Inability of enzyme immunoassays to discriminate between infections with herpes simplex virus types 1 and 2

Article Abstract:

Herpes simplex viruses cause both mouth lesions, or cold sores, and genital lesions. As a rule, herpes simplex type 1 is responsible for mouth (oral) lesions and herpes simplex type 2 is responsible for genital disease. These viruses can cause disease when the patient is first infected, and then lay dormant for months to years before causing further disease. Some people acquire infection with the viruses without an initial illness, but remain capable of transmitting the virus unknowingly to someone else. The most reliable way to test for exposure to herpes viruses is through the use of sophisticated blood tests that can distinguish between types 1 and 2. Several kits are available to test for these viruses in a physician's office. A study was done comparing three of these commercial kits, using blood samples from patients whose infectious status with herpes simplex 1 and 2 was already known. A total of 163 people were tested. The first commercial kit gave inaccurate results in 37 percent of cases, the second in 26 percent of cases, and the third provided incorrect results in 37 percent of cases. Since a mother's infection with herpes simplex type 2 might infect her child during birth, accurate knowledge of her status as a carrier of that virus is necessary. None of the three kits tested performed satisfactorily in accurately identifying which virus a person carried or if, indeed, the person was infected at all. These commercial kits are not recommended when such information is important. (Consumer Summary produced by Reliance Medical Information, Inc.)

Medical tests, Identification and classification, Herpesviruses, Herpesvirus diseases, Herpesvirus infections

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Suppression of subclinical shedding of herpes simplex virus type 2 with acyclovir

Article Abstract:

Acyclovir therapy may reduce the number of released or shed cells infected with herpes simplex virus-2 (HSV-2) into genital secretions in patients with a recent HSV-2 infection. Researchers compared the incidence of viral shedding in 34 women with a recent HSV-2 infection taking either acyclovir or a placebo for 70 days followed by a 2-week rest period. Twenty-six of these women continued treatment for an additional 70 days taking the reverse medication. Acyclovir therapy reduced the frequency of viral shedding by as much as 62% to 100% at the three genital sites tested daily. However, nearly half of the women continued to have unexplained genital sores, most of which were negative for HSV-2. There were no adverse genital symptoms reported on half of the days that swabs revealed evidence of viral shedding.

Acyclovir

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Herpes simplex virus type 2 detection by culture and polymerase chain reaction and relationship to genital symptoms and cervical antibody status during the third trimester of pregnancy

Article Abstract:

The polymerase chain reaction test may be more accurate than culture in detecting asymptomatic herpes simplex virus type 2 shedding from the genital tract. Researchers collected daily genital tract samples from nine pregnant women during the third trimester who were infected with herpes simplex virus type 2 and analyzed samples for asymptomatic herpes simplex virus shedding. Polymerase chain reaction detected more asymptomatic herpes simplex virus shedding in both women without genital herpes and in symptomatic women. Women without genital herpes may transmit the virus to their infants. Immunoglobulin A appeared to fight herpes simplex virus.

Polymerase chain reaction, Immunoglobulin A

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