[Herpes serology for genital herpes].
The epidemiology of genital herpes is changing. The seroprevalence of HSV-2 infections is increasing, while HSV-1 is an increasingly common cause of herpetic ulcerations. The reference examination provides direct diagnosis after viral isolation in a cell culture or genome amplification. Herpes serology is indicated principally if direct examination is negative and in the absence of lesions. Non-type-specific serology detects antibodies common to HSV-1 and HSV-2. Its specificity and sensitivity are excellent, and it is approved as a reimbursable laboratory procedure. It cannot specify the viral type involved. Type-specific serology can distinguish between anti-HSV-1 and anti-HSV-2 antibodies. Currently available kits have a sensitivity and specificity, depending on the population studied, of 90 to 100%. It is not approved as a reimbursable laboratory procedure. HSV-1-specific serology cannot diagnose old HSV-1 genital infections, but seropositivity for HSV-2 generally suffices to diagnose HSV-2 genital herpes. The indication for type-specific serology must be discussed according to clinical context. The value of non-type-specific serology is limited.
Legoff
Jérôme
J
Université Paris V, Laboratoire de virologie, Hôpital européen Georges Pompidou, F-75015 Paris, France.
Aymard
Michèle
M
Braig
Suzanne
S
Ramel
Françoise
F
Dreno
Brigitte
B
Bélec
Laurent
L
Malkin
Jean-Elie
JE
D005260:Female; D006558:Herpes Genitalis / Q000097:blood* / Q000175:diagnosis; D018259:Herpesvirus 1, Human; D018258:Herpesvirus 2, Human; D006801:Humans; D008297:Male; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000097:blood / Q000175:diagnosis; D012698:Serologic Tests