Type specific HSV serology testing

Genital herpes is usually diagnosed at the time of presentation, when a specimen from a blister or erosion is sent to the laboratory for viral culture, which is still the current gold standard for diagnosis of genital HSV infections.

Although the test is very accurate and reliable for diagnosis of the infection, a number of problems exist. The main problem is that patients often present when the lesions are healed, or when lesions are absent. The yield of positive cultures declines with duration of lesions.

Type-specific serological tests (TSST) for diagnosis of HSV infections would therefore offer doctors another means of diagnosis.

However, there are certain points that must be borne in mind.

• HSV-1 is the usual cause of cold sores. Most infections are acquired during early childhood and it is estimated that more than 50% of adults have evidence of previous infection with this virus.
• Most genital infections are caused by HSV-2. However, the practice of oro-genital sex has meant that HSV-1 genital infections are occurring with increasing frequency. This factor may complicate interpretation of blood tests.
• Seroconversion may take up to 6 - 8  weeks. TSST may thus not be positive if done immediately after a first episode of genital herpes