HSV 1 & 2 DNA (Herpes simplex virus 1 & 2 DNA nucleic acid amplification test)
HSV 1 & 2 DNA (Herpes Simplex Virus DNA nucleic acid amplification test)
Detection and typing of herpes simplex virus (HSV) DNA
|Test Code||Reporting Name||Available Separately||Always Performed|
|HSV 1/2 and VZV DNA||No||Yes|
Indications for Testing
Detection of HSV 1 or 2 DNA from any site in which HSV infection may be present
Special Instructions and Forms
Previous tests such as microscopy, antigen detection, traditional and rapid culture, DFA from direct specimens have been replaced by HSV1/2 DNA PCR detection
HSV 1/2 and VZV DNA
Specimen Required/Minimum volume/Transport temperature
- Ulcerative lesions: Flock swab placed in non-expired universal or viral transport media (UTM/VTM) sampled from vesicular and/or ulcerative lesions from anywhere on the skin or oral, genital or peri-anal mucosa, or corneal ulcer. Biopsy material in UTM/VTM transport media. Maintain at 2-8°C and transport on ice packs within 72 hours.
- Cerebrospinal fluid (CSF): Minimum 1mL obtained in sterile container and maintained at 2-8°C and delivered to laboratory within 72 hours.
- BAL/Blood/plasma/serum/tissues – HSV DNA NAT has not been validated on these specimen sources and can be offered off-label if clinically indicated. Maintain specimen at 2-8°C and delivered to laboratory within 72 hours.
Reject Due To:
· Prolonged transport
· Previously reported resulted from the same site within 1 week
· Insufficient specimen volume received
· Specimen transported in inappropriate container
· CSF with no pleocytosis and a protein level within normal limits
Identification and typing of herpes simplex virus 1 & 2 (HSV 1 & 2)
Herpes simplex viruses (HSV) are ubiquitous among humans. Once acquired, HSV can remain latent in the regional sensory ganglia and, when reactivated, move back along the sensory nerves to produce recurrent infections. Common HSV infection manifestations include ulcerative genital lesions, cold sores, pharyngitis, ocular keratitis, and encephalitis.
The viruses are classified as type 1 or 2 according to their genetic and antigenic composition. Although each type has been associated with a characteristic pattern of infection (ie, oral HSV 1 and genital HSV 2), the site of infection is not an accurate predictor of the virus type. For example, HSV 1 is now known to cause a significant proportion of primary genital herpes infection.
Direct detection of HSV infection is required in many situations, including infection of neonates, immunocompromised patients, pregnant women, and individuals suspected of having herpes encephalitis. In addition, specific diagnosis is useful in the counseling of sexually active individuals. Typing has importance in a) prognosis, since the recurrence rate of genital HSV 1 infection is less than that of genital HSV 2; b) treatment, since the antiviral duration of chemotherapeutic agents can differ between the two HSV types; and (c) epidemiology, for assessing the association of HSV infection with other disease processes (eg, cervical carcinoma).
Like many viral infections, laboratory diagnosis is by direct and indirect methods. Direct methods include electron microscopy, tissue culture and detection of viral DNA by molecular techniques. Indirect methods include identifying antibodies for HSV 1 and/or 2. NL PHML offers HSV 1/2 nucleic acid testing (NAT) for direct testing and HSV type specific serology for indirect testing.
Medications that inhibit viral replication include acyclovir, famciclovir, valacyclovir, penciclovir, foscarnet and cidofovir.
Early diagnosis is important since treatment with antivirals may substantially alter course of HSV infections. Untreated herpes encephalitis and neonatal herpes are fatal in 70% of patients, with neurologic sequelae in most survivors. Disseminated disease usually occurs in immunocompromised patients.
There is no effective commercially available vaccine for HSV infections.
Transmission is by direct human contact with infected lesions or secretions.
Detected HSV 1/2 DNA indicates HSV infection
Not Detected: HSV 1/2 DNA not detected does not necessarily always exclude infection.
ARUP Consult. Herpes Simplex Virus. The Physician’s Guide to Laboratory Test Selection and Interpretation. ARUP Laboratories, National Reference Laboratory, Salt Lake City, UT.
Jerome, K. R., and Morrow, R. A. 2007. Herpes Simplex Viruses and Herpes B Virus, p. 1523-1536. In Murray, P. R., Baron, E. J., Jorgensen, J. H., Landry, M. L., and Pfaller, M. A. Manual of Clinical Microbiology, 9th ed., vol. 2. ASM Press, American Society for Microbiology, Washington, DC.
Mayo Medical Laboratories. Unit Code 84429: Herpes Simplex Virus (HSV). Test Catalogue. Mayo Medical Laboratories, Mayo Clinic, Rochester, MN.
Schiffer, J. T, and Corey, L. 2010. Herpes Simplex Virus, p. 1943-1962. In Mandell, D., Bennett, J. E., and Dolin, R. Principles and practice of infectious diseases, 7th ed., vol. 2. Churchill Livingstone, Elsevier, Philadelphia, PA.
Trinity Biotech USA. 2007. MicroTrak® HSV 1/ HSV 2 Culture Identification/Typing Test: package insert. Trinity Biotech USA., Jamestown, NY.
Trinity Biotech USA. 2007. MicroTrak® HSV 1/ HSV 2 Direct Specimen Identification/Typing Test: package insert. Trinity Biotech USA., Jamestown, NY.
HSV 1 & 2 DNA PCR
HSV 1 & 2 DNA PCR
Day(s) and Time(s) Test Performed
Monday to Friday and on weekends with Microbiologist on call approval for CSF
Tuesday and Friday for UTM
Maximum Laboratory Time
Specimen Retention Time
2 weeks for eluent/2 years for original specimen
Performing Laboratory Location
Newfoundland & Labrador Public Health and Microbiology Laboratory