Field P R, Ho D W, Irving W L, Isaacs D, Cunningham A L
Virology Department, Westmead Hospital, Sydney, NSW.
Pathology. 1993 Apr;25(2):175-9. doi: 10.3109/00313029309084794.
The reliability and limitations of the currently used routine tests for herpes simplex virus type 2 (HSV-2) antibody in Australia are reviewed. Six case reports illustrate the clinical dangers of overinterpretation of the currently available kits and the need for a readily available specific HSV-2 antibody test. In Sydney, HSV-2 causes approximately 85% of primary genital herpes and > 95% of recurrent genital herpes. Due to the extensive serological cross-reactivity between HSV-1 and HSV-2, currently available "type specific" commercial assays cannot reliably distinguish between the 2. Isolation of herpes simplex virus (HSV) or detection of HSV antigen in vesicle fluid is the preferred diagnostic test but may be overlooked or patients may have no visible lesions. The only accurate techniques for detecting HSV-2 specific antibody are the Western blot assay and an enzymatic immunoassay using glycoprotein G (gG-2), a component of the HSV-2 envelope. These tests, which still are restricted to research laboratories can be used to accurately identify people with previous exposure to HSV-2 (IgG) or to diagnose primary infection where virus isolation has not been performed or is impossible. Current commercially available antibody tests may have extensive cross-reactivity.
本文回顾了澳大利亚目前用于检测2型单纯疱疹病毒（HSV-2）抗体的常规检测方法的可靠性及局限性。六项病例报告说明了过度解读现有试剂盒的临床风险，以及开展便捷的特异性HSV-2抗体检测的必要性。在悉尼，HSV-2导致约85%的原发性生殖器疱疹和超过95%的复发性生殖器疱疹。由于HSV-1与HSV-2之间存在广泛的血清学交叉反应，目前市售的“型特异性”检测方法无法可靠地区分这两种病毒。单纯疱疹病毒（HSV）的分离或水疱液中HSV抗原的检测是首选的诊断方法，但可能会被忽视，或者患者可能没有明显的皮损。检测HSV-2特异性抗体的唯一准确技术是蛋白质印迹法和使用HSV-2包膜成分糖蛋白G（gG-2）的酶免疫测定法。这些检测方法目前仍仅限于研究实验室使用，可用于准确识别既往接触过HSV-2的人群（IgG），或诊断未进行病毒分离或无法进行病毒分离的原发性感染。目前市售的抗体检测可能存在广泛的交叉反应。
