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Test Code INPT389 Herpes Simplex Virus (HSV), Molecular Detection, PCR, Varies

Additional Codes

YLHSV


Ordering Guidance


If herpes simplex virus (HSV) is suspected in blood, order HSVPB / Herpes Simplex Virus (HSV), Molecular Detection, PCR, Blood.

 

If HSV is suspected in cerebrospinal fluid, order HSVC / Herpes Simplex Virus (HSV), Molecular Detection, PCR, Spinal Fluid.

 

If varicella-zoster virus is suspected, order VZVPV / Varicella-Zoster Virus, Molecular Detection, PCR, Varies.



Necessary Information


Specimen source is required.



Specimen Required


Submit only 1 of the following specimens:

 

Specimen Type: Body fluid

Sources: Pleural, peritoneal, ascites, pericardial, amniotic, or ocular

Container/Tube: Sterile container

Specimen Volume: 0.5 mL

Collection Instructions: Do not centrifuge.

 

Specimen Type: Swab

Sources: Genital, dermal, ocular, nasal, throat, or oral

Supplies: M4-RT (T605)

Container/Tube: Multimicrobe media (M4-RT)

Specimen Volume: Entire collection

Collection Instructions: Place swab back into multimicrobe media (M4-RT)

Additional Information: Source information must include main anatomical site of collection.

 

Specimen Type:Respiratory

Sources: Bronchial washing, bronchoalveolar lavage, nasopharyngeal aspirate or washing, sputum, or tracheal aspirate

Container/Tube: Sterile container

Specimen Volume: 1.5 mL

 

Specimen Type: Tissue

Sources: Brain, colon, kidney, liver, lung, etc

Supplies: M4-RT (T605)

Container/Tube: Sterile container containing 1 mL to 2 mL of sterile saline or multimicrobe medium (M4-RT)

Specimen Volume: Entire collection

Collection Instructions: Submit only fresh tissue.

Additional Information: Source information should include main anatomical site of collection.

 

Specimen Type: Urine (<1-month old infant)

Container/Tube: Sterile container

Specimen Volume: 0.5 mL


Useful For

Aiding in the rapid diagnosis of herpes simplex virus (HSV) infections, including qualitative detection of HSV DNA in nonblood clinical specimens

 

This test should not be used to screen asymptomatic patients.

Method Name

Real-Time Polymerase Chain Reaction (PCR)/DNA Probe Hybridization

Reporting Name

Herpes Simplex Virus, PCR, Varies

Specimen Type

Varies

Specimen Minimum Volume

Amniotic or ocular fluid: 0.4 mL; Sterile body fluid (Pleural, peritoneal, ascites, pericardial): 0.5 mL; Respiratory Specimen: 1 mL; Swab, tissue, or urine: See Specimen Required

Specimen Stability Information

Specimen Type Temperature Time Special Container
Varies Refrigerated (preferred) 7 days
  Frozen  7 days

Reject Due To

Calcium alginate-tipped swab
Wood swab
Transport swab containing gel
Formalin-fixed and/or paraffin-embedded tissues
Heat-inactivated specimens		 Reject

Clinical Information

Herpes simplex virus (HSV) types 1 and 2 are members of the Herpesviridae family and produce infections that may range from mild stomatitis to disseminated and fatal disease. Clinical conditions associated with HSV infection include gingivostomatitis, keratitis, encephalitis, vesicular skin eruptions, aseptic meningitis, neonatal herpes, genital tract infections, and disseminated primary infection.

 

Infections with HSV types 1 and 2 can differ significantly in their clinical manifestations and severity. HSV type 2 primarily causes urogenital infections and is found almost exclusively in adults. HSV type 1 is closely associated with orolabial infection, although genital infection with this virus can be common in certain populations.

 

The diagnosis of HSV infections is routinely made based on clinical findings and supported by laboratory testing using polymerase chain reaction or viral culture.

Reference Values

HERPES SIMPLEX VIRUS (HSV)-1

Negative

 

HERPES SIMPLEX VIRUS (HSV)-2

Negative

Interpretation

This is a qualitative assay; results are reported either as negative or positive for herpes simplex virus (HSV) type 1, HSV type 2, or HSV type indeterminate. Results can also be reported as invalid.

An indeterminate result indicates that HSV DNA was detected but the assay is unable to differentiate between HSV-1 and HSV-2. If typing is required, it is suggested that a new specimen be collected for testing by an alternate method.

 

An invalid result points to the inability to determine presence or absence of HSV-1 or HSV-2 DNA in the sample.

 

Detection of HSV DNA in clinical specimens supports the clinical diagnosis of infection due to the virus.

Cautions

A negative result does not eliminate the possibility of herpes simplex virus (HSV) infection.

 

Although the reference range is typically "negative" for this assay, this assay may detect viral nucleic acid shedding in asymptomatic individuals. This may be especially relevant when dermal or genital sites are tested since intermittent shedding without noticeable lesions has been described.(1)

 

This assay is only to be used for patients with a clinical history and symptoms consistent with HSV infection and must be interpreted in the context of the clinical picture.

Method Description

Viral nucleic acid is extracted by the MagNA Pure 96 automated instrument (Roche Applied Science) from genital, dermal, or tissue specimens. Primers directed to the DNA polymerase of herpes simplex virus (HSV) produce a 215-base pair amplicon. The LightCycler or LightCycler 480 instrument (Roche Applied Science), amplifies and monitors by fluorescence the development of target nucleic acid sequences after the annealing step during polymerase chain reaction (PCR) cycling. This is an automated PCR system that can rapidly detect (30-40 minutes) amplicon development through stringent air-controlled temperature cycling and capillary cuvettes or 96 well plate. The detection of amplified products is based on the fluorescence resonance energy transfer (FRET) principle. For FRET product detection, a hybridization probe with a donor fluorophore, fluorescein, on the 3'-end is excited by an external light source and emits light that is absorbed by a second hybridization probe with an acceptor fluorophore at the 5'-end. The acceptor fluorophore then emits a light of a different wavelength that can be measured with a signal that is proportional to the amount of specific PCR product. LightCycler hybridization probes are designed for HSV-type 2 and sequence differences between HSV-type 2- and HSV-type 1 are detected by melting curve analysis. Melting curve analysis is performed following PCR amplification. Sequence differences between the PCR amplification and probe melting curves are accomplished through the use of LightCycler software.(Binnicker MJ, Espy MJ, Duresko B, Irish C, Mandrekar J. Automated processing, extraction and detection of herpes simplex virus types 1 and 2: A comparative evaluation of three commercial platforms using clinical specimens. J Clin Virol. 2017;89:30-33)

Day(s) Performed

Monday through Sunday

Report Available

Same day/1 to 4 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

87529 x 2

87529 (if appropriate for government payers)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
HSVPV Herpes Simplex Virus, PCR, Varies 94580-8

 

Result ID Test Result Name Result LOINC Value
HSVS Specimen Source 31208-2
618328 HSV 1, PCR 94581-6
618329 HSV 2, PCR 94582-4

Forms

If not ordering electronically, complete, print, and send 1 of the following:

-Microbiology Test Request (T244)

-General Request (T239)