Herpes Simplex Test

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Test for Herpes Simplex Virus (HSV) infection can be performed virology and serology, each instance of the investigation are as follows: 
Virology
  1. Light microscope. Samples derived from cells at the base of the lesion, smears on the mucosal surface, or from a biopsy, may be found in internuclear inclusions (Lipschutz inclusion bodies). Infected cells may show an enlarged cells resembling balloons (ballooning) and found fusion. In the experiment Tzanck with Giemsa or Wright staining, can be found in many core datia cells and inclusion bodies intra nuclear.
  2. Examination direct antigen (immunofluorescence). Cells of the specimens included in the frozen acetone. Then the examination is done by using light electrons (90% sensitivity, 90% specific) but, this examination can not be matched with viral culture.
  3. PCR, polymer chain reaction test for HSV DNA is more sensitive than traditional viral culture (sensitivity> 95%, compared with a culture that only 75%). But its use in the diagnosis of HSV infection has not been conducted on a regular basis, most likely because the cost is expensive. This test is commonly used to diagnose HSV encephalitis because the results are faster than culture virus.6
  4. The virus culture, viral culture of vesicle fluid in the lesion (+) for HSV is the best way because the most sensitive and specific than other methods. HSV can develop within 2 to 3 days. If the test is (+), almost 100% accurate, especially if the fluid comes from the primary vesicles rather than vesicles recurrence. Growth of virus in the cell indicated by the occurrence of cytoplasmic granulation, balloon degeneration and giant cell core a lot. Since the virus is difficult to develop, test results often (-). However, this method has the disadvantage due to a long examination time and expensive.
Serology
Serological examination is recommended to people who have symptoms of genital herpes recurrences, but from the negative viral culture results, as confirmed in people infected with genital herpes symptoms, to determine whether the sexual partners of people diagnosed with genital herpes is also infected and those who have many sex partners and to distinguish the types of other sexual transmitted infections. Sample on serological examination was taken from the blood or serum. Examination may include:
ELISA.
The basis of the ELISA is the bond between antigens and antibodies, where antigen derived from a conjugate of Ig G and antibodies derived from serum specimens. After the specimens are washed to clean the sample of material (HRP) and then labeled IgG antibody conjugate. This conjugate can bind to specific HSV-II antibodies. immune complex is formed by bonding a plus conjugate Tetramethylbenzidine (TMB), which will give a blue reaction. Sulfuric acid added to stop the reaction that would give a yellow reaction. Reading of reactions carried out with mikrowell ELISA plate reader with a wavelength of 450 nm.
Interpretation of results:

  • If there are antibodies to HSV-II means that once infected with HSV-II, the virus dormant in the sacral nerve and the patient was suffering from genital herpes.
  • If antibodies to HSV-II, no mean 95-98% you do not suffer from genital herpes unless you've just infected with HSV-II because of new antibodies will be formed 6 weeks later, even some individuals (1 out of 5) only able to form antibodies after 6 months, therefore it is better to repeat examination 6-8 weeks later.
  • If there are antibodies to HSV-I mean you have an infection of HSV-I. These antibodies could not detect the virus dormant. In most people (> 90%) virus is present in the mouth and eye nerves. Some people who have the infection on genital HSV-I may have antibodies from HSV-I infection on the genital area.
  • If there are no antibodies to HSV-I and HSV-II, you are not infected with HSV-I and HSV-II, but one day you may be infected. But it is possible that you've just infected but not yet formed antibodies.
  • In primary infection, antibodies to HSV-I and II can be detected in the early days after the onset of the disease. Seroconversion to the content of Ig M and IgG antibodies required as detection of primary infection, in addition to specific IgA antibodies can also be detected following the formation of IgM and IgG antibodies. When the infection runs, IgM and IgA antibodies have not detected a few weeks and months when the individual has had IgG antibodies that persist in the body for a lifetime and in high titer. Another serological patterns prove the content of IgG, IgM and IgA in cases of reactivation of latent infection or reinfection period. Most of the serum samples taken within 7-10 days after infection showed a significant increase in IgG antibodies. Increased levels of IgA antibodies are also frequently encountered, the increase in IgA seroconversion also occurred in cases where elevated levels of IgG showed that the serum samples infected with HSV serologic.
Western Blot Test
Western Blot test is very accurate test to detect HSV, but more expensive than other tests and takes longer to Interpretation. This test is the gold standard method in the examination of antibodies. This test is only used as a reference and confirm if the tests by ELISA showed dubious results. This test has the accuracy to specifically conclude that the sample truly contains antibodies against specific proteins of the virus.

Biokit HSV-II
Biokit test is a test to detect antibodies to HSV type II. This test is a rapid test, only approximately takes 10 minutes and the results are also quickly shown. Positive results are indicated by two red colors that are thinner when compared with controls. If antibodies to HSV-II does not exist, then only one color appears red. If only contain antibodies to HSV-I, then there would be only one red mark. If there is no red mark then the test is invalid and must be repeated.