Q:

Can serology differentiate between herpes simplex viruses (HSV) type 1 and type 2?

A:

Serology is an effective way to diagnose subclinical HSV type 2 infections, but currently most available tests are of limited value because they cannot accurately discriminate between HSV-I1 and HSV-2 antibodies. Because herpes virus types 1 and 2 share many common antigens, there is considerable cross-reactivity among most type 1 and type 2 enzyme immunoassays (EIA) based on whole viral proteins.

Western blot (WB) analysis has the ability to distinguish between types 1 and 2 antibody and is considered the traditional gold standard for differentiating these antibodies. Due to its cumbersome nature, WB is not a practical option for the routine clinical laboratory.

Recently, type-specific purified glycoproteins G (gG1 and gG2) have been used to develop reliable type-specific immunoassays to detect antibodies to herpes simplex. Many EIA tests are based on these purified glycoproteins, and when compared to WB, had a sensitivity of 95 percent and a specificity of 96 percent for HSV-1, and a sensitivity of 98 percent and a specificity of 97 percent for HSV-2.