title: Sensitivity and specificity of herpes simplex virus-2 serological assays among HIV-infected and uninfected urban Ugandans.
abstract: Herpes simplex virus type 2 (HSV-2) is a risk factor for HIV-1 infection. We characterized HSV-2 serology assay performance in HIV-positive and HIV-negative Africans. Serostatus for HSV-2 and HIV-1 was determined in 493 serum specimens stored from a community HSV-2 prevalence survey in Kampala, Uganda. HSV-2 serology by Focus HerpeSelect ELISA, Biokit HSV-2 rapid assay and Kalon HSV-2 was compared with HSV-2 Western blot (WB) according to HIV-1 serostatus. Sensitivity/specificity was: 99.5%/70.2% for Focus, 97.0%/86.4% for Biokit and 97.5%/96.2% for Kalon. Focus with Biokit confirmation improved sensitivity/specificity (99.4%/96.8%, respectively). Use of a higher Focus index value cut-off of 2.2 instead of 1.1 increased specificity from 70.2% to 92.4%. Kalon had higher specificity than Focus (P < 0.001). Of commercially available HSV-2 serological assays, Kalon alone, or Focus ELISA followed by Biokit confirmation perform best. Improved HSV-2 assays are needed for HSV-2 and HIV-1 public health activities in Africa.
authors.affiliation: Department of Global Health, University of Washington, Seattle, WA 98102, USA. lingappa@uw.edu
authors.forename: J
authors.initials: J
authors.lastname: Lingappa
authors.forename: E
authors.initials: E
authors.lastname: Nakku-Joloba
authors.forename: A
authors.initials: A
authors.lastname: Magaret
authors.forename: D
authors.initials: D
authors.lastname: Friedrich
authors.forename: J
authors.initials: J
authors.lastname: Dragavon
authors.forename: F
authors.initials: F
authors.lastname: Kambugu
authors.forename: M
authors.initials: M
authors.lastname: Joloba
authors.forename: C
authors.initials: C
authors.lastname: Whalen
authors.forename: R
authors.initials: R
authors.lastname: Coombs
authors.forename: C
authors.initials: C
authors.lastname: Celum
authors.forename: R Ashley
authors.initials: RA
authors.lastname: Morrow
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000097:blood*; D005260:Female; D015658:HIV Infections / Q000175:diagnosis; D006561:Herpes Simplex / Q000150:complications / Q000175:diagnosis*; D018258:Herpesvirus 2, Human / Q000276:immunology* / Q000302:isolation & purification; D006801:Humans; D007118:Immunoassay / Q000379:methods; D008297:Male; D011933:Reagent Kits, Diagnostic; D012680:Sensitivity and Specificity; D014454:Uganda; D014773:Virology / Q000379:methods*
chemical_list: D000914:Antibodies, Viral; D011933:Reagent Kits, Diagnostic