Diagnosis of genital herpes simplex virus infections

Genital herpes simplex virus (HSV) infections have increased markedly in the last ten years. The clinical distinction between HSV and other infectious and noninfectious causes of genital ulcer can be difficult. As such, laboratory confirmation of HSV infection should be used for all women who present with ulcerative or clinically atypical genital lesions. Isolation of the virus in tissue culture remains the gold standard for the laboratory diagnosis of HSV infections. However, many new diagnostic methods of detecting HSV antigens in clinical specimens have been developed. Those procedures appear most useful in specimens taken from genital lesions, and at present they are unproven as reliable methods of obstetric management. Serologic methods can be useful in detecting past HSV infection; however, serodiagnosis is a less sensitive and timely procedure in patients with acute HSV infection.