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Herpes Simplex Virus
Type 1 & 2 DNA
by Real-Time (PCR)-Qualitative

Test code: 900.

Method: Real-time polymerase chain reaction (PCR)-Qualitative.

Specimen requirements: SurePath™: 1.0 mL (0.50 mL) minimum. T

Collection and transport SurePath™ : In addition to the cervix, a thorough brushing of the vaginal wall is necessary to ensure adequate sample source.

Causes for rejection: SurePath™: Less than 0.50 mL and/or more than 28 days.

Specimen stability: SurePath™: Stable for up to 28 days room temp.

Reference range: Not detected.

TAT: 1-5 days.

CPT codes: 87529x2: Herpes simplex virus Type 1 & 2, amplified probe technique.

Clinical significance: Herpes simplex virus I & II (HSV) is one of the most prevalent viruses found in the general population today. It is estimated that more than 107 million people worldwide are infected with herpes and only 21.4 million are diagnosed. Type 1 infections usually involve non-genital areas, whereas type 2 infections are primarily found in genital areas although there can be overlap between the two types. The clinical courses of acute first episode genital herpes among patients with Herpes simplex virus I and Herpes simplex virus II infections are similar and both can cause symptomatic or asymptomatic rectal and perianal infections. HSV infections may not be apparent because symptoms do not always follow a typical pattern.

By utilizing Real-time polymerase chain reaction (PCR)-Qualitative, HSV has been demonstrated in asymptomatic patients on 28% of days tested versus 8.1% by viral isolation. As a result, the rate of detection for Real-time polymerase chain reaction (PCR)-Qualitative is 3.5 times that of a traditional viral culture in asymptomatic patients. Asymptomatic shedding was shown on 60% of days where HSVDNA was measured by Real-time polymerase chain reaction (PCR)-Qualitative. Patients with ulcerative lesions have positive Real-time polymerase chain reaction (PCR)-Qualitative results on 15 of 17 days (88.2%) versus positive culture results on 3 of 17 days (17.6%). Culture isolation or immunologic analysis of HSV from cerebrospinal fluid (CSF) is limited.

These techniques lack sensitivity and specificity and do not yield results quickly. Real time polymerase chain reaction (PCR)-Qualitative offers a rapid and sensitive way to test for HSV. In Conclusion, the detection of HSV DNA by Real-time polymerase chain reaction (PCR)-Qualitative has been proven to be the most specific, rapid and sensitive means to diagnosis anogenital and CNS infections.

References
1. Marchant J, Roe A. Genital herpes: Recognizing and addressing patients’ needs. Herpes J 1997; 4:36:41.
2. Walt A. Subclinical shedding of herpes simplex virus in genital tract: implications from transmission Herpes J 1997;4:20-35
3. Cone Wyatt, Richard, et al. Extended duration of herpes simplex virus DNA in gential lesion detected by the polymerase chain reaction. J Infect Dis 1991 Oct;146(4):757-60.

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