The antibody assays are not intended to replace viral isolation and/or identification and should not be used as the sole basis for diagnosis, nor for diagnosis of primary or re-activated infection Viral isolation in tissue culture or, for severe infections (neonatal herpes, meningitis, encephalitis) PCR for detection of HSV DNA, are the methods of choice.
HSV serotypes demonstrate approximately 50% sequence homology and most of the viral proteins show extensive cross-reactivity. Assays based on whole virus antigens do not discriminate between the serotypes however glycoprotein G based assays are type specific.
HSV infections may present in a variety of ways. The more common include vesicular skin eruptions, genital tract infections, gingivostomatitis (primary infection in children), keratitis, aseptic meningitis, neonatal herpes, disseminated primary infection and encephalitis. As with all herpes viruses, HSV remains in a latent state after primary infection. The host's immune response plays a critical role in the severity of both primary and reactivated HSV infections. Patients most at risk for severe disseminated disease are neonates who contract infection during birth.