Genital herpes simplex virus (HSV) infections are a major global public health problem:
● An increase in genital HSV infections has been documented from seroprevalence studies.
● There is a wide diversity of the clinical spectrum of genital HSV disease.
● Like all herpes virus strains, HSV establishes a latent state followed by viral reactivation and recurrent local disease.
● Perinatal transmission of HSV can lead to significant fetal morbidity and mortality.
● A link has been established between HSV-related genital ulcer disease and sexual transmission of HIV.
Genital HSV infections are a major global public health problem. Herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2) are common infections worldwide. However, genital HSV is frequently under-recognized because infection is often subclinical.
It is estimated that the majority of genital herpes infections are transmitted by persons unaware that they have the infection, or are asymptomatic when transmission occurs.
Varicella-zoster virus (VZV) infection causes two clinically distinct diseases. Primary infection with VZV results in varicella (chickenpox), which is characterized by vesicular lesions on an erythematous base in different stages of development; lesions are most concentrated on the face and trunk. Herpes zoster, also known as shingles, results from reactivation of latent VZV that gained access to sensory ganglia during varicella. Herpes zoster is characterized by a painful, unilateral vesicular eruption, which usually occurs in a single or two contiguous, dermatomes.
Microbiology - Virology
Register each sample on an individual request
Please consult laboratory if urgent.
Swabs of lesions, ulcers and vesicles are acceptable samples. Please clearly note the sampling site on the swab or request form.
It is optimal to collect specimens within three days of eruption. Disrupt/remove top of vesicle, and collect fluid with a dry swab. With the same swab rub the base of the lesion, ulcer or open vesicle. Snap the swab into Viral Transport media.
Dry swabs are acceptable if VTM is not available but DO NOT place in bacterial transport medium as this is inhibitory to PCR.
For non-vesicular lesions it is recommended that cells be collected from the base of the lesion using a swab pre-moistened with sterile saline.
Swabs will routinely be tested for HSV-1 and HSV-2. VZV will be tested if specifically requested or if clinical details provided indicate testing.
Please refer to the Swab Identification Guide (link below).
Collection packs can be ordered by emailing LabInfo@cdhb.health.nz
For Herpes testing on other specimen types please refer to https://www.chl.co.nz/test/herpes-simplex-virus/
Chilled (2 - 8 degrees Celsius)
Herpes simplex virus causes both latent, asymptomatic and symptomatic infections. During primary infection shedding can occur from sites other than the primary lesion, similarly during reactivation virus shedding may occur in the presence or absence of symptoms.
Diagnostic testing is helpful when clinical diagnosis is uncertain (especially immunocompromised individuals), where atypical lesions are present or when antiviral therapy is contemplated.
Results are reported as Herpes simplex virus (1 or 2) DNA DETECTED or Herpes simplex virus DNA NOT detected, and Varicella zoster virus DNA DETECTED or Varicella zoster virus DNA NOT detected.
PCR results should always be interpreted in conjunction with clinical history or symptomatic presentation.
Detection of HSV and/or VZV DNA. Nucleic acid extraction, PCR amplification and detection.
Diagnostic testing for Herpes simplex virus (HSV) is very helpful when a clinical diagnosis is uncertain (especially in immunocompromised individuals), where atypical lesions are present or when antiviral therapy is contemplated.
The referrer needs to indicate the site and virus of interest. This will help the laboratory rationalise what testing is needed. For example genital sites will be tested for Herpes simplex viruses (HSV) one and two. Cutaneous sites can be tested for Varicella zoster virus (VZV) in addition to HSV if clinically indicated. Samples from oral and lip lesions will be tested for HSV. Often HSV and VZV skin infections are clinically indistinguishable.
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