Erlich K S
Department of Medicine, University of California, San Francisco.
Clin Lab Med. 1987 Dec;7(4):759-76.
The diagnosis of infection due to herpesviruses can be performed by several laboratory techniques, including virus culture, demonstration of virus-specific cellular antigens, detection of virus-induced serum antibodies, detection of viral nucleic acids (using radiolabeled probes), or visualization of histologic changes in infected tissue. Virus culture is the most sensitive technique for diagnosis of most infections due to herpes simplex virus (HSV) and cytomegalovirus (CMV), but is insensitive for the diagnosis of varicella-zoster (VZV) infection and not routinely available for Epstein-Barr virus (EBV). Identification of viral antigens on infected cells with monoclonal antibodies is useful for definitive identification of virus in cell culture and for rapid diagnosis of infection due to HSV, VZV, or CMV. Serologic studies are useful for the diagnosis of EBV infection, because clinical symptoms and an antibody response occur simultaneously, and other diagnostic tests are generally unavailable. Although serologic studies may be used retrospectively to diagnose infections due to HSV, VZV, or CMV, these results are seldom available in time to be useful in managing the acute infection or in guiding antiviral chemotherapy. Newer diagnostic techniques, such as detection of viral nucleic acids using radiolabeled probes, may become useful in the future for the rapid diagnosis of EBV or CMV infection.
疱疹病毒感染的诊断可通过多种实验室技术进行，包括病毒培养、病毒特异性细胞抗原的显示、病毒诱导的血清抗体检测、病毒核酸检测（使用放射性标记探针）或感染组织中组织学变化的可视化。病毒培养是诊断大多数单纯疱疹病毒（HSV）和巨细胞病毒（CMV）感染最敏感的技术，但对水痘带状疱疹病毒（VZV）感染的诊断不敏感，且对爱泼斯坦-巴尔病毒（EBV）通常无法常规开展。用单克隆抗体鉴定感染细胞上的病毒抗原，有助于在细胞培养中明确鉴定病毒，以及快速诊断HSV、VZV或CMV感染。血清学研究对EBV感染的诊断有用，因为临床症状和抗体反应同时出现，且其他诊断测试通常无法开展。虽然血清学研究可用于回顾性诊断HSV、VZV或CMV感染，但这些结果很少能及时获得，对处理急性感染或指导抗病毒化疗没有帮助。更新的诊断技术，如使用放射性标记探针检测病毒核酸，未来可能对EBV或CMV感染的快速诊断有用。
