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Open Access Highly Accessed Review

Diagnosis of genital herpes simplex virus infection in the clinical laboratory

Jérôme LeGoff1*, Hélène Péré23 and Laurent Bélec23

Author Affiliations

1 Université Paris Diderot, Sorbonne Paris Cité, Microbiology laboratory, Inserm U941, Hôpital Saint-Louis, APHP, 1 Avenue Claude Vellefaux, Paris 75010, France

2 Laboratoire de Microbiologie, hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Sorbonne Paris Cité, Paris, France

3 Faculté de Médecine Paris Descartes, Université Paris Descartes (Paris V), Sorbonne Paris Cité, Paris, France

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Virology Journal 2014, 11:83  doi:10.1186/1743-422X-11-83

Published: 12 May 2014

Abstract

Since the type of herpes simplex virus (HSV) infection affects prognosis and subsequent counseling, type-specific testing to distinguish HSV-1 from HSV-2 is always recommended. Although PCR has been the diagnostic standard method for HSV infections of the central nervous system, until now viral culture has been the test of choice for HSV genital infection. However, HSV PCR, with its consistently and substantially higher rate of HSV detection, could replace viral culture as the gold standard for the diagnosis of genital herpes in people with active mucocutaneous lesions, regardless of anatomic location or viral type. Alternatively, antigen detection—an immunofluorescence test or enzyme immunoassay from samples from symptomatic patients--could be employed, but HSV type determination is of importance. Type-specific serology based on glycoprotein G should be used for detecting asymptomatic individuals but widespread screening for HSV antibodies is not recommended. In conclusion, rapid and accurate laboratory diagnosis of HSV is now become a necessity, given the difficulty in making the clinical diagnosis of HSV, the growing worldwide prevalence of genital herpes and the availability of effective antiviral therapy.

Keywords:
Herpes simplex virus; Genital herpes; Diagnosis