title: Comparative performance of the Kalon and HerpeSelect enzyme-linked immunosorbant assays to determine the prevalence of herpes simplex virus type 2 in Papua New Guinea.
abstract: Background Infection with herpes simplex virus type 2 (HSV-2) is common worldwide and an important risk factor for HIV infection. Aetiological diagnosis of HSV-2 is typically determined with the use of commercially available type-specific enzyme-linked immunosorbent assays (ELISAs). This study aimed to determine the prevalence of HSV-2 among people attending sexual health clinics in the Highlands of Papua New Guinea. The study also aimed to compare the performance of two type-specific ELISA assays, the Kalon and HerpeSelect glycoprotein G2 assays, in this context.
  
  
  METHODS
  Participants were recruited as part of a longitudinal sexual health study. Participants attended four appointments over a 12-month period and had blood taken for HSV-2 serology at each time point. Both the Kalon and HerpeSelect assays were performed as per manufacturer's instructions.
  
  
  RESULTS
  A total of 132 participants were tested for HSV-2 using the Kalon and HerpeSelect ELISAs. HSV-2 prevalence was 52% (95% CI, 43-60) and 61% (95% CI, 52-69) with Kalon and HerpeSelect assays respectively. There was high concordance (87%, ?=0.75, P<0.001, n=115) between the two assays at the manufacturer recommended index value cut-offs. For participants with discordant results at baseline, (n=16), three sero-conversions were observed over the 12-month period when sequential sera was tested.
  
  
  CONCLUSIONS
  A high HSV-2 prevalence was observed in this clinic-based population. Our longitudinal data indicate the higher prevalence of HSV-2 detected with the HerpeSelect ELISA was likely due to false positives rather than a higher sensitivity in the early stages of infection.
authors.affiliation: Papua New Guinea Institute of Medical Research, Goroka, Eastern Highlands Province 441, Papua New Guinea.
authors.forename: Claire E
authors.initials: CE
authors.lastname: Ryan
authors.affiliation: Papua New Guinea Institute of Medical Research, Goroka, Eastern Highlands Province 441, Papua New Guinea.
authors.forename: Cassey S
authors.initials: CS
authors.lastname: Simbiken
authors.affiliation: Burnet Institute, 85 Commercial Road, Melbourne, Vic. 3004, Australia.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Agius
authors.affiliation: Papua New Guinea Institute of Medical Research, Goroka, Eastern Highlands Province 441, Papua New Guinea.
authors.forename: Joyce
authors.initials: J
authors.lastname: Allen
authors.affiliation: HOPE World Wide, Port Moresby, NCD, Papua New Guinea.
authors.forename: Joyce
authors.initials: J
authors.lastname: Sauk
authors.affiliation: Tininga Clinic Mount Hagen General Hospital, Mount Hagen, Western Highlands Province, Papua New Guinea.
authors.forename: Petronia
authors.initials: P
authors.lastname: Kaima
authors.affiliation: Pathology Department, Mount Hagen General Hospital, Mount Hagen, Western Highlands Province, Papua New Guinea.
authors.forename: Zure
authors.initials: Z
authors.lastname: Kombati
authors.affiliation: Papua New Guinea Institute of Medical Research, Goroka, Eastern Highlands Province 441, Papua New Guinea.
authors.forename: Peter
authors.initials: P
authors.lastname: Siba
authors.affiliation: Kirby Institute, UNSW Australia, Sydney, NSW 2052, Australia.
authors.forename: John M
authors.initials: JM
authors.lastname: Kaldor
authors.affiliation: Papua New Guinea Institute of Medical Research, Goroka, Eastern Highlands Province 441, Papua New Guinea.
authors.forename: Andrew
authors.initials: A
authors.lastname: Vallely