Herpes Simplex Virus

Herpes simplex virus (HSV) occurs worldwide causing several diseases. There are two herpes antigenic types, type 1 and type 2. Definitive diagnosis of genital herpes infections is fundamental to the management of patients and the development of strategies to prevent transmission to partners and neonates. Genital Herpes Simplex Virus Type 2 (HSV-2) infections are reaching epidemic proportions in the United States. Recent Centers for Disease Control (CDC) data indicate that as many as 21.9% of the population between 12 and 74 years of age are infected with HSV-2. The prevalence is higher among persons who attend sexually transmitted diseases (STD) clinics and in many obstetrical practices. These data represent a 30% increase in HSV-2 seroprevalence in the early 1990's as compared with the late 1990's. The United States is not the only country that has seen a marked increase in genital herpes in the last twenty years. Genital herpes epidemics are now well documented in Europe, Africa, and South America.

There are multiple reasons for this rise in HSV-2 infections worldwide. However, a major contributor is the fact that most HSV-2 seropositive persons are unaware of their infections. New diagnostic tests are now available that could definitively identify those with HSV-2. Accurate diagnosis is key to treatment and prevention of genital herpes. Genital herpes can be diagnosed, can be treated, and most importantly, may be prevented.

Genital herpes diagnosis has proven inaccurate when based solely on clinical history and impression. Instead, virus, antigen or nucleic acid detection and classification is used for patients presenting with lesions or type-specific serological tests may be used when lesions are absent.

For type specific serology, either western blot or assays or type specific protein are used. Acceptable type specific classification is not possible using whole virus lysate, the commonly used antigen of early HSV serology kits. The most commonly used type specific protein is glycoprotein G. ImmunoWELL HSV typing tests use HSV gG type 1 and type 2 recombinant proteins.

The newest GenBio products are ImmunoWELL and ImmunoDOT products, using type specific recombinant glycoprotein G (gG1 and/or gG2) for diagnosis of HSV type 1 or HSV type 2*. An ImmunoFLOW gG2 IgG product is in development.

In some cases, whole virus IgM and IgG serology combined with type-specific anti-gG detection is the preferred serodiagnostic methodology. GenBio manufactures a more traditional ImmunoWELL HSV IgM kit, detecting both type 1 and 2 IgM antibodies* and ImmunoDOT kits for detection of HSV IgM antibodies. GenBio also manufactures an ImmunoDOT kit (TORCH panel) which detects IgG HSV antibodies using non-type specific antigens**.

ImmunoDOT TORCH test also includes an HSV IgG dot as indicated in TORCH IgG testing. This analyte is included as part of a comprehensive prenatal screening protocol. This test detects antibodies to both virus types and does not differentiate between them.

*Herpes Typing kits and IgM kits for HSV are CE marked for Export only at this time

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