From: Diagnosis of genital herpes simplex virus infection in the clinical laboratory
Context | Indication and interpretation |
---|---|
Asymptomatic patients | Not routinely recommended |
Confirmation of clinical diagnosis | HSV-2 antibodies are supportive of a diagnosis of genital herpes. |
History of recurrent or atypical genital disease with direct virus detection negative | HSV-1 antibodies do not differentiate between genital and oropharyngeal infection. |
Counseling of HSV-2 IgG-negative, HSV-1 IgG-positive patients should take into account that HSV-1 is an uncommon cause of recurrent genital disease. | |
First-episode genital herpes | Differentiation between primary and established infection guides counseling and management. |
At the onset of symptoms, the absence of HSV IgG against the virus type detected in the genital lesion is consistent with a primary infection. | |
Seroconversion should be demonstrated at follow-up. | |
Partner with genital herpes | Knowledge of infection status can guide patient education and counseling if the partnership is discordant. |
Pregnant women | Not routinely recommended. |
HSV-1 and/or HSV-2 seronegative women should be counseled about strategies to prevent a new infection with either virus type during pregnancy. | |
HIV infected patients | Not routinely recommended. |
Although HSV-2 seropositivity increases the risk of HIV transmission and frequent HSV recurrences augment HIV replication, there is limited evidence to inform the management of HSV-2 co-infection in HIV-infected patients without symptoms of genital herpes. | |
Limited data suggest an increased risk of perinatal HIV transmission among HSV-2 seropositive HIV-infected women. As the evidence is not consistent, testing of HIV-positive pregnant women is not routinely recommended. |