General Information, Immunochemistry, Microbiology, Molecular Diagnostics, Referral/Sendouts

Herpes Simplex Virus (HSV) IgM Antibody Testing Update

As of November 25th 2019 the following tests for Herpes Simplex Virus (HSV) IgM antibody testing will be obsoleted.

Herpes IgM Antibody Screen – LAB3576

Herpes Simplex Virus (HSV) Antibody Screen, IgM, by EIA, Serum – LAB3578

Herpes Simplex Panel – LAB1230539

HSV IgM has several limitations, including 1) inability to differentiate between HSV-1 and HSV-2, 2) prolonged time (10-21 days) between infection and seroconversion, and 3) prolonged positivity (3-6 months) of anti-HSV IgM antibodies following infection.  Collectively, these characteristics limit the use of anti-HSV IgM as a marker for acute or recent HSV infection.

Additionally, the Centers for Disease Control and Prevention (CDC), the Infectious Diseases Society of American (IDSA), and the American Academy of Pediatrics (AAP) do not recommend anti-HSV IgM testing.

As alternatives to HSV IgM testing, for the diagnosis of acute HSV infection molecular testing is recommended.  Specimen source should guide ordering.  Molecular testing is recommended over viral culture for CSF and swabs of cutaneous and mucocutaneous lesions.  For determination of patient exposure history, HSV IgG testing is recommended.  For summary of available HSV testing see table below.

Questions may be directed to Laboratory Services using the “contact us” link above.

REFERENCES

1. Workowski, KA, et al. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep, 2015. 64(RR-03): p. 1-137.
2. American Academy of Pediatrics. Committee on Infectious Diseases, et al., Red book: 2018-2021 report of the Committee on Infectious Diseases. 31st edition. ed. 1 online resource.
3. Miller, MJ, et al. A Guide to Utilization of the Microbiology Laboratory for Diagnosis of Infectious Diseases: 2018 Updated by the Infectious Diseases Society of America and the American Society for Microbiology. Clin Infect Dis. 2018;67(6):e1-e94

TEST INFORMATION

Herpes Simplex (HSV 1/2), PCR – Epic #LAB9170, Interface #10830, CPT #87529
Herpes Simplex PCR for Lesions – Epic #LAB3549, Interface #55010, CPT #87529
Herpes Simplex Virus Culture – Epic #LAB9460, Interface #50029, CPT #87252, 87254
Herpes Simplex (HSV 1/2) Antibody, IgG – Epic #LAB507, Interface #10792, CPT #86695, 86696

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