Detection of cutaneous herpes simplex virus infections by immunofluorescence vs. PCR.

Journal of the European Academy of Dermatology and Venereology : JEADV

PubMedID: 12834453

Bezold G, Lange M, Gethöffer K, Gall H, Peter RU. Detection of cutaneous herpes simplex virus infections by immunofluorescence vs. PCR. J Eur Acad Dermatol Venereol. 2003;17(4):430-3.
BACKGROUND
Detection of cutaneous infections with herpes simplex virus (HSV) has proven difficult, as serum antibody tests sometimes are not sensitive and specific enough for that purpose.

OBJECTIVE
This study was conducted to compare the sensitivity for detection of HSV of an immunofluorescence method (Syva Microtrak) and an internally controlled PCR.

METHODS
Cutaneous swabs from skin lesions were analysed by immunofluorescence separately for HSV types 1 and 2 and by competitive PCR. Detection of PCR products was done by ELISA, if positive additionally by agarose gel electrophoresis.

RESULTS
Of 79 samples 34 were PCR-positive by ELISA (34 = 100%), of which 23 (68%) were also positive on the agarose gel. Eleven samples (32%) were positive by immunofluorescence. No sample was positive by immunofluorescence and negative by PCR.

CONCLUSIONS
These results demonstrate that immunofluorescence using Syva Microtrak is not suitable for exclusion of herpes simplex virus infection as sensitivity was only 32%. However, as immunofluorescence is cheaper and faster than PCR, first screening can be done with immunofluorescence, and negative samples can be investigated by PCR to finally prove or exclude the presence of HSV DNA.