Laboratory techniques in the diagnosis of herpes simplex infection.

A. Introduction B. Clinical manifestations of genital herpes 1. Primary genital herpes 2. Non-primary first episodes 3. First episode reactivation 4. Recurrent genital herpes 5. Genital herpes in immunocompromised patients 6. Asymptomatic or unrecognised genital herpes 7. Genital herpes in pregnancy 8. Diagnostic testing of neonates C. Laboratory techniques to detect HSV 1. Viral culture a. Culture confirmation b. HSV typing c. Modified culture techniques 2. HSV direct detection tests a. Cytology b. Electron microscopy c. HSV antigen detection d. HSV DNA detection e. HSVPCR D. Serological techniques to detect HSV antibodies 1. General considerations 2. Functional antibody assays a. Neutralising antibody assays (Nt) b. Complement fixation (CF) c. Antibody dependent cell cytotoxicity (ADCC) 3. Solid phase binding assays a. Reverse passive hemagglutination (RPHA) b Indirect fluorescent antibody assays (IFA) c Enzyme immunoassays (EIA) d Antibody typing by IFA or EIA 4. Type-specific immunoassays a Protein-specific immunoassays b Western blot ("immunoblot") E. Future direction for HSV laboratory diagnosis