title: Diagnosis of genital herpes simplex virus infection in the clinical laboratory.
abstract: Since the type of herpes simplex virus (HSV) infection affects prognosis and subsequent counseling, type-specific testing to distinguish HSV-1 from HSV-2 is always recommended. Although PCR has been the diagnostic standard method for HSV infections of the central nervous system, until now viral culture has been the test of choice for HSV genital infection. However, HSV PCR, with its consistently and substantially higher rate of HSV detection, could replace viral culture as the gold standard for the diagnosis of genital herpes in people with active mucocutaneous lesions, regardless of anatomic location or viral type. Alternatively, antigen detection-an immunofluorescence test or enzyme immunoassay from samples from symptomatic patients--could be employed, but HSV type determination is of importance. Type-specific serology based on glycoprotein G should be used for detecting asymptomatic individuals but widespread screening for HSV antibodies is not recommended. In conclusion, rapid and accurate laboratory diagnosis of HSV is now become a necessity, given the difficulty in making the clinical diagnosis of HSV, the growing worldwide prevalence of genital herpes and the availability of effective antiviral therapy.
authors.affiliation: Université Paris Diderot, Sorbonne Paris Cité, Microbiology laboratory, Inserm U941, Hôpital Saint-Louis, APHP, 1 Avenue Claude Vellefaux, Paris 75010, France. jerome.le-goff@sls.aphp.fr.
authors.forename: Jérôme
authors.initials: J
authors.lastname: LeGoff
authors.forename: Hélène
authors.initials: H
authors.lastname: Péré
authors.forename: Laurent
authors.initials: L
authors.lastname: Bélec
mesh_terms: D019411:Clinical Laboratory Techniques / Q000379:methods*; D003955:Diagnostic Tests, Routine / Q000379:methods*; D005455:Fluorescent Antibody Technique; D006558:Herpes Genitalis / Q000175:diagnosis*; D018259:Herpesvirus 1, Human / Q000302:isolation & purification; D018258:Herpesvirus 2, Human / Q000302:isolation & purification; D006801:Humans; D016133:Polymerase Chain Reaction; D014776:Virus Cultivation