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- Title
Inability of enzyme immunoassays to discriminate between infections with herpes simplex virus types 1 and 2.
- Authors
Ashley, Rhoda; Cent, Anne; Maggs, Vanna; Nahmias, Andre; Corey, Lawrence; Ashley, R; Cent, A; Maggs, V; Nahmias, A; Corey, L
- Abstract
<bold>Objective: </bold>To determine the accuracy of three commercial enzyme immunoassays in detecting and subtyping antibodies to herpes simplex virus type 1 or 2.<bold>Design: </bold>Cross-sectional.<bold>Setting: </bold>Referral medical center.<bold>Patients: </bold>Ninety patients with culture-positive lesions caused by infection with herpes simplex virus type 1 or 2. The results of Western blot and glycoprotein G immunodot enzyme assays showed that an additional 53 patients had subclinical herpes simplex virus 2 infection, that another 20 patients had subclinical herpes simplex virus type 1 infection, and that 23 patients were seronegative.<bold>Measurements: </bold>Three commercial enzyme immunoassays were used to determine herpes simplex virus antibody subtypes.<bold>Main Results: </bold>All three commercial assays performed poorly in all patient groups (except in patients who were seronegative for herpes simplex virus). Among the 40 patients with a first episode of genital herpes, seroconversion to the appropriate viral type was shown by the three assays in only 33%, 55%, and 75% of cases. Among patients with recurrent genital herpes, the three commercial assays identified more than 90% of patients with only herpes simplex virus type 2 antibodies but failed to identify herpes simplex virus type 2 infections in 58% to 76% of patients with antibodies to both virus subtypes. The three assays correctly identified only 55%, 75%, and 85% of the 53 "silent carriers" of herpes simplex virus type 2. Overall, the three enzyme immunoassays detected herpes simplex virus type 2 antibodies in 60%, 62%, and 93% of patients with subtype 2 infections and falsely detected type 2 antibodies in 8%, 27%, and 49% of patients with type 1 infections.<bold>Conclusion: </bold>Currently licensed enzyme immunoassays give inaccurate or misleading results about the correct herpes simplex virus infecting subtype.
- Subjects
ENZYME-linked immunosorbent assay; HERPES simplex virus; IMMUNOGLOBULINS; COMPARATIVE studies; DIFFERENTIAL diagnosis; HERPES genitalis; HERPES simplex; HERPESVIRUSES; IMMUNITY; IMMUNOBLOTTING; IMMUNOENZYME technique; RESEARCH methodology; MEDICAL cooperation; RESEARCH; VIRAL antibodies; EVALUATION research; PREDICTIVE tests; CROSS-sectional method
- Publication
Annals of Internal Medicine, 1991, Vol 115, Issue 7, p520
- ISSN
0003-4819
- Publication type
journal article
- DOI
10.7326/0003-4819-115-7-520