Lab Test

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

Test Codes

EPIC: LAB5837, SOFT: HSVGS

Department

Special Chemistry

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/Draw 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. 

In-Lab Processing

Let specimen clot 30-60 minutes then immediately centrifuge to separate serum from cells. Room temperature is acceptable for a maximum of eight hours. (Minimum Serum: 0.5 mL)


Storage

Specimen Stability for Testing:

Centrifuged SST tubes and Microtainers® with Separator Gel
Room Temperature (20-26°C or 68-78.8°F): 8 hours
Refrigerated (2-8°C or 36-46°F): 7 days
Frozen (-20°C/-4°F or below): Unacceptable

Red-top Tubes and Microtainers® without Separator Gel
Room Temperature (20-25°C or 68-77°F): 8 hours
Refrigerated (2-8°C or 36-46°F): 7 days
Frozen (-20°C/-4°F or below): Unacceptable

Serum Specimens (Pour-Overs)
Room Temperature (20-26°C or 68-78.8°F): 8 hours
Refrigerated (2-8°C or 36-46°F): 7 days
Frozen (-20°C/-4°F or below): 2 months

Specimen Storage in Department Prior to Disposal:

Refrigerated (2-8°C or 36-46°F): 7 days

Laboratory

Royal Oak Special Testing Laboratory

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). 

Epidemiology

HSV-1 infections are generally acquired during childhood. By age 60, up to 90% of the population has antibodies to HSV-1. HSV-2 infections are usually acquired after puberty and antibody prevalence rates seem to correlate with past sexual activity. Over the past ten years, HSV-1 prevalence rates have steadily declined while the prevalence rates for HSV-2 appear to be rising (1).

Incubation Period

The incubation period ranges from 1-26 days and with a mean of 6-8 days (1).

Transmission

Transmission of HSV typically occurs through close personal contact (kissing, sharing eating utensils, etc.) or through some form of sexual contact. Virus is shed during primary infection, during episodes of recurrent herpes, and periodically in the absence of any clinically apparent disease. Asymptomatic shedding is a significant source of virus transmitted to susceptible hosts (1).

Reference

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

CPT Codes

86695, 86696.
LOINC:  51916-5, 43180-9, HSV1 51916-5, 16952-4, HSV2 43180-9, 16960-7

Contacts

Last Updated

1/11/2023

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