Herpes Simplex Virus Detection by ELISA: Effect of Enzyme Amplification, Nature of Lesion Sampled and Specimen Treatment

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Abstract
The relative sensitivity of two enzyme detection procedures was investigated in a simultaneous “monoclonal” ELISA for herpes simplex virus (HSV). A cyclical enzyme amplified detection system with alkaline phosphatase. rather than horseradish peroxidase and a conventional chromogenic substrate, gave an increase in absolute sensitivity and a 20 to 30% increase in the detection of HSV in routine isolation‐positive genital specimens collected in transport medium. The HSV detection rate, with both procedures, was shown to vary with the site and clinical stage of lesion sampled; it was highest with penile vesicular lesions. Direct extraction of the swab specimen in a small volume of diluent further increased the sensitivity of antigen detection giving positive and negative predictive values of 100 and 96% respectively. The overall sensitivity of HSV detection was equivalent to that obtained by isolation in cell culture. The amplified ELISA offers an alternative, rapid, simple, non‐culture technique for routine HSV diagnosis that does not rely upon retention of virus viability.