Departments of Pediatrics and Medicine, University of Colorado School of Medicine Anschutz Medical Campus, Aurora, CO 80045.
Departments of Pediatrics, Medicine and Pathology, University of Colorado School of Medicine Anschutz Medical Campus, Aurora, CO 80045.
Microbiol Spectr. 2016 Jun;4(3). doi: 10.1128/microbiolspec.DMIH2-0017-2015.
The most common specimens from immunocompromised patients that are analyzed for detection of herpes simplex virus (HSV) or varicella-zoster virus (VZV) are from skin lesions. Many types of assays are applicable to these samples, but some, such as virus isolation and direct fluorescent antibody testing, are useful only in the early phases of the lesions. In contrast, nucleic acid (NA) detection methods, which generally have superior sensitivity and specificity, can be applied to skin lesions at any stage of progression. NA methods are also the best choice, and sometimes the only choice, for detecting HSV or VZV in blood, cerebrospinal fluid, aqueous or vitreous humor, and from mucosal surfaces. NA methods provide the best performance when reliability and speed (within 24 hours) are considered together. They readily distinguish the type of HSV detected or the source of VZV detected (wild type or vaccine strain). Nucleic acid detection methods are constantly being improved with respect to speed and ease of performance. Broader applications are under study, such as the use of quantitative results of viral load for prognosis and to assess the efficacy of antiviral therapy.
免疫功能低下患者最常分析的用于检测单纯疱疹病毒 (HSV) 或水痘-带状疱疹病毒 (VZV) 的标本来自皮肤损伤。许多类型的检测方法适用于这些样本，但有些方法，如病毒分离和直接荧光抗体检测，仅在病变的早期阶段有用。相比之下，核酸 (NA) 检测方法通常具有更高的灵敏度和特异性，可应用于皮肤损伤的任何进展阶段。NA 方法也是检测血液、脑脊液、房水或玻璃体液以及黏膜表面的 HSV 或 VZV 的最佳选择，有时甚至是唯一选择。当同时考虑可靠性和速度（24 小时内）时，NA 方法可提供最佳性能。它们可轻松区分检测到的 HSV 类型或检测到的 VZV 来源（野生型或疫苗株）。NA 检测方法在速度和操作简便性方面不断得到改进。正在研究更广泛的应用，例如使用病毒载量的定量结果进行预后评估和评估抗病毒治疗的疗效。
