Recommended procedures for the diagnosis of persistent active herpesvirus infections

While reliable tests are available to diagnose acute herpesvirus infections, this does not apply equally well to the identification of chronic active or recurrent infections. Common serology in most cases is not very reliable, unless the antibody response is carefully dissected to determine the response to some early antigens related to viral replication, such as against EA complex in Epstein-Barr virus infections. There are a number of techniques that hold some promise for the future: antigen demonstration by monoclonal antibodies such as in the shell vial assay or in tissue culture cells exposed to body fluids; in situ hybridization for viral DNA and polymerase chain reaction; and antigen assays by combined blotting/monoclonal antibody techniques. In developing meaningful parameters for defining persistent active or reactivated herpesvirus infections, techniques for quantitating virus and/or antigen should be helpful.