Herpes Simplex Virus (HSV) and Varicella-Zoster Virus (VZV), Molecular Detection, PCR, Dermal
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
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 10 years of age. After primary infection with VZV, the virus persists in latent form and may emerge (usually in adults 50 years of age and older) clinically to cause a unilateral vesicular eruption, generally in a dermatomal distribution (shingles).(2)
An automated PCR instrument (LightCycler) is used for nucleic acid amplification in our laboratory. The method has been shown to be more sensitive and rapid than the shell vial assay for the detection of HSV and VZV DNA.
Rapid diagnosis of herpes simplex virus and varicella-zoster virus infections
Detection of herpes herpes simplex virus (HSV) or varicella-zoster virus (VZV) DNA indicates the presence of HSV or VZV in the specimen.
This test, which detects HSV and VZV DNA using an automated PCR instrument (LightCycler) for nucleic acid amplification, is more sensitive and faster than shell vial cell culture.
This LightCycler PCR assay does not yield positive results with other herpesvirus gene targets (HSV, cytomegalovirus, Epstein-Barr virus).
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
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 and HSV infection, and must be interpreted in the context of the clinical picture. This test is not used to screen asymptomatic patients.
Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
Clinical References Provides recommendations for further in-depth reading of a clinical nature
1. Schiffer JT, Corye L: New concepts in understanding genital herpes. Curr Infect Dis Rep Nov 2009;11(6):457-464
2. Espy MJ, Uhl JR, Svien KA: Laboratory diagnosis of herpes simplex virus infections in the clinical laboratory by LightCycler PCR. J Clin Microbiol 2000;38(2):795-799
3. Espy MJ, Ross TK, Teo R: Evaluation of LightCycler PCR for implementation of laboratory diagnosis of herpes simplex virus infections. J Clin Microbiol 2000;38(8):3116-3118
4. Sauerbrei A, Eichhorn U, Hottenrott G, Wutzler P: Virological diagnosis of herpes simplex encephalitis. J Clin Virol 2000;17(1):31-36
5. Mitchell PS, Espy MJ, Smith TF, et al: Laboratory diagnosis of central nervous system infections with herpes simplex virus by PCR performed with cerebrospinal fluid specimens. J Clin Microbiol 1997;35(11):2873-2877
6. Yi-Wei T, Mitchell PS, Espy MJ, et al: Molecular diagnosis of herpes simplex virus infections in the central nervous system. J Clin Microbiol 1999;37(7):2127-2136
7. Cinque P, Bossolasco S, Vago L, et al: Varicella-zoster virus (VZV) DNA in cerebrospinal fluid of patients infected with human immunodeficiency virus: VZV disease of the central nervous system or subclinical reactivation of VZV infection? Clin Infect Di1997;25(3):634-639
8. Brown M, Scarborough M, Brink N, et al: Varicella zoster virus-associated neurological disease in HIV-infected patients. Int J STD AIDS 2001;12(2):79-83
9. Studahl M, Hagberg L, Rekabdar E, Bergstrom T: Herpesvirus DNA detection in cerebrospinal fluid: differences in clinical presentation between alpha-, beta-, and gamma-herpesviruses. Scand J Infect Dis 2000;32(3):237-248
10. Iten A, Chatelard P, Vuadens P, et al: Impact of cerebrospinal fluid PCR on the management of HIV-infected patients with varicella-zoster virus infection of the central nervous system. J Neurovirol 1999;5(2):172-180