Herpes simplex virus (HSV) occurs worldwide and produces a variety of clinical manifestations, ranging from mild stomatitis to fatal disease.
Tests generally appear in the order most useful for common clinical situations
| Test name: Herpes Simplex Virus DFA with Reflex to Herpes Simplex Virus Culture |
| ARUP #: 0060280 |
| Methodology: Direct Fluorescent Antibody Stain |
| Use: Rapid diagnostic test with culture backup Culture is gold standard test for identifying acute HSV infection in acute lesions (eg, vesicles, ulcers, inflammation of mucous membranes) |
| Limitations: Sensitivity of DFA methodology dependent upon adequacy of specimen; if there are fewer than 20 cells, DFA result will be reported as "sample inadequate" |
| Test name: Herpes Simplex Virus by PCR |
| ARUP #: 0060041 |
| Methodology: Qualitative Polymerase Chain Reaction |
| Use: Rapid diagnostic for
Sensitivity 97-98% |
| Limitations: Negative result does not rule out PCR inhibitors in patient specimen or herpes simplex virus DNA concentrations below level assay can detect |
| Test name: Herpes Simplex Virus Culture |
| ARUP #: 0065005 |
| Methodology: Cell Culture/Immunoassay |
| Use: Traditionally, gold standard test for identifying acute HSV infection in acute lesions (eg, vesicles, ulcers, inflammation of mucous membranes) Skin lesion stages
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| Test name: Varicella-Zoster Virus & Herpes Simplex Virus DFA with Reflex to Varicella-Zoster Virus Culture & Herpes Simplex Virus Culture |
| ARUP #: 0060283 |
| Methodology: Direct Fluorescent Antibody Stain |
| Use: Rapid diagnostic test with culture backup that may be helpful when uncertain whether a lesion is due to VZV or HSV |
| Limitations: Sensitivity of DFA methodology dependent upon adequacy of specimen; if there are fewer than 20 cells, DFA result will be reported as "sample inadequate" |
| Test name: Herpes Simplex Virus Type 1 & Type 2 Glycoprotein G-Specific Antibodies, IgG by Immunoblot (HerpeSelect®) |
| ARUP #: 0050459 |
| Methodology: Qualitative Immunoblot |
| Use: Differentiate between HSV-1 and HSV-2 for epidemiological purposes |
| Limitations: Individuals infected with HSV may not exhibit detectable IgG antibody to glycoprotein G in the early stages of infection; 5-10% of infections may occur with glycoprotein G-deficient virus |
| Test name: Herpes Simplex Type 1 & Type 2 Glycoprotein G-Specific Antibodies, IgG by ELISA (HerpeSelect®) |
| ARUP #: 0051152 |
| Methodology: Semi-Quantitative Enzyme-Linked Immunosorbent Assay |
| Use: Detect antibodies to HSV-1 and HSV-2 |
| Limitations: Patients may not exhibit antibody in early disease |
| Test name: Herpes Simplex Virus Culture with Reflex to HSV Typing |
| ARUP #: 0065065 |
| Methodology: Cell Culture/Immunoassay |
| Use: HSV typing can be done by DFA on positive specimens PCR is standard of care for diagnosing HSV meningitis/meningoencephalitis in CSF specimens |
| Test name: Herpes Simplex Virus Type 1 and/or 2 Antibodies, IgG, CSF |
| ARUP #: 0050394 |
| Methodology: Quantitative Chemiluminescent Immunoassay |
| Use: Identify from CSF specimens seropositive organ transplant recipients who often have prophylactic antiviral therapy initiated prior to the transplantation procedure |
| Test name: Herpes Simplex Virus Type 1 (HSV 1) by Immunohistochemistry |
| ARUP #: 2003944 |
| Methodology: Immunohistochemistry |
| Use: Aid in histologic diagnosis of HSV Stained and returned to client pathologist; consultation available if needed |
| Test name: Herpes Simplex Virus Type 2 (HSV 2) by Immunohistochemistry |
| ARUP #: 2003954 |
| Methodology: Immunohistochemistry |
| Use: Aid in histologic diagnosis of HSV Stained and returned to client pathologist; consultation available if needed |
| Test name: Herpes Simplex Virus Type 1 and/or 2 Antibodies, IgG with Reflex to Type 1 and 2 Glycoprotein G-Specific Ab, IgG |
| ARUP #: 0051708 |
| Methodology: Refer to individual components. |
| Comments: Detect antibodies to HSV |
| Test name: Herpes Simplex Virus Type 1 and/or 2 Antibodies, IgG & IgM with Reflex to Type 1 & 2 Glycoprotein G-Specific Ab, IgG |
| ARUP #: 0050916 |
| Methodology: Refer to individual components |
| Comments: Identify type of HSV in a patient who is exhibiting symptoms or in a patient who has recent exposure but has yet to show symptoms Low levels of IgM antibody may persist months after initial infection |
