Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
Euro Surveill. 2010 Nov 4;15(44):19703. doi: 10.2807/ese.15.44.19703-en.
These guidelines aim to provide comprehensive information about sexually transmitted herpes simplex virus (HSV) infection and its laboratory diagnosis in eastern European countries. They are primarily intended for professionals testing specimens from patients at a sexual healthcare clinic but may also be helpful for community-based screening programmes. In particular, the guidelines recommend: (i) either viral culture or validated and approved nucleic acid amplification tests (NAATs) as the tests of choice for symptomatic patients, which should be promoted for laboratory confirmation of HSV infection; (ii) if culture or NAATs are not available, antigen detection--a direct immunofluorescence test or enzyme immunoassay from samples from symptomatic patients--could be employed, but HSV type determination is of importance; (iii) only type-specific serology should be used for detecting asymptomatic individuals, testing pregnant women at risk of acquiring HSV infection close to delivery, men who have sex with men and people who are HIV positive; (iv) widespread screening for HSV antibodies should be discouraged; and (v) any non-validated diagnostic tests should be validated against a recommended, approved gold standard.
这些指南旨在为东欧国家提供有关性传播单纯疱疹病毒 (HSV) 感染及其实验室诊断的全面信息。它们主要针对在性保健诊所检测患者标本的专业人员,但也可能对社区为基础的筛查计划有帮助。特别是,指南建议:(i) 对于有症状的患者,应选择病毒培养或经过验证和批准的核酸扩增检测(NAAT)作为首选检测方法,以促进实验室确认 HSV 感染;(ii) 如果无法进行培养或 NAAT,可使用来自有症状患者的样本进行抗原检测——直接免疫荧光试验或酶免疫测定,但 HSV 型别的确定很重要;(iii) 仅应使用针对特定型别的血清学检测来检测无症状个体,对接近分娩时可能感染 HSV 的孕妇、男男性行为者和 HIV 阳性者进行检测;(iv) 应避免广泛筛查 HSV 抗体;以及 (v) 任何未经验证的诊断检测都应针对推荐的、批准的金标准进行验证。