This assay utilizes recombinant type-specific antigens to differentiate HSV-1 from HSV-2 infections. A index positive result cannot distinguish between recent and past infection. If recent HSV infection is suspected but the results are negative or equivocal, the assay should be repeated in 4-6 weeks. The performance index characteristics of the assay have not been established for pediatric populations, immunocompromised patients, or neonatal screening.
Herpes Simplex Virus 1 and 2 (IgG), Type-Specific Antibodies - Herpes Simplex Virus (HSV) is responsible for several clinically significant human viral diseases, with severity ranging from inapparent to fatal. Clinical manifestations include genital tract infections, neonatal herpes, meningoencephalitis, keratoconjunctivitis, and gingivostomatitis. There are two HSV serotypes that are closely related antigenically. HSV Type 2 is more commonly associated with genital tract and neonatal infections, while HSV Type 1 is more commonly associated with infections of non-genital sites. Specific typing is not usually required for diagnosis or treatment.
Infection with either herpes simplex virus type 1 (HSV-1) or type 2 (HSV-2) is common in the United States. Overall seroprevalence in 2015-2016 was 48% for HSV-1 and 12% for HSV-2 among people 14 to 49 years old. However, seroprevalence was much higher in some ethnicities: 72% for HSV-1 among Mexican-Americans (though only 9% for HSV-2) and 35% for HSV-2 among non-Hispanic blacks.
Seropositivity does not necessarily indicate the site of infection, but HSV-1 most often causes oral herpes and HSV-2 most often causes genital herpes. However, HSV-1 is responsible for an increasing proportion of primary genital infections; in some populations (eg, college students, young women), HSV-1 has been reported to account for over half of genital herpes infections.
Genital infections may be associated with small, painful lesions affecting anogenital areas as well as generalized symptoms such as fever, muscle aches, and malaise. However, most genital herpes infections are transmitted by individuals who do not know they are infected, as symptoms are often mild or absent.
Genital HSV-1 and HSV-2 infections can also cause neonatal herpes, especially among women who acquire genital herpes near the time of delivery.2 If genital herpetic lesions are present at the onset of delivery, cesarean delivery should be considered to prevent neonatal infection. Newborns exposed to HSV during birth should be followed closely with consideration of antiviral therapy.
Diagnosing infection and determining HSV type can indicate risk of disease recurrence, transmission risks, and prognosis. However, the pathogenesis of herpes infection can make diagnosis difficult, as antibodies and nucleic acids are measurable at different points of pathogenesis.
Herpes Simplex Virus 1 and 2 (IgG), Type-Specific Antibodies
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