Tests for detecting herpes simplex virus and varicella-zoster virus infections

Several laboratory diagnostic methods are available for the diagnosis, differentiation, and subtyping of HSV and VZV infections. In the office or at the bedside of a hospitalized patient, a positive Tzanck smear preparation is an inexpensive, rapid, and morphologic technique for confirming a suspected diagnosis of a herpesvirus infection. An expedient, slightly more expensive, reliable technique for establishing a HSV infection, yet not able to differentiate the subtype of that infection, is a recently marketed monoclonal antibody-based filtration type enzyme immunoassay (Kodak SureCell Herpes Test Kit). Serologic tests traditionally do not have a major role in the diagnosis of HSV infection; yet, new type-specific methods using Western blot assays may be useful for confirming the presence of unrecognized, subclinical HSV2 infections that are presently being underdiagnosed by current procedures. The gold standard for establishing the diagnosis of HSV infection has been the viral tissue culture. The fluorescent antibody to membrane antigen test and viral tissue culture have been the principal methods for diagnosing VZV infection. Immunomorphologic techniques have been useful adjuvant methods for both the diagnosis and the differentiation of HSV and VZV infections. Molecular virology techniques (particularly those using PCR) are likely to become the diagnostic methods of choice for both HSV infection and VZV infection once these tests become commercially available.