Slomka M J, Emery L, Munday P E, Moulsdale M, Brown D W
Enteric and Respiratory Virus Laboratory, Central Public Health Laboratory, London, United Kingdom.
J Med Virol. 1998 Jun;55(2):177-83.
Patients attending the genitourinary medicine clinic at Watford General Hospital, UK, were examined for clinical signs of genital herpes infection. Genital swabs were taken from 194 patients (126 female, 68 male) who presented with genital ulceration or symptoms which were suggestive of genital herpes infection. Swabs from these patients were tested by three methods: (i) Detection of herpes simplex virus (HSV) antigen by direct HSV enzyme immunoassay (EIA), (ii) HSV isolation in Vero cell culture and (iii) HSV polymerase chain reaction (PCR). HSV was detected in 76 patients (39%) by EIA, in 93 (48%) by isolation in cell culture, and in 115 (59%) by PCR. Isolation by cell culture has been considered as the "gold standard" for the detection of HSV in genital lesions, but in this study HSV PCR was significantly more sensitive. Comparison of the three methods was as follows: Cell culture vs. PCR: Sensitivity 93/115 (80.9%), Specificity 79/79 (100%). HSV EIA vs. PCR: Sensitivity 75/115 (65.2%), Specificity 78/79 (98.7%). HSV EIA vs. Cell culture: Sensitivity 75/93 (80.7%), Specificity 100/101 (99%). EIA was less effective in detecting HSV among recurrent than among first episode infections, in comparison to culture or HSV PCR. This is the first comparison of HSV PCR with two other routine diagnostic methods for confirming genital herpes infection in a symptomatic population. The infecting HSV type was identified by restriction digestion of 108 HSV amplicons: HSV-1:37/108 (34%), HSV-2:71/108 (66%). In this population HSV-1 causes a significant proportion of genital herpes cases, and HSV-1 genital infection was detected in significantly more first episode infections (40.3%) than among recurrent infections (22.2%).
对英国沃特福德综合医院泌尿生殖医学门诊的患者进行了生殖器疱疹感染临床体征检查。从194例出现生殖器溃疡或有生殖器疱疹感染症状的患者（126例女性，68例男性）中采集了生殖器拭子。这些患者的拭子通过三种方法进行检测：（i）通过直接单纯疱疹病毒酶免疫测定（EIA）检测单纯疱疹病毒（HSV）抗原；（ii）在Vero细胞培养中分离HSV；（iii）HSV聚合酶链反应（PCR）。通过EIA在76例患者（39%）中检测到HSV，通过细胞培养分离在93例（48%）中检测到，通过PCR在115例（59%）中检测到。细胞培养分离一直被视为生殖器病变中检测HSV的“金标准”，但在本研究中HSV PCR的敏感性明显更高。三种方法的比较如下：细胞培养与PCR：敏感性93/115（80.9%），特异性79/79（100%）。HSV EIA与PCR：敏感性75/115（65.2%），特异性78/79（98.7%）。HSV EIA与细胞培养：敏感性75/93（80.7%），特异性100/101（99%）。与培养或HSV PCR相比，EIA在检测复发性感染中的HSV方面不如在初发性感染中有效。这是首次在有症状人群中比较HSV PCR与另外两种用于确诊生殖器疱疹感染的常规诊断方法。通过对108个HSV扩增子进行限制性酶切鉴定感染的HSV类型：HSV-1：37/108（34%），HSV-2：71/108（66%）。在该人群中，HSV-1导致相当比例的生殖器疱疹病例，且在初发性感染中检测到的HSV-1生殖器感染（40.3%）明显多于复发性感染（22.2%）。
