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Herpes simplex virus (HSV) causes various clinical syndromes. Anatomic sites infected include skin, lips and oral cavity, eyes, genital tract, and central nervous system.(1) Varicella-zoster virus (VZV) causes both varicella (chickenpox) and herpes zoster (shingles). VZV produces a generalized vesicular rash on the dermis (chickenpox) in normal children, usually before age 10. After primary infection with VZV, the virus persists in latent form and may emerge (usually in adults age 50 and older) clinically to cause a unilateral vesicular eruption, generally in a dermatomal distribution (shingles).(2)
Rapid diagnosis of herpes simplex virus and varicella-zoster virus infections
Herpes Simplex Virus (HSV) PCR:
This is a qualitative assay; results are reported either as negative or positive for HSV type 1 or HSV type 2. In a small number of cases (eg, <1%), HSV is detected but this assay may not be able to provide a definitive subtype (HSV-1 versus HSV-2). This is due to mutations in the region of the HSV genome to which the PCR probes bind. When this result is observed, the report will go out as "Indeterminate", which means that HSV DNA was detected, but the assay was unable to provide a specific subtype.
Detection of HSV DNA in clinical specimens supports the clinical diagnosis of infection due to the virus. HSV DNA is not detected in cerebrospinal fluid from patients without central nervous system disease caused by this virus.
Varicella-Zoster Virus (VZV) PCR:
Detection of VZV DNA in clinical specimens supports the clinical diagnosis of infection due to this virus.
VZV DNA is typically not detected in cerebrospinal fluid from patients without central nervous system disease caused by this virus.
This PCR assay is specific to HSV and VZV, and should not yield positive results if other herpesviruses (ie, cytomegalovirus, Epstein-Barr virus) are present.
A negative result does not eliminate the possibility of herpes simplex virus (HSV) or varicella-zoster virus (VZV) infection. Inhibitors of PCR may be present in some specimens.
The reference range is typically "negative" for this assay. This assay is only to be used for patients with a clinical history and symptoms consistent with VZV or HSV infection, and must be interpreted in the context of the clinical picture. This test is not used to screen asymptomatic patients.
Herpes Simplex Virus PCR
Varicella-Zoster Virus PCR
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