Comparison of viral isolation, direct immunofluorescence, and indirect immunoperoxidase techniques for detection of genital herpes simplex virus infection

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Abstract
Consecutive patients (76) presenting to a genital herpes simplex virus (HSV) clinic were enrolled in a study comparing viral isolation (VI), indirect immunoperoxidase (indirect IP) and direct immunofluorescence (direct FA) techniques for the detection of HSV antigen. Of the 76 patients, 61 (80%) demonstrated HSV by VI, compared with 66% by indirect IP and 55% by direct FA (P < 0.05). Genital lesions from 9 patients demonstrated HSV antigen by direct FA or indirect IP but were VI negative; 8 of 9 patients had subsequent episodes of genital HSV confirmed by VI. During the vesicular-pustular stage of the disease, VI was positive in 90%, indirect IP was postive in 76%, and direct FA was positive in 71% of the lesions; with ulcerative lesions, VI was positive in 72%, indirect IP was positive in 55% and direct FA was positive in 38%. These commercially available rapid viral diagnostic techniques are specific and useful if adequate specimens are obtained from early genital lesions.