![]() Mortality rates in untreated infants who develop disseminated infections can exceed 80% ( 7), with at least half of those who do survive developing permanent neurological impairment. Type-specific assays can also aid in diagnosis and, hence, prevention of maternal transfer of HSV to the neonate. These type-specific assays allow accurate identification of asymptomatic HSV-2 infection in patients who pose a risk of transmission to their sexual partners, as many individuals are unaware that they are infected or do not recognize subtle or atypical symptoms. Immunoassays based on these purified glycoproteins have been available for over 10 years and have now become the standard of use for HSV type-specific serology ( 3, 10, 12, 13, 15, 16). Type-specific glycoproteins (gG-1 and gG-2) have been identified which allow for the discrimination of immunoglobulin G (IgG) antibodies to either HSV-1 or -2. Many of these antigens share common epitopes resulting in high cross-reactivity between HSV-1 and -2. Following primary infection, the virus colonizes the sensory neurons, where it remains latent and may reactivate at a later time ( 6).Īntibodies are produced against structural components of the virus, as well as the viral envelope, capsid, and internal proteins. The immune response, however, cannot completely eliminate the virus, allowing recurrent outbreaks or persistent disease. Primary infections with either type of HSV give rise to both cell-mediated and humoral immune responses capable of neutralizing the virus and killing virus-infected cells. Seropositivity for HSV-2 has been reported in 10 to 40% of U.S. Genital infections with HSV-1, however, are increasing and now exceed 50% in certain populations ( 4, 8, 11, 14). HSV-2 has classically been associated with neonatal infections and genital herpes. HSV-1 is most often associated with orofacial (mouth, lips, tongue, pharynx, and eyes) transmission and infection, with 70 to 80% seropositivity in U.S. There are two well-recognized species of HSV classified as HSV type 1 (HSV-1) and HSV type 2 (HSV-2). ![]() Infection with HSV produces a variety of clinical manifestations, ranging from mild stomatitis to potentially fatal viral encephalitis. Herpes simplex virus (HSV) occurs worldwide and is one of the most common human pathogens. Advantages of the multiplex assay include multiple results per assay, the inclusion of internal controls for each specimen, and higher throughput of results. Our studies show that the multiplexed microsphere-based assay offers a sensitive and specific alternative method for the detection HSV-1 and -2 type-specific antibodies. For HSV-2, the sensitivity and specificity ranges were 92.6 to 98.9% and 98.3 to 98.7%, respectively. Sensitivities for HSV-1 ranged from 94.9 to 97.9%, with specificities of 93 to 97%. Agreement of the multiplex assay was 95% or greater ( n = 332) for both HSV-1 and -2 compared to the three assays. In this study, a multiplex assay capable of concurrent detection of HSV-1 and -2 immunoglobulin G (IgG) antibodies was compared to immunoblot, Western blot, and enzyme-linked immunosorbent assays. Differentiation of antibodies to these specific antigens can provide useful information for the diagnosis of subclinical or undiagnosed HSV-2 infections, as well as for reducing the risk of maternal transfer of HSV to the neonate. The human herpes simplex virus (HSV) is highly pathogenic, with infections caused by two distinct antigenic types, HSV-1 and HSV-2.
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