ABSTRACT
The epidemiology of genital herpes is changing. The seroprevalence of HSV-2 infections is increasing, while HSV-1 is an increasingly common cause of herpetic ulcerations. The reference examination provides direct diagnosis after viral isolation in a cell culture or genome amplification. Herpes serology is indicated principally if direct examination is negative and in the absence of lesions. Non-type-specific serology detects antibodies common to HSV-1 and HSV-2. Its specificity and sensitivity are excellent, and it is approved as a reimbursable laboratory procedure. It cannot specify the viral type involved. Type-specific serology can distinguish between anti-HSV-1 and anti-HSV-2 antibodies. Currently available kits have a sensitivity and specificity, depending on the population studied, of 90 to 100%. It is not approved as a reimbursable laboratory procedure. HSV-1-specific serology cannot diagnose old HSV-1 genital infections, but seropositivity for HSV-2 generally suffices to diagnose HSV-2 genital herpes. The indication for type-specific serology must be discussed according to clinical context. The value of non-type-specific serology is limited.
Subject(s)
Herpes Genitalis/blood , Herpesvirus 1, Human , Herpesvirus 2, Human , Female , Herpes Genitalis/diagnosis , Humans , Male , Pregnancy , Pregnancy Complications, Infectious/blood , Pregnancy Complications, Infectious/diagnosis , Serologic TestsABSTRACT
The prevalence and incidence of genital herpes are increasing worldwide. Conversely, the incidence of neonatal herpes shows global discrepancies: very higher numbers of cases are reported in parts of the USA, whereas rates remain low across much of Europe. As illustrated by the French experiences reported here, regionally appropriate management strategies for genital herpes during pregnancy do not alone account for differences in neonatal herpes rates.
