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Review
. 1999 Jan;12(1):1-8.
doi: 10.1128/CMR.12.1.1.

Genital herpes: review of the epidemic and potential use of type-specific serology

R L Ashley  1 , A Wald
Affiliations
Review

Genital herpes: review of the epidemic and potential use of type-specific serology

R L Ashley et al. Clin Microbiol Rev. 1999 Jan.

Abstract

Prevention of genital herpes simplex virus (HSV) infections is desirable from both a public health standpoint and the patient's perspective. A key factor in the spread of genital herpes infections is the high proportion of undiagnosed infections. Persons with subclinical or unrecognized infections are best diagnosed by accurate, type-specific antibody tests. Unfortunately, these tests are only now becoming widely available. The use of current, conventional (non-type-specific) serologic tests for diagnosis of herpes infections has resulted in confusion and misdiagnosis of patients. This review provides recent information on the epidemiology of genital herpes infections, describes the importance of subclinical herpes infection and shedding, summarizes the status of HSV type-specific serologic assays being developed, and provides indications for using such assays.

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Figures

FIG. 1
FIG. 1
Profile of the development of antibodies to HSV-2. Eighteen patients with primary genital HSV-2 were monitored weekly for 8 weeks and then monthly for 12 to 18 months. Sera drawn at these visits were tested, as sets, following adsorption against HSV-1 proteins. Antibodies reacting with HSV-2 proteins were detected by Western blotting. HSV-2 targets of type-specific antibodies were identified by migration characteristics. The cumulative percentage of patients with antibodies (Ab) to glycoproteins gB, gG, and gD, to nucleocapsid proteins VP5 and ICP-35, and to the tegument protein, VP16, were determined for each period (Days) following the onset of genital herpes.
FIG. 2
FIG. 2
Cumulative seroconversion as shown by Western blotting. Patients with culture-documented first episodes of genital herpes were samples sequentially; 26 were seronegative at the onset of symptoms; of these, 8 had HSV-1 genital herpes (HSV-1 Primary) and 18 had HSV-2 genital herpes (HSV-2 Primary). Twelve were HSV-1 seropositive at onset and had HSV-2 cultured from lesions (HSV-2 Non-primary). The earliest time (Month Post-Infection) at which seroconversion was detected by Western blotting was recorded. The cumulative proportion of patients diagnosed (% Diagnosis) is presented for each period.
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References

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    1. Ashley R. Type-specific antibodies to HSV-1 and -2: review of methodology. Herpes. 1998;5:33–38.