Evaluation of immunologic tests for the detection of ocular herpes simplex virus

Four immunologic tests, Herpchek (HC), latex agglutination (AGG), enzyme immunofiltration (IF), and 1 hour enzyme-linked immunoassay (1EIA), were evaluated for detecting herpes simplex virus (HSV) from ocular specimens. Compared with the standard of HSV-positive cell cultures, 24 (65%) of 37 positive HC tests and 22 (59%) of 37 positive IF tests were significantly more sensitive (P less than 0.0005) than the AGG (3%, 1/37) and 1EIA (26%, 1/34) tests. The HC and IF tests were 100% specific, and easy to interpret. In addition, the clinical diagnosis of HSV infection after a thorough ophthalmologic examination was as sensitive (59%, 22/37) (P = 0.4) as any of the immunologic tests. In conclusion, for definitive diagnosis of HSV, the HC test seems more suitable for a central laboratory that handles a large number of viral specimens, and processes HC-negative tests with follow-up cell culture isolation. The enzyme immunofiltration test seems more suitable for a low-volume viral laboratory which confirms all IF test samples with follow-up cell culture isolation.