULTS
Acceptance of HSV-2 testing was associated with free testing (odds ratio, 7.5; 95% CI, 6.0-9.9), older age, and white race. Sensitivity of the HSV-2 assay was 80.5% and specificity was 98.5%. The HSV-2 positive and negative predictive values were 95.8% (95% CI, 91.6-98.0%) and 92.2% (95 % CI, 89.6 -94.2%), respectively. Antibodies to HSV-2 were detected in 25.9% of 606 persons with no history of genital herpes.


CONCLUSIONS
Acceptance of HSV-2 serologic testing was cost sensitive. In this high-prevalence population, the positive predictive value of the enzyme-linked immunosorbent assay was sufficient to warrant its use without a confirmatory test. This assay could be useful in the screening of sexually active adults to detect unrecognized HSV-2 infection.
Center for AIDS and STD, Department of Medicine, University of Washington, Seattle 98104, USA.
W L
WL
Whittington
C L
CL
Celum
A
A
Cent
R L
RL
Ashley
D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood*; D015153:Blotting, Western; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay / Q000191:economics / Q000379:methods*; D005260:Female; D006558:Herpes Genitalis / Q000175:diagnosis* / Q000453:epidemiology; D018258:Herpesvirus 2, Human / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D016036:Seroepidemiologic Studies; D012749:Sexually Transmitted Diseases / Q000453:epidemiology; D014759:Viral Envelope Proteins / Q000276:immunology*; D014861:Washington / Q000453:epidemiology
D000914:Antibodies, Viral; D014759:Viral Envelope Proteins; C045464:glycoprotein G, herpes simplex virus type 2