Details

Herpes Simplex Virus 1 (IgG) and Herpes Simplex Virus 2 (IgG) Antibodies

HSV 1 (IgG) and HSV 2 (IgG), Herpes Simplex Virus Antibody Panel, HSV Antibody Panel , EPIC: LAB5837, SOFT: HSVGS

Specimen Collection Criteria

Collect (preferred specimen): One Gold-top SST tube. (Minimum Whole Blood: 2.0 mL)
Also acceptable: One plain Red-top tube. (Minimum Whole Blood: 2.0 mL)

Physician Office/Drawsite Specimen Preparation

Let specimen clot 30-60 minutes then immediately centrifuge to separate serum from cells. Refrigerate (2-8°C or 36-46°F) the centrifuged collection tube within eight hours of collection. (Minimum Serum: 0.5 mL)

Preparation for Courier Transport

Transport: Centrifuged collection tube, refrigerated (2-8°C or 36-46°F). (Minimum Serum: 0.5 mL)

Rejection Criteria

  • Plasma specimens. 
  • Severely lipemic, icteric, or grossly hemolyzed specimens. 

Performed

Monday, Wednesday, Friday.
Results available within 2 business days. 

Reference Range

HSV-1 IgG Index Value
Negative: Less than or equal to 0.90
Equivocal: Greater than 0.90 - less than 1.10
Positive: Greater than or equal to 1.10

HSV-2 IgG Index Value
Negative: Less than 0.90
Equivocal: 0.90-1.10
Positive: Greater than 1.10

Test Methodology

Chemiluminescent.

Clinical Utility

The enzyme-linked immunosorbent HSV-1 IgG and HSV-2 IgG assays are used to determine past exposure to HSV-1 and HSV-2, respectively. HSV IgG first appears 7-14 days after infection and antibody levels peak 4-6 weeks thereafter. Antibody levels remain relatively stable over the lifetime of the patient. Demonstration of seroconversion can aid in the diagnosis of a recent infection.

Clinical Disease

Two herpes simplex virus (HSV) serotypes have been identified: HSV-1 and HSV-2.

Primary HSV-1 infections usually occur after contact with infected saliva or a person with oral lesions. Most HSV-1 infections are asymptomatic. Patients with HSV-1 infections can present with gingivostomatitis, conjunctivitis, keratitis, and herpetic whitlow. Gingivostomatitis is common in children under 5 years of age and is characterized by the presence of painful vesicular lesions of the palate, buccal mucosa, pharynx, tongue, and the floor of the mouth. Lesions resolve within 2-3 weeks after primary infection and 4-7 days after recurrent infection. HSV-1 infections are responsible for more than 95% of herpes simplex virus encephalitis cases.

Historically, HSV-1 had been associated with oral infections and HSV-2 had been associated with genital infections. This distinction is no longer true, as 30-50% of genital herpes infections are caused by HSV-1 and 5-20% of oral infections are caused by HSV-2. HSV reactivation depends on the virus type and the anatomic site of infection.

Primary HSV-2 infections typically present as herpes genitalis and are characterized by extensive, bilaterally distributed papules or vesicles that merge to form large pustular or ulcerative lesions. Lesions often crust after 10-15 days and resolve within 2-4 weeks. Patients with primary infections may also present with fever, inguinal lymphadenopathy and dysuria.

Neonates with HSV infections have the highest incidence of visceral and CNS infections of any patient population with more than 70% of untreated cases producing disseminated or CNS infections. The mortality rate for neonatal infections is 65%. Less than 10% of neonates develop normally following HSV infection (1). 

Reference

  1. Wiedbrauk D, Johnston SLG. Manual of Clinical Virology. Raven Press, New York, NY, 1993.

CPT Code

86695, 86696.

Test Codes

EPIC: LAB5837, SOFT: HSVGS

Last Updated

7/11/2019