[Signification and limitations of virology diagnostic tools in herpes facialis, herpes genitalis, herpes gestationis and in neonates at risk].
BACKGROUND
Cutaneomucous herpes is frequent in humans. Laboratory confirmation of clinical diagnosis is important, as there are atypical presentations in genital herpes.


METHODS
The review of the French and English literature on virological diagnosis of herpes simplex, indexed in Medline (1990-2001), Embase and Cochran Library (1995-2001) was carried out.


RESULTS
172 publications were selected, and 125 of them were used for this work. The current methods to diagnose herpes in cutaneous lesions are detection of antigens by immunofluorescence or ELISA, culture and PCR. The sensitivity and accuracy of the diagnostic methods are directly linked to the quality of the sampling. Antigen detection is a rapid method, but lacks sensitivity. Culture (the gold standard) is sensitive but sometimes the detection of the virus requires several days. Most of the PCR procedures developed are individual non standardized "in house methods. However, the rapidity and sensitivity of this latter technic make it very useful. Serology allows determination of the immune status of the patients. The development of type specific serology had lead to numerous seroepidemiological studies demonstrating that genital herpes due to HSV2 has increased in most of the countries.


CONCLUSIONS
Rapid and sensitive methods are available for the diagnosis of cutaneous herpes in virological laboratories. However, questions remain for the acceptance of PCR and type specific serology in routine diagnosis. These two technics still have to be standardised before being widely used.
Laboratoire de Virologie, Domaine Rockefeller, 69373 Lyon, France.
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Najioullah
D000914:Antibodies, Viral / Q000032:analysis; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D005455:Fluorescent Antibody Technique; D006558:Herpes Genitalis / Q000175:diagnosis* / Q000821:virology; D006560:Herpes Labialis / Q000175:diagnosis* / Q000821:virology; D018259:Herpesvirus 1, Human / Q000302:isolation & purification; D018258:Herpesvirus 2, Human / Q000302:isolation & purification; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D016133:Polymerase Chain Reaction / Q000379:methods; D011247:Pregnancy; D012680:Sensitivity and Specificity
D000914:Antibodies, Viral