Public Health Laboratory, St John's, Newfoundland and Labrador.
Can J Infect Dis Med Microbiol. 2007 Jul;18(4):233-40. doi: 10.1155/2007/505364.
Accurate identification of persons with genital herpes is necessary for optimal patient management and prevention of transmission. Because of inherent inaccuracies, clinical diagnosis of genital herpes should be confirmed by laboratory testing for the causative agents herpes simplex virus type 1 (HSV-1) and HSV type 2 (HSV-2). Further identification of the HSV type is valuable for counselling on the natural history of infection and risk of transmission. Laboratory methods include antigen detection, culture, polymerase chain reaction (PCR) and conventional and type-specific serology (TSS). PCR has, by far, the greater sensitivity and should be the test of choice for symptomatic cases. HSV-2 TSS is indicated for patients with genital lesions in whom antigen detection, culture or PCR fail to detect HSV, and for patients who are asymptomatic but have a history suggestive of genital herpes. HSV-2 TSS is further indicated for patients infected with HIV. HSV-2 TSS along with HSV-1 TSS may be considered, as appropriate, in evaluating infection and/or immune status in couples discordant for genital herpes, women who develop their first clinical episode of genital herpes during pregnancy, asymptomatic pregnant women whose partners have a history of genital herpes or HIV infection, and women contemplating pregnancy or considering sexual partnership with those with a history of genital herpes. The above should be performed in conjunction with counselling of infected persons and their sex partners.
准确识别生殖器疱疹患者对于优化患者管理和预防传播至关重要。由于存在固有误差，生殖器疱疹的临床诊断应通过实验室检测来确认引起生殖器疱疹的单纯疱疹病毒 1 型（HSV-1）和单纯疱疹病毒 2 型（HSV-2）。进一步确定 HSV 类型对于感染自然史和传播风险的咨询很有价值。实验室方法包括抗原检测、培养、聚合酶链反应（PCR）以及常规和型特异性血清学（TSS）。迄今为止，PCR 的灵敏度最高，应该是症状性病例的首选检测方法。对于生殖器病变患者，若抗原检测、培养或 PCR 未能检测到 HSV，则应进行 HSV-2 TSS；对于无症状但有生殖器疱疹病史的患者，也应进行 HSV-2 TSS。对于感染 HIV 的患者，还应进行 HSV-2 TSS。在评估夫妻一方患有生殖器疱疹、孕妇首次出现生殖器疱疹临床症状、伴侣有生殖器疱疹或 HIV 感染史的孕妇、计划怀孕或考虑与有生殖器疱疹病史的人发生性关系的孕妇的感染和/或免疫状态时，可以考虑进行 HSV-1 TSS 和 HSV-2 TSS。以上操作应结合对感染者及其性伴侣的咨询。