| Test name: Meningoencephalitis Panel, CSF with Reflex to HSV Type 1 & Type 2 Glycoprotein G-Specific Ab, IgG |
| ARUP #: 2001765 |
| Methodology: Semi-Quantitative Enzyme-Linked Immunosorbent Assay/Semi-Quantitative Indirect Fluorescent Antibody |
| Comments: Panel components include California encephalitis, Eastern equine encephalitis, St. Louis equine encephalitis, Western equine encephalitis, West Nile virus, measles, mumps, varicella-zoster virus, HSV types 1 and 2, and lymphocytic choriomeningitis antibodies |
| Test name: Meningoencephalitis Panel, Serum with Reflex to HSV Type 1 & Type 2 Glycoprotein G-Specific Ab, IgG |
| ARUP #: 2001764 |
| Methodology: Semi-Quantitative Enzyme-Linked Immunosorbent Assay/Semi-Quantitative Indirect Fluorescent Antibody/Chemiluminescent Immunoassay |
| Comments: Panel components include California encephalitis, Eastern equine encephalitis, St. Louis equine encephalitis, Western equine encephalitis, West Nile virus, measles, mumps, varicella-zoster virus, HSV types 1 and 2, and lymphocytic choriomeningitis antibodies |
| Test name: Herpes Simplex Virus Type 1 and/or 2 Antibodies, IgG & IgM |
| ARUP #: 0050291 |
| Methodology: Semi-Quantitative Enzyme-Linked Immunosorbent Assay/Chemiluminescent Immunoassay |
| Comments: Diagnose acute infection Note: Acute and convalescent samples required for proper interpretation, even with tests for IgM antibody because low levels of IgM antibody may persist months after initial infection |
| Test name: Herpes Simplex Virus Type 2 Glycoprotein G-Specific Antibody, IgG by ELISA (HerpeSelect®) |
| ARUP #: 0050294 |
| Methodology: Semi-Quantitative Enzyme-Linked Immunosorbent Assay |
| Comments: Differentiate between HSV-1 and -2 |
| Test name: Herpes Simplex Virus Type 1 Glycoprotein G-Specific Antibody, IgG by ELISA (HerpeSelect®) |
| ARUP #: 0050292 |
| Methodology: Semi-Quantitative Enzyme-Linked Immunosorbent Assay |
| Comments: Differentiate between HSV-1 and -2 A few patients will not form glycoproteins, so testing will be negative |
| Test name: Herpes Simplex Virus Type 2 Glycoprotein G-Specific Antibody, IgG by ELISA (HerpeSelect®), CSF |
| ARUP #: 0050359 |
| Methodology: Semi-Quantitative Enzyme-Linked Immunosorbent Assay |
| Comments: Identify the type of HSV in a patient with meningitis Patients may not exhibit antibody in early disease PCR is primary means of establishing diagnosis of herpes encephalitis |
| Test name: Herpes Simplex Virus Type 1 and/or 2 Antibodies, IgG & IgM (CSF) with Reflex to Type 1 & 2 Glycoprotein G-Specific Ab, IgG |
| ARUP #: 0050364 |
| Methodology: Refer to individual components |
| Comments: Identify type of HSV in a patient with meningitis Detect antibodies to HSV in CSF |
| Test name: Herpes Simplex Virus Type 1 Glycoprotein G-Specific Antibody, IgG by ELISA (HerpeSelect®), CSF |
| ARUP #: 0050379 |
| Methodology: Semi-Quantitative Enzyme-Linked Immunosorbent Assay |
| Comments: Patients may not exhibit antibody in early disease |
| Test name: Herpes Simplex Virus Type 1 and/or 2 Antibodies, IgM by ELISA, CSF |
| ARUP #: 0050408 |
| Methodology: Semi-Quantitative Enzyme-Linked Immunosorbent Assay |
| Comments: |
| Test name: Herpes Simplex Virus Type 1 and/or 2 Antibodies, IgG |
| ARUP #: 0050293 |
| Methodology: Chemiluminescent Immunoassay |
| Comments: Patients may not exhibit antibody in early disease |
| Test name: Herpes Simplex Virus Type 1 and/or 2 Antibodies, IgM by ELISA |
| ARUP #: 0050641 |
| Methodology: Semi-Quantitative Enzyme-Linked Immunosorbent Assay |
| Comments: |
| Test name: TORCH Antibodies, IgG |
| ARUP #: 0050772 |
| Methodology: Chemiluminescent Immunoassay |
| Comments: |
| Test name: TORCH Antibodies, IgM |
| ARUP #: 0050665 |
| Methodology: Refer to individual components |
| Comments: |
| Test name: Herpes Simplex Virus Typing |
| ARUP #: 0060847 |
| Methodology: Cell Culture/Immunofluorescence |
| Comments: Used for epidemiological purposes |
| Test name: Encephalitis Panel, CSF with Reflex to HSV Type 1 & 2 Glycoprotein G-Specific Ab, IgG |
| ARUP #: 2001741 |
| Methodology: Semi-Quantitative Enzyme-Linked Immunosorbent Assay/Semi-Quantitative Indirect Fluorescent Antibody |
| Comments: |
| Test name: Encephalitis Panel, Serum with Reflex to HSV Type 1 and Type 2 Glycoprotein G-Specific Ab, IgG |
| ARUP #: 2001742 |
| Methodology: Semi-Quantitative Enzyme-Linked Immunosorbent Assay/Semi-Quantitative Indirect Fluorescent Antibody |
| Comments: |