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Underestimation of HSV-2 seroprevalence in a high-risk population by microneutralization assay
R L Ashley1, J Dalessio, J Dragavon
1Department of Laboratory Medicine, School of Medicine, University of Washington.
Background:
Complement independent neutralizing antibody assays (CINA) have been used in seroepidemiologic studies and in diagnostic laboratories to distinguish between antibodies to herpes simplex virus types 1 (HSV-1) and 2 (HSV-2). The accuracy of CINA has not been rigorously tested against protein-specific typing assays, such as Western blot.
Goal Of This Study:
To determine the ability of CINA to identify HSV-2 antibodies alone or in the presence of HSV-1 antibodies.
Study Design:
Sera from randomly selected women at the Seattle King County Sexually Transmitted Disease Clinic were tested by CINA and Western blot.
Results:
Of 521 women tested, 81% had HSV antibodies by Western blot and 76% had neutralizing antibodies. Of 220 sera with HSV-2 antibodies by Western blot, 106 (48%) were serotyped correctly by CINA. Of the women studied, 140 (27%) had type-indeterminate neutralizing antibodies; 55 of these sera (39%) had antibody only to HSV-1 by Western blot.
Conclusion:
The seroprevalence of HSV-2 in an STD clinic population was seriously underestimated by CINA.