Requests for HSV specific serology are considered acceptable for:
1. Pre-transplant screening.
2. Investigation of clinical herpes in Pregnancy.
Molecular testing for HSV has now superseded serological testing for the vast majority of clinical indications. The sub-optimal sensitivity and specificity of HSV serology can be misleading and lead to sub-optimal clinical management, particularly when used in relation to sexually transmitted infection.
Herpes simplex virus serology guidelines (updated Dec 2019)
Microbiology - Serology
Herpes simplex type specific
Should an HSV specific serology request be considered necessary outside of the pre-transplant / perinatal setting this can be discussed by contacting one of our Clinical Microbiologists, prior to referral.
Chilled (2 - 8 degrees Celsius)
If overnight - Chilled (2 - 8 degrees Celsius)
Minimum aliquot, serum 500 uL. Preferred aliquot, serum 2 mL
Herpes Simplex Virus:
The initial mucocutaneous infection caused by Herpes simplex virus Type 1 or 2 results in the establishment of latent infection in the dorsal root ganglia. Subsequent viral reactivation is accompanied by viral excretion from the original mucocutaneous sites of infection, with or without clinical signs or symptoms. Transmission results from direct contact with infected secretions from a symptomatic or asymptomatic host. Previous infection with HSV 1 does not prevent infection upon exposure to HSV 2.
Clinical maifestations include oral and genital ulceration – primary infection may be accompanied by fever and lymphadenopathy, encephalitis, conjunctivitis, keratitis and herpetic whitlow.
PCR for HSV in CSF samples can give false negative results where sampling is early and the viral load is still low, in which case a repeat may be indicated, or where antiviral therapy has already been instigated and may interfere with HSV DNA detection by PCR.
PCR offers a highly sensitive and specific technique for diagnostic testing and allows for results within 4 hours of receipt of CSF. All positive DNA detected is subtyped using RFLP analysis.
Specimens: CSF, tissue biopsy (please consult laboratory).
Sensitivity of Assay: More sensitive than cell culture (the gold standard).
Specificity of Assay: This assay detects Herpes Simplex Virus only, and does not cross-react with other member of the Herpesviridae group.
Tests available at Canterbury Health Laboratories for the detection of Herpes Simplex Virus:
•Serology – IgG
•Serology-IgG type specific
Reported as (IgG Type I and IgG Type II) Negative or Equivocal or Positive
EIA Both HSV 1 and HSV 2 performed for the one price.
$54.04 (Exclusive of GST)
The Serology/Virology Department at Canterbury Heath Laboratories would like to remind referrers of the limited utility of Herpes simplex serology and confirm our endorsement of the guidelines from the New Zealand Microbiology network and BPAC NZ.
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